1. BSI/PPE/SS 2. AVPU 3. ALS/AED 4. check pulse/breathing 5. start compressions (30:2) 6. AED arrives, hand off compressions 7. turn on AED 8. follow AED prompts 9. clear (verbally and hands) to analyze 10. clear (verbally and hands) to shock 11. return to compressions 12. switch compressors every 2 minutes (or more often)

daily drills Flashcards by Naomi Markman

BVM - airway management of apneic pt

BSI/PPE/SS
AVPU
AED/ALS
check pulse/breathing
airway open (jaw thrust maneuver)
airway clear - prep suction unit
measure suction
turn on suction unit
suction out in circular motion for 15/10/5 seconds (adults/kids/infants)
airway maintainable - size and insert OPA/NPA
2 rescue breaths
reassess pulse and breathing
attach BVM to O2 and ventilate every 5-6 seconds

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O2 - admin of O2 via non-rebreather

BSI/PPE/SS
gather and inspect materials
purge O2 take
attach pressure regulator
turn on tank
purge regulator
check pressure (should be between 1500-2000, replace if under 500PSI)
check for leaks
attach O2 tubing to nipple and NRB
turn on regulator to 10-15 L/min
cover flutter valve to allow bag to fill fully
put mask snugly on pt

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CPR

BSI/PPE/SS
AVPU
ALS/AED
check pulse/breathing
start compressions (30:2)
AED arrives, hand off compressions
turn on AED
follow AED prompts
clear (verbally and hands) to analyze
clear (verbally and hands) to shock
return to compressions
switch compressors every 2 minutes (or more often)

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medical assessment

scene size up
1. BSI/PPE/SS
2. PENMANN

primary assessment
3. general impression of pt
4. AVPU + A/O score
5. C/C
6. XABC
7. transport decision

history taking
8. OPQRST
9. SAMPLE

vitals
10. PRO-BELLSS

secondary assessment
11. focused assessment
12. field impression
13. interventions

reassess
14. updated vitals
15. how often

radio report
16. ACHIVE

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OPQRST

Onset
Provoke/Palliate
Quality
Region/Radiation
Severity
Time

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6 Rights

right patient
right medication
right dose
right route
right time (frequency)
right documentation

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DDICE

drug
dosage
integrity
clarity/concentration
expiration

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PRO-BELLSS

Pulse
Respiration Rate
O2 Saturation (Pulse Ox)
Blood Pressure
Eyes (PERRL)
LOC
Lung Sounds
Skin Signs (+ Cap Refill)
Sugar/Glucose Readings

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SAMPLE

Signs/Symptoms
Allergies
Medications
Pertinent Past Medical Hx
Last Oral Intake (+ other Lasts)
Events Leading Up To

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PPPT

Person
Place
Purpose (Event)
Time

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PENMANN

Personal/Partner/Peeper Safety
Environmental Hazards
Number of Patients
MOI/NOI
Additional Resources
Need for Extrication
Need for Spinal Immobilization

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GCS

Eyes (4)
4 - Alert
3 - Voice
2 - Pain
1 - Unresponsive

Verbal (5)
5 - Oriented
4 - Confused
3 - Inappropriate
2 - Incomprehensible
1 - None

Motor (6)
6 - Follows Commands
5 - Localizes to Pressure
4 - Withdraws from Pressure
3 - Abnormal Flexion
2 - Abnormal Extension
1 - None

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ACHIVE

Age
C/C
Hx
Impression/Interventions
Vitals
ETA

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BE-FAST

Balance
Eyes
Facial droop
Arm drift
Speech
Time

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shock

s/s: tachycardia, tachypnea, low BP (<100 sys), weak pulse, cool pale diaphoretic skin
tx: POWR (position of comfort/supine, o2, warm, rapid transport)

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COPS

cap refill, obvious bleeding, pulse, skin signs

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DCAPBTLS-TIC

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deformities
contusions
abrasions
punctures/penetrations
burns
tenderness
lacerations
swelling
tenderness
instability
crepitus

DRGERM

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distention
rigidity
guarding
eviscerations
rebound tenderness
(pulsating) masses

PIG

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priapism
incontinence
genital bleeding

PMSC

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pulse
motor
sensory
cap refill

