ILS

Question 1

Airway

Question 2

Breathing

Question 3

Circulation

Question 4

Disability

Question 5

Exposure

Question 6

What are the four Hs?

Answer 6

Hypoxia - tissues not receiving adequate oxygenation.
Hypothermia - low temperature (>35).
Hypovolaemia - loss of fluid or water.
Hypo/Hyperkalaemia - low/high potassium.

Question 7

What are the four Ts?

Answer 7

Tamponade - fluid or blood build up around the heart.
Thrombosis - blood clot.
Toxins