4 aims of emergency care?
Preserve the patients life
Prevent the patients condition from deteriorating
Promote the patients recovery
Phone the emergency services
Chain of survival?
Early recognition and call for help
Early CPR
Early defibrillation
Post resuscitation care
Number for resuscitation team in hospital?
2222
Tidal volume of rescue breaths?
500 - 600ml
Treatment for a patient not breathing but with a pulse
Give rescue breaths every 6 secs and assess after a minute
10 causes of unconsciousness?
Fainting
Imbalance of heat
Shock
Head injury
Stroke Heart attack Asphyxia Poisoning Epilepsy Diabetes (FISH SHAPED)
Signs and symptoms of a fracture? (5)
Visible fracture deformity pain swelling discolouration
How should you treat a fracture?
ABCDE Get help Immobilise Splinter/ sling Control bleeding if open fracture Monitor limb circulation
What do you do if a patient is chocking but can cough?
Encourage them to cough
What do you do if a patient is choking and falls unconscious?
Start CPR
What do you do if a patient is chocking with an ineffective cough but is conscious?
5 back blows followed by 5 abdominal thrusts
What is the first thing you ask someone to do if they are choking?
Cough
Assessment of airways (4)
Unresponsive
use of accessory muscles
added sounds
see saw respiratory pattern
Airway interventions? (unconscious and no gag reflex)
Open airways
Suction
Artificial airway e.g. nasal airways, i gel
Once airway is open, give 15L of oxygen via a non-rebreather mask keeping sats love 94% (88% for COPD patient)
Assessment of breathing?
Look (rate, symmetry, effort, SpO2, colour)
Listen (talking, auscultation, wheeze, silent chest, other added sounds)
Feel (chest expansion, percussion)
Breathing intervention?
Ventilation (with bag/ valve/ mask) if resp. rate
Position upright if struggling to breath
Specific treatment e.g. salbutamol for asthma
Circulation assessment?
Look at colour
Feel peripheries temperature
pulse
cap. refill (should refill in
Approx. systolic bp if central pulse present
60mmHg
Approx. systolic bp if femoral pulse present
70mmHg
Approx. systolic bp if radial pulse present
80-90 mmHg
What is shock
3 general causes
inadequate tissue perfusion
hypovolaemia
pump failure
vasodilation (sepsis, anaphylaxis)
Symptoms of shock
Nausea and vomiting thirst rapid breathing sweating fast and weak pulse pale cold clammy skin reduced consciousness confused and anxious
Circulation interventions
position supine with legs raised (left lateral tilt in pregnancy) IV access SpO2 monitor if available keep patient warm loosen tight clothing get help reassure
Assessment of disability
AVPU pupil size/ response posture blood sugar monitoring check drugs you've given
Disability interventions
Optimise airway, breathing, circulation
recovery position
treat underlying causes e.g. deceased BM, control seizures (buccal Midazolam)
Exposure intervention
Examine clothes
keep warm
maintain dignity
monitor vital signs