Clinical skills - Professionalism and the Patient Perspective

Question 1

Objectives of first aid

Answer 1

3P’s

Preserve life
Prevent further harm
Promote recovery

Question 2

Priorities of first aid

Answer 2

First on the scene 
Assess the situation 
Make the area safe 
Don't put yourself at risk 
Reassure and comfort 
Assess the in cured
Treat most serious conditions first 
Seek help, call an ambulance

Question 3

ABC’s of first aid

Answer 3

Airway
Breathing
Circulation

Question 4

A - Airway

Answer 4

Bearing in mind cerival spine in jury
Clear airway by removing dentures, any food and debris in the mouth
Pull chin forward to stop tongue falling back and obstructing airway

Question 5

B - Breathing

Answer 5

If necessary, ventilate

May need to perform ‘kiss of life’ or formal ventilation w/ insertion of an airway and ventilating

Question 6

C - circulation

Answer 6

Seek out sources of bleeding and stop bleeding by direct pressure or by applying tourniquet if limbs bleeding

Question 7

How do you check if an unconscious is still breathing

Answer 7

Look to see if chest is rising/ falling
Listen over their mouth and nose for breathing sounds
Feel their breath against your cheek for 10s

Question 8

First thing to do when you see an unconscious person

Answer 8

Ask them if they are alright

Ask them to open their eyes

Question 9

What should you do if you get no response from an unconscious person

Answer 9

Open their airway
Place on hand on the patients’s forehead and gently tilt their head back
Lift the chin using two fingers

Question 10

Why do we lift the chin using two fingers

Answer 10

This moves tongue away from back of throat

Question 11

Suspected spinal injury in someone who is unconscious

Answer 11

Do not extend neck but lift jaw forward - jaw thrust

Question 12

If unconscious and not breathing

Answer 12

Start CPR immediately

Question 13

CPR steps

Answer 13

Place the heel of the hand on the centre of breastbone. Place other hand on top and interlock fingers
Position yourself with shoulders above your hands
Use bodyweight to push down 5-6cm on their chest
Keeping hands on chest, release compression and allow chest to return to orig. position
Repeat compression at rate of 100-120x/min until ambulance arrive

Question 14

CPR w/ rescue breaths

Answer 14

After every 30 chest compression, give two breaths
Tilt the casualty’s head gently and lift the chin up w/ two fingers. Pinch the person’s nose. Seal your mouth over theirs and blow steadily and firmly for one second. Check their chest rises, give two breaths
Continue w/ cycles of two breaths until they begin to recover, or emergency help arrives

Question 15

Recovery position

Answer 15

Place patient on the side

Bend knee and elbow at 90 degrees and place on floor

Question 16

Chain of survival

Answer 16

Early recognition and call for help
Early CPR
Early defibrillation
Post resuscitation care

Question 17

To confirm cardiac arrest

Answer 17

Patient response 
Open airway 
Check for normal breathing - caution gasping breathing 
Check circulation 
Monitoring

Question 18

Cardiac arrest confirmed

Answer 18

Call resuscitation team
Attach defribillator/ monitor
Minimise interruptions

Question 19

First aid for conscious patients

Answer 19

Comfort and reassure casualty
Neck immobilisation
Maintaining airway
Maintain neck immobilisation

Question 20

Child resuscitation

Answer 20

Try to get a response by asking or gently tapping
If no response, tilt head back and lift chin to open airway. Listen for any breathing
Clear airway removes any obstruction, dentures, tongue. Give 5 rescue breaths
Start CPR until signs of recovery w/ coughing, speaking or moving purposefully

Question 21

Bleeding

Answer 21

Pale and cold and clammy skin 
Thready and weak pulse, feel carotid and femoral pulses 
Rapid and shallow breathing 
Confusion, irritable combative 
Altered consciousness 
Bleeding source 
History of assault; injury

Question 22

What to do when someone is bleeding

Answer 22

Assess the situation 
make the area safe and don't put yourself at risk 
Reassure and comfort 
Assess the injures 
Treat the most serious injury first 
Seek help, call an ambulance 
Apply direct pressure and maintain pressure 
Apply tourniquet on extremity 
Leave offending weapon in situ

