Ch 05-2: Full Scenario Flashcards Preview

Emergency Medical Responder > Ch 05-2: Full Scenario > Flashcards

Flashcards in Ch 05-2: Full Scenario Deck (1)
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Q

Scenario - Repeat Aloud

A
Scene Assessment:
	PPE
		Gloves
		Eyewear
		Gown
		Face Shield
		Reflective Clothing
S P E R M
	Safety:	
		Are there any obvious hazards in the scene?
		Do I have clear access to the patient?

	Patient:
		How many patients are there?
		What is the general behaviour of people on scene?
		Environment:
			What is the weather?
			Where is the scene located?
			Is it lit?
			Is it Cold/Hot
		Resources:
			4 EMR's
			ALS / BLS
			Fire
			Police
			Hazmat
			Poison Control
	Mechanism of Injury:
		Are there any obvious clues to the mechanism of injury?

Bystander Information
	General Impression
		Are their eyes tracking
		Difficulty breathing
		Deadly bleeds
		Obvious fractures or dislocations
		C-spine
		Age / Gender
	C – Spine
		Rule:
			I will take c-spine precaution
		Rule – Out:
			I will rule out trauma to the head and spine

Primary Survey:
Introduction
Don’t move / Hello,
My name is Sable, I am an EMR.

Gain Consent
	May I help you?

C – Spine
	Delegate C-spine precaution to partner
	L O C
		Alert / Oriented
			What is your name?
			Do you know where we are?
			Do you know what time it is?
			Do you know what happened?
		Verbal
		Pain
		Unresponsive
A B C D D
	Airway
		Open airway
			Choking / Suction / OPA / NPA
		Breathing
			Rate
				12 – 20
			Rhythm
			Depth
			Effort
			Apply Oxygen
				Non-rebreather Mask, 15 lpm
				BVM, 15 lpm
			Rescue Breathing
				 Less than 8 greater than 30
				1 every 5 – 6 seconds
		Circulation
			Pulse
				Radial
				Carotid
				Bracheal
			Rate
				60 – 100 bpm
			Rhythm 
			Quality
			Skin Color and Condition
			CPR
	Deadly Bleeding
		Checking for any deadly bleeding
		Fix Deadly Bleeds

	Transport Decision
		Load and Go
		Stay and Stabilize
Primary Survey
	Head
		Looking For:
			Deformities
			Contusions
			Abrasions
			Penetrations
			Burns
			Lacerations
			Swelling
	Feeling For:
		Tenderness
		Instability
		Crepitus
		Also checking for:
			Battle Signs
			Racoon Eyes
			Fluid 
			Soot
			Missing Teeth
Neck
	Checking For:	
		DCAP BLS TIC
		Also Checking For:
			Jugular Vein Distention
			Tracheal Deviation
			Accessory muscle use
			Apply C-Collar
	Chest
		Checking For:
			DCAP BLS TIC
		Also Looking For:
			Paradoxical Movement
			Medication Patches
			Pace Makers
			Needle Marks
			Scars
		Treatment:
			Sucking chest wound 
				Put a gloved hand on wound
				3 sided occlusive dressing
			Flail Chest
				Put Gloved hand over it
				Bulky dressing and tape over just top bottom
	Auscultating the Lung Sounds:
		Apeces - Mid Clavicular Level
		Baces - Mid Auxiliary Level
		Air is present, Clear, Equal Bilaterally
	Abdomen
		Looking For:
			DCAP BLS
			Pulsating Masses
			Eviscerations
	Palpating the four quadrants for:
		Tenderness
		Rigidity
		Distention

	Is there any Guarding?

	Eviscerations
		Moist, sterile dressing
		Occlusive dressing
		Blanket

Pelvis
	Looking For:
		DCAP BLS

	Feeling inward then down for:
		TIC
		Is the pelvis stable?

	Also checking for:
		Priapism
		Incontinence
		Bleeding
	Lower Extremities
		Hand over hand Bilaterally I am checking for:
			DCAP BLS TIC
			Edema
			Needle Marks
			Scars
	Also checking the feet for:
		Motor Function
			Press on my hand downward / Press upward

		Sensation while also checking capillary refill
			Which toe am I pinching

		Pulse
			Pedal Pulse

	If you find a break
		Manual Stabilization
	Upper Extremities
		Hand over hand Bilaterally I am checking for
			DCAP BLS TIC
			Edema
			Needle Marks
			Scars
		I am also checking the hands for:
			Motor Function
				Can you squeeze my fingers with both hands?
		Sensation while also checking capillary refill
			Which finger am I pinching?

