Treatment Flashcards
Neurological defect ( dementia, parkinon’s ,motor neuron disease an ALS
Arrival: safety
LOC
Nervous System
A: Swallow defect , open and clear, abnormalities
B: effective rise and fall, accessory muscle use?
C: radial and central?
D:Pupils/ Normal GCS?
E: Bracelet, previous injuries,
Signs to look for: Pre-existing neuro difficulties, AEIOU TIPS, cardiac hx, Neuro assessment pupils, motor (abnormal or none), sensory(hearing) , cognitive test, FAST assessment, BGL<
Tx: Posture, treat findings
Priorities: Airway, posture, reassurance
Stroke
Arrival: Safety, standard precaution, gloves when in pt engagement
LOC
Which system: Nervous system
A: Note airway clear, color and patency , speech and swallow?
B: Rate and effort
C: Radial strong or weak
D:Pupils unequal? GCS now and normally? visual disturbance
E: bracelet, signs of raised ICP Head injury ? cerebal fluid? eccymosis
SIGNS: sudden head ache? seizure present ? FAST ,HUNTER 8 , vitals X: Semi reclined so 45 degree head angle of the head with vitals treated, cannula 18 g
rosier arm leg and facial symmetry with speech and sigh distrubance with no seizure or loss of counicessness
PRIORITIES: Rapid transport, breathing, and constant vitals
Seizures
Arrival: Safety
LOC
A: Patency ?trismus ? colour?
B:Breathing effectivelydepth and rate ?
C:Radial ?
D:Pupils pinpoint, unequal or dilated , GCS
E: Bracelet, Avoid patient further injury
SIGNS: History – Key findings: • Time of onset• Events – mechanism of injury • Associated symptoms: − Fever/current febrile illness (particularly with pediatrics) Altered level of consciousness − Incontinence • Relevant past medical history• Medication history/compliance,clinic tonic or absent ? HX , Vitals ,BGL ,Temp
TX: airway suction, try if the airway is tolerant,midazolam, oxygen , postion in recovery position , do not restrain the pt
PRIORITIES: Stop seizure ,airway and oxygen
Asthma
Arrival: Safety , COVID , disease, common cause
systems: respiratory
LOC
A: Patent ? swelling of tongue ? colour
B: Hyperventilation? rise and fall ? breath sounds? wheeze or crackles? spaking in full senatces
C:BP radial? regular?
D:Pupils. GCS
E: Bee stings, rashes, angioedema
SIGNS: Rate the level on accessory muscle use, SPO2, sentences, HR ,and colour
TX: posture pt upright , adrenaline if life threatening , salbutamol, ipratropium , hydrocortisone and magnesium in QLD with IPPV if nessascary , Massage the hyperventilation air space. Re ass vital . Peak flow .
PRIORITIES: Airway, breathing, and oxygen
COPD
Arrival: COVID, check for signs of diseases
systems: respiratory
LOC
A: patent , color, swollen tongue
B: rise and fall, crackles or wheeze, sentences or words
C: Radial strong or week, regular
D:Pupils, GCS
E: Injuries depends on the age
SIGNS: smoking hx, home 02 , cardiac hx, medication regular use ,sputum color, hypoxic drive ?onset of arrhythmia and SPO@ /RR
TX: posture ,suction ,oxygen , ipratropium, salbutamol ,hydrocortisone, IPPV
PRIORITIES: Breathing management, oxygen, transport to managent
PE
A: patent , color, swollen tongue
B: rise and fall, crackles or wheeze, sentences or words
C: Radial strong or week, regular
D:Pupils, GCS
E: Injuries depends on the age
SIGNS: smoking hx, home 02 , cardiac hx, medication regular use ,sputum color, surgery ?, DVT ? ,Maglignency during treatment , Sharp unilateral chest pain with no ECG change ,Blood thinners?
TX: wells criteria , pain management transport ,posture upright
PRIORITIES: sepsis ? Pain relief , and transport
Croup
Arrival: COVID, Precautions LOC A: Patent, Colour, mucus? ,nasal flaring , B: Adequate rise and fall, rapid ? C: Cyanosis ,radial D: pupils, GCS E: rashes , bee stings , swelling SIGNS: • Barking cough- lasting 3 – 7 days. Allergies • Inspiratory stridor- kid letheragic or vomitting • Hoarseness - behaviour • Respiratory distress - feeding • GI disturbances are also common -SPO2
TX: adrenaline NEB, Oxygen , panadol if fever, posture upright, transport
PRIORITIES:
Bronchitis
l: COVID, Precautions LOC A: Patent, Colour, mucus? ,nasal flaring , B: Adequate rise and fall, rapid ? C: Cyanosis ,radial D: pupils, GCS E: rashes , bee stings , swelling SIGNS: Fever, Behaviour, wet cough ,feeding ,accessory muscles, aponea episodes, SpO2 TX: PRIORITIES:
Cardiac ACS/Angina
Arrival: COVID
LOC
A: Patent, colour, dry,
B: Rapid, rise and fall, Pain on breath?heart /chest sounds
C:Cyanosied, CRT, Pain and type (sharp pleurtic, crushing ACS). Radial? strong regular rapid
D: Pupils ,GCS
E: rashes
SIGNS: on exercise or rest, cardiac hx , allergies , medications , blood thinners, stents?, ECG , cardio assessment
TX: Aspirin, oxygen , GTN , Clopidogrel ,tenecteplase , enoxaparin
PRIORITIES: Transport , Aspirin, and thrombolytics
Hypoglycemia
Arrival: COVID
LOC: seizuring?
A: Patnent, trizmus , colour, dehydrated ,can they swallow
B: Rise and fall, rapid
C: CPT, radial
D: Pupils, GCS
E: braclet ? signs of seizure
SIGNS: , neuro assessment, FAST, Lethargic ,behaviour , feeding , drinking ,slip trip and fall hazard, elderly patients at risk ,head ache, dizzy , loss of conciusness
TX: gel , glucagon or 10%. posture in safe postion
transport if alone ,unwilling to eat , pregnant , inadequate response to treatment
PRIORITIES: Sugar, if they can mange , see possible support services
Hyperglycemia
Arrival: COVID LOC A: patent, Trismus , colour , tongue colour, swallow ? B: rise and fall, RR and sounds, C: CPT, Radial D: pupils GCS E: Braclet, seizure signs Signs :neuro assessment of cognitive and sensory , • Kussmaul’s breathing (DKA) • Fruity breath odour (DKA)- HX of diabetes if so what type • Weakness • Blurred vision • Nausea • Vomiting • Altered LOC • Increased urination • Lethargy • Hunger • Abdominal pain • Dizziness • Headaches • Unexplained weight loss TX: fluids for dehydration Transport if moderately dehydrated, new-onset , pregnant, can't swallow fluids, further investigation Priorities : fluids ,management and reassurance
Owatta knee
>55 years patella isolation injury Tenderness at top of fibia inability to flex 90 degrees Inability to weight bear
Owatta ankle
Tenderness on
Posterior on tip or lateral malleous, Base of fifth metatarsal ,navicular ,unable to weight bear
SIRS ( systemic inflammation response sydrome )
38.3 or 36
HR >90
7.7 BGL
ALOC
sepsis
wBC elminate cell s and release nitric oxide and reacts blood vessels by dilating vascular space and slows down blood flow , increase permeability and drease vascular resistance . causes fluid build up causing shock . when effecting respiratory system by destroying vessels . warm skin from blood to the skin organs lose function
