Everyday Skills

Question 1

NPA
Indications

Answer 1

To maintain an airway with a basic adjunct when an OPA cannot be used.

Question 2

NPA
Contraindications

Answer 2

• Significant nasal or mid-facial trauma.
• Epistaxis

Question 3

NPA
Precautions

Answer 3

• 3rd trimester pregnancy.
• Patients prone to epistaxis.
• Never force an NPA if resistance is felt.
• Use with caution in suspected skeletal fractures, e.g. base of skull fractures.
• Insertion may cause mild bleeding.

Question 4

OPA
Indications

Answer 4

To rapidly assist in maintaining the airway patency of an unconscious patient.

Question 5

OPA
Precautions

Answer 5

• The placement of an OPA MUST NOT interrupt effective compressions in Cardiac Arrest.
• If the patient gags during the insertion of the oropharyngeal airway, remove immediately and be prepared to suction.
• Paediatrics <6 years: insertion should be performed without twisting and should follow the natural curvature of the airway to prevent damage to the oropharynx.
• Suspicion of traumatic injury: ensure spinal alignment and immobilisation of head and neck (jaw thrust method)

Question 6

Modified Valsalva Manoevure
Indications

Answer 6

To terminate SVT/narrow complex tachycardia by increasing intrathoracic pressure to stimulate vagal nerve response.

Question 7

Modified Valsalva Manoevure
Contraindications

Answer 7

• Recent or current acute myocardial infarction
• Severe coronary artery disease
• Haemodynamic instability (i.e. systolic BP below 90mmHg)
• Known glaucoma or retinal myopathy

Question 8

Modified Valsalva Manoevure
Precautions

Answer 8

• The following side effects might be experienced by the patient when performing the Valsalva Manoeuvre:
• Dizziness, Hypotension, Syncope, Tinnitus, Headache
• If patient is on the stretcher, procedure is only to be performed while stretcher is locked into ambulance or lowered to ground height.

Question 9

Spinal immobilsation
Indication

Answer 9

Immobilisation of patients with suspected spinal injury.

Question 10

Spinal immobilisation
Precautions

Answer 10

• Do not readjust the torso straps after the head has been secured. This causes movement of the immobilisation device in relation to the torso.
• Do not secure the arms inside the spider straps. This causes the straps to be too tight or loose. If the arms need to be secured an additional strap or bandage should be used.
• Do not secure the base plate of the head blocks or the towel rolls to the Ferno 50/E stretcher. The head and chin straps should be used to keep the blocks in place.
• Prolonged immobilisation on the extrication board can increase the risk of pressure ulcers. Bony prominences should be sufficiently padded.
• Should additional padding be required to support the head, this should be placed underneath the head block base plate.
• In the restless/claustrophobic patient, continuous inline immobilisation might be needed instead of a C-Spine collar and/or head blocks.
• Ensure adequate assistance is utilised when lifting patient.
• Note:
• Safe work load of the extraction board: 220kg
• Safe work load of the scoop stretcher: 159kg

Question 11

Pelvic splints
Indications

Answer 11

Haemodynamically compromised trauma patients meeting the pelvic binder decision tool criteria

Should be considered an immediate and urgent intervention in symptomatic cases

Question 12

Pelvic splints
Contraindications

Answer 12

• Patients under 23kg
• Isolated hip fractures
• Fall from standing

Question 13

Pelvic splints
Precautions

Answer 13

• Elevate male genitalia out of the groin area to prevent compression injury.
• For use on adults and children >23kg (7-8 years of age).
• Pregnant patients; be vigilant to ensure correct placement (i.e. not inadvertently placed too high)
• Not for use on any other fractures.
• Approximately 40% of all pelvic binders are misplaced, often too high
  *