		Pulse
			Radial Pulse
	Back
		Checking the Back
		Doing a log roll at my partners count to check the back for
			DCAP BLS TIC
		Use a scoop if pelvis issues
		Immobilize
		Put on spine board

Getting them into the Ambulance
Final Transport Decision
Load and Go

Load
	Log roll onto a spine board securing the body, legs, then head with head blocks
	Extremity lift
	Scoop

Driver
	One of the EMRs is driving
	Take along
		One family member / Bystander
		Personal belongings
		Medication
		DNR
		EMR's
Oxygen
	Switch the Oxygen tank from the D tank to the M tank

Leave
	I am off scene

History
Reassess LOC and ABCD’s

	S A M P L E
		Signs and Symptoms
			What are you feeling right now?  
		Allergies
			Do you have any allergies?
		Medications
			Are you currently taking any medications?  
				Prescription
				Over the Counter
				Herbal
				Recreational Drugs
				Erectile Disfunction
		Past Medical History
			What is your most important past medical history
	Last Oral Intake
		What was the last thing you had to eat?
		When was the last time you went to the bathroom?

	Events Prior
		What happened before you got hurt / sick?
	O P Q R S T
		Onset of pain
			When did the pain start?
		Provoke / Alleviate
			Does anything make it better or worse?
		Quality
			Describe how the pain feels
		Radiate
			Where does it hurt?
		Severity
			On a scale of one to ten, what would you rate the level of pain you are feeling?
		Time
			When did the pain start?
	Vitals
		Blood Pressure
		Blood Glucose Level
		Blood Oximetry
		Body Temperature
		Breathing Rate
		Pulse
		Pupils equal and reactive to light
		Level of Consciousness
		Skin Color and Condition
Medications
	6 Rights
		Patient
		Medication
		Route
		Dose
		Time
		Documentation
	4 C's and E
		Color
		Concentration
		Clarity
		Condition
		Expiry Date
	Medical Direction
	Poison Control
	Educate and consent
	Give / Assist
	Redo Vitals
Types of Medication
	Oral Glucose – Monosaccharide
		Give
		1 25ml Tube orally
		1 tube q 3 -5 minutes as needed
		Hypoglycemic, BGL less than 4
	Acetylsalicylic Acid – Aspirin
		Give
		1 160mg or 325mg tablet orally
		Once
		Do not have asthma, no bleeding ulcers
Salbutamol – Ventolin
	Assist
	100 mcg / spray
	6 sprays q 10 minutes; Maximum 20 metered dose inhaler
	Shake for half a minute before handing to patient
	Ipratroprium Bromide – Atrovent
		Assist
		20 mcg / spray
		2 – 4 sprays q 10 minutes;  Maximum 10 metered dose inhaler
		Only give after Ventolin, never alone
	Epinephrine – Epi Pen 
		Assist
		0.3mg / injection
		1 every 10 minutes intramuscular
		Confirm anaphylaxis, no pulmonary edema, not elderly
Nitroglycerin - Nitrostat
	Assist
	0.4mg / spray
	1 spray q 5 minutes; maximum of 3 Sublingual
	Must not have taken erectile dysfuntion medications, Blood Pressure over 100 Systolic
Secondary Survey
	Head
		DCAP BLS TIC
		Battle Signs
		Racoon Eyes
		Fluid
		Soot
		Missing Teeth
	Neck
		DCAP BLS TIC
		Tracheal Deviation
		Jugular Vein Distention
		Accessory Muscle Use
	Chest
		DCAP BLS TIC
		Paradoxical Motion
		Sucking Chest Wounds
		Medication Patches
		Pace Makers
		Medic Alert
		Scars
Lung Sounds
	Apeces - Mid Clavicular Level
	Baces - Mid Auxiliary Level
	Air is Present, Clear, Equal Bilaterally 
	Abdomen
		DCAP BLS TRD
		Evisceration
		Pulsating Masses
		Needle Marks
		Scars
	Pelvis
		Is the pelvis still stable?
		DCAP BLS TIC
		Priapism
		Incontinence
		Bleeding
	Lower Extremities
		Hand over hand Bilaterally I am checking for
			DCAP BLS TIC
			Motor Function
			Sensation
			Cap Refill
			Pedal Pulse
			Edema
			Needle Marks
			Scars
	Upper Extremities
		Hand over hand bilaterally I am checking for
			DCAP BLS TIC
			Motor Function
			Sensation
			Cap Refill
			Radial Pulse
			Edema
			Needle Marks
			Scars
Back
	As best I can I am checking for
		DCAP BLS TIC
Ongoing Care
	Reassess LOC ABCD's Vitals every 5 minutes
	Checking my Vitals
	Give medication if you couldn't before
	Check any interventions
	Cover with a blanket
	I want my vitals again
Patch the Hospital
	C H A T
		Chief Complaint
		History
		Assessment
		Estimated Time of Arrival
I want to be at the Hospital