Beck’s Triad

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(s/s cardiac tamponade)
JVD
narrowing pulse pressure
muffled heart sounds

Cushing’s Triad

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(s/s increased ICP)
increased/widening BP [hypertension]
decreased pulse [bradycardia]
abnormal breathing patterns

Revised Trauma Score

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(out of 12 total)

GCS
4 - 13-15
3 - 9-12
2 - 6-8
1 - 4-5
0 - <3

SYS
4 - >89
3 - 76-89
2 - 50-75
1 - 1-49
0 - 0

RR
4 - 10-29
3 - >29
2 - 6-9
1 - 1-5
0 - 0

Rule of Nines

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head = 9%
anterior trunk = 18%
posterior trunk = 18%
each arm = 9%
each leg = 18%
genitals = 1%

infant - head = 18%, legs = 13.5%
child - head = 12%, legs = 16.5%

APGAR

PAT

JUMP-START Triage

peds vitals

TRAUMA ASSESSMENT

1. dispatch 2. BSI/PPE/SS 3. PENMANN 4. manual in-line stabilization [head man] 5. general impression 6. AVPU (if U, check breathing/pulse) 7. C/C 8. XABCs 9. transport decision 10. PRO-BELLSS and SAMPLE [leg man] 11. secondary assessment - DCAP-BTLS-TIC -head -neck -TRAUMA NAKED -chest -abdomen -pelvis -extremities -back 12. reassess how often (5 mins, 2 if BVM)

TA head

gloved finger sweep palpate skull and facial bones eyes: PERRL, contacts, redness, raccoon eyes ears: battle sign, bleeding/CSF nose: bleeding/CSF mouth: avulsed teeth, bleeding, unusual/foul odors, adjuncts

TA neck

step-offs JVD tracheal deviation stoma medical tags subcutaneous emphysema

TA chest

barrel hoop shoulder girdle check sternal rock sucking chest wounds flail segments paradoxical chest rise subcutaneous emphysema auscultate heart and lung sounds

TA abdomen

whale tail palpate all four quadrants DR GERM

TA pelvis

barrel hoop open book fracture PIG

TA extremities (lower and upper)

offset pressure PMSCs

TA back

exit wounds step offs incontinence genital/rectal bleeding auscultate lung sounds

BACKBOARD

(pre-set equipment by buckling straps) 1. BSI/PPE/SS 2. manual inline stabilization [head man] 3. PMSCs (all 4 extremities) 4. C-collar [chin piece, measure/adjust, slide under neck toward you, secure] 5. log roll [on head man's count] 6. backboard at 45' angle 7. Z drag to center [down with hips, up with pits] 8. straps: chest [in X, tighten on deep inhale], head [replace hands with blocks], legs 9. recheck PMSCs 10. pad any voids or open spaces

BLEEDING CONTROL (tourniquet)

1. BSI/PPE/SS 2. direct pressure with gauze (5 mins) 3. have pt apply pressure 4. grab tk 5. place tk ~2 inches proximal to wound (not on joints) 6. velcro 7. turn until it won't turn anymore 8. secure 9. write time 10. signs of hypoperfusion - tx with POWR

JOINT IMMOBILIZATION (splint)

1. BSI/PPE/SS 2. have pt hold in position of comfort 3. grab 2 triangle bandages 4. PMSCs 5. tie knot 6. knot facing outside at elbow, wrap around neck - SLING 7. wrap thinned SWATHE around trunk (under uninjured arm, not touching break) 8. PMSCs

LONG BONE IMMOBILIZATION (SAM/cardboard splint)

1. BSI/PPE/SS 2. position of comfort 3. PMSCs 4. measure on good side 5. use bandages through holes to lace up above and below injury (not over break) 6. sling and swathe (if arm) 7. PMSCs bend goes at elbow or ankle, tuck small flaps in for leg/ankle

SUPINE SPINE IMMOBILIZATION (KED)

1. BSI/PPE/SS 2. manual inline stabilization [head man] 3. PMSCs 4. c-collar 5. place vest behind pt 6. secure vest to pt 7. buckle: my baby looks hot tonight (middle bottom legs head top) 8. reassess PMSCs 9. move pt to long backboard + PMSCs

daily drills Flashcards

(41 cards)