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Year 3/4 H&S > Acute CARE > Flashcards

Acute CARE Flashcards

1
Q

What are the most common signs of domestic violence?

A

Contusions, lacerations, fractures, abrasions - multiple locations

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2
Q

What are 5 key fractures seen in domestic abuse

A

Metaphysical fracture
sternal fracture
Rib fracture
Outer third clavicle fracture
Scapula fracture

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3
Q

What locations are likely domestic abuse locations

A

Face neck extremities and back usually

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4
Q

What are the steps of rehab process

A

Specialist consultant in charge and MDT team coordinate patient analysis/assessment, immediate treatment and management plan

Referred immediately to physiotehrpasit for assessment and movement

OT. For home changes, social worker for support and geriatricians for elderley likely to be invovled in care

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5
Q

5 impacts trauma can have on a patietn

A
  1. Depending on the trauma could be life limiting/changing
  2. Sick role adopted
  3. Off work - loss of independence
  4. Lean on close family and friends for support (character role swap)
  5. Stress andd concern about long term impacts
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6
Q

What are signs of non-accidental injuries

A
  1. Delayed presentation to the doctor
  2. A non-care/family member has brought them
  3. History doesnt match clinical findings
  4. Failure to have a complete and compatible history
  5. Associated injuries of perceived domestic abuse
  6. Other injuries that could indicate forcefulness or abuse
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7
Q

6 ways to health promote about burns and scalds

A

Fire alarm tests
PAT tests
Close doors when sleeping
Fire safety drills and regulations
Fire safety training
Charity

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8
Q

When are burns looking like a non-accident

A

No splashmarks are visible
Usually reinforcinng behaviour is clear on clinical findings
Lack of parental care
Signs of sparing of flexion creases (being in foetal position)

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9
Q

Who are at most risk of burns

A
  1. Under 5 year olds (50% happen in kitchen 45% of burns are children
  2. Diabetic neuropathy patients
  3. > 75s
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10
Q

Who are risk of suicide?

A
  1. Males
  2. Elderley
  3. Immigrant and refugees
  4. Prisoners
  5. Students
  6. Low socioeconomic class
  7. Low education
  8. Doctors
  9. Lack of social support
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11
Q

What are clinical causes of suicide?

A
  1. Previous mental health
  2. Specific illness with high rates of suicide or terminal illness
  3. Recent post-discharge
  4. Previous suicide
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12
Q

What are risk factors of a suicide attempt

A
  1. Severity of suicide attempt
  2. Plans to do it again
  3. No remorse/ regrets
  4. Done it before
  5. Want to do it again/intention
  6. Waiting to be alone
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13
Q

Protective factors against suicide

A
  1. Family and friends - children
  2. Cultural or religious beliefs
  3. Coping and problem solving skills
  4. Interacting with mental health services
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14
Q

What professionals are involved in mental health sectioning.

A

Section 12 doctor
AMHP (approved mental health professional)
Doctor known by patietn

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15
Q

Section 2?

A

Allows for compulsory admission to hospitals for assessment, diagnosis and treatment for 28 days.
- GP/known doctor, section 12 doctor needs to approve
- family relative or AMHP needs to make application for section 2

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16
Q

Section 4?

A

Emergency section, doctor to detain patient for 72 hours to assess/diagnose but not treat no application needed
signed by a doctor and either a AMHP/relative

17
Q

Section 5(2)

A

Doctor can detain patient whilst waiting on someone to assess diagnose for 72 hours

18
Q

Section 5(4)?

A

Nurse holding powers, nurse can detain for 6 hours waiting for approved psychiatrist

19
Q

Who is an AMHP?

A

Social worker, nurses, OTs and psychologists

20
Q

What 2 types of clinical reasoning are there

A

Type 1 type 2

21
Q

what is type 2 clinical reasoning?

A

hypothetical-deductive reasoning. Make logical diagnoses but use follow up tests and scans to rule out other potential disease that could be more life threatening or severe

22
Q

What is type 1 clinical reasoning/

A

Quick more fast process reasoning. Uses knowledge, experience and pattern recognition to assume a diagnosis and treat for it accordingly

23
Q

what are some draw backs of type 1 clinical reasoning

A
  • overconfidence may mean other serious diseases are overlooked
  • not reliable source of reasoning due to no evidence
  • flawed judgement can lead to omissions
  • faults can be made more likely
24
Q

what are some draw backs of type 2 reasoning?

A
  • longer route, patient neeeds to be capable of waiting (not an emergency)
  • patient needs to understand the different diseases and purposes of going to the scans and checks
  • doctor needs to be willing to put time and effort in
  • more robust as based off evidence
25
Q

What are other names for type 1 and type 2 clinical reasoning?

A

Type 1 - intuitive
Type 2 - rational

26
Q

What are the levels of care in hospital?

A

4 - 1:1 nursing care, 2 or more organ systems failing, almost always on ventilators
3 - 2:1 nursing care, HDU picture, just off ventilators, invasive monitoring still happening
2 - 4:1 nursing care, AMU picture, potential risk of condition decline, less invasive monitoring
1 - 8:1 nursing care, ward picture, routine bloods and treatment being given (IV, NG Feed etc.)

27
Q

What is ceilings of care?

A

The maximum level of treatment method deemed appropriate for the patient, may not be given but set out in a plan for steps to be put into place based on shared decision making and family/friends of patient

28
Q

How is ceilings of care assisted?

A

RESPECT form

29
Q

What factors contribute towards ceilings of care?

A
  1. Patient requests
  2. Family requests
  3. Patients condition
  4. Anticipated outcome for the patient
  5. Acceptance and environmental factors (can they go to HDU?)
30
Q

What is DNACPR

A

Do not attempt CPR
- used when CPR is not beneficial to the patient found on RESPECT form

31
Q

When is DNACPR used?

A
  1. Patient too elderly risks of CPR worse than benefits
  2. Outcome of good CPR is low, let patietn die a dignified none ruthless death
  3. Patient refusal prior
32
Q

What is a respect form?

A

Recommended summary of treatment plan for patietn if they may potentially lose capacity or at risk of rapid decline in health. Contains DNACPR and advanced wishes etc.

33
Q

what are 2 types of risk assessment tools ?

A
  1. Risk scores (ASA, higher = worse outcome)
  2. Risk prediction models (POSSOM)
34
Q

What is the most leading cause od death in children and young adults?

A

Traumatic brain injury.

35
Q

Leading cause of TBI?

A
  1. Falls
  2. Motor vehicles
  3. Struck by/against
  4. Assaults
  5. Sports related injuries
  6. Others

Year 3/4 H&S (4 decks)

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