Question 23

First aid for choking

Answer 23

Clear mouth, food, dentures
Hit them firmly on their back between their shoulder blade 5x
Perform the Heimlich manoeuvre 5x
Call 999

Question 24

Domestic electrocution

Answer 24

Causes muscular spasms contractions
Avoid touching person
Requires hosp check up

Question 25

High voltage electrocution

Answer 25

Usually fatal
‘Arc’ may jump 20 yds
Only when safe approach casualty

Question 26

First aid for broken bones

Answer 26

Support the injured hand with opposite hand
Rest on a cushion or clothing to prevent unnecessary movement
Apply a splint

Question 27

MSK injury of upper limb

Answer 27

Apply reaction sling

Question 28

MSK injury of pelvis and legs

Answer 28

Blind legs

Question 29

Nosebleed

Answer 29

Pinch nose and lean forward

Question 30

First aid for epileptic fit

Answer 30

Ease casualty to ground 
Place padding behind the head 
When finished fitting, check they're breathing 
Place in recovery position 
May have urinated or bitten tongue

Question 31

First aid for drowning

Answer 31

If unconscious and not breathing, open airway and give 5 breaths
If no response, starts candiac massage
Keep warm

Question 32

Responding to a stroke

Answer 32

Face
Arms
Speech
Timt

Question 33

First aid for burns

Answer 33

Stop burning process 
Remove any clothing or jewellery near burnt area skin 
Cool burn with cool or lukewarm water 
Keep person warm 
Cover burn w/ cling film 
Painkillers 
Hosp

Question 34

First aid for anaphylactic shock

Answer 34

Lay patient flat legs elevated
100% oxygen
Need adrenaline im/iv
Intramuscular 0.5mg to 1mg every 10 minutes

Question 35

Examples of corrosive substances used in acid attacks

Answer 35

H2SO4
HCL
HNO2
NAOH (caustic soda)

Question 36

Treating acid attacks w/ corrosives

Answer 36

Report it immediately 
Remove clothing and jewellery 
Rinse with copious water continuously 20 mins 
Use sterile water for eyes 
Throw head back then wash face 
Brush away powders

Question 37

Things not to do when treating acid attacks

Answer 37

Don’t use milk
Don’t pour water over head
Avoid acid getting into eyes

Question 38

Assessing pain as part of AVPU

Answer 38

Trapezius squeeze
Fingernail squeeze
Ear lobe squeeze

Question 39

Pupils fixed - PEARL

Answer 39

Opioid overdose, treat with naloxone hydrochloride

Question 40

Pupils dilated - PEARL

Answer 40

Hypoxia & extreme blood loss

Question 41

Pupils unequal - PEARL

Answer 41

Can be a natural occurrence (ask pt), indicative of injury

Question 42

Recovery position for injured pt

Answer 42

Roll onto injured side

Question 43

Recovery position for pregnant women

Answer 43

Roll them to the left

Question 44

Log roll

Answer 44

Those with suspected spinal injury, 4 people to roll, grabbing opposite side, ready, steady, roll. First one immobilise head and rest spread out along body

Question 45

Performing abdominal thrusts

Answer 45

Make a fist and turn thumb toward body

Inwards & upwards, inbetween end of sternum and navel, hosp for check up

Question 46

Age limit for abdominal thrusts

Answer 46

A I’ve 1

Under 1 is chest thrusts

Question 47

Arterial bleed

Answer 47

Bright red blood
High pressure (spurts)

Question 48

Venous bleed

Answer 48

Dark red blood
Medium pressure (gush)

Question 49

How long does it take for the clotting cascade to kick in

Answer 49

8-10 mins

Question 50

Applying a tourniquet

Answer 50

Apply tourniquets 2-3cm above wound,
Max 2 hr
Try to preserve as much limb integrity
Shouldn’t be able to feel pulse underneath

Question 51

When should an epistaxis be taken to hosp

Answer 51

If has not stopped after 30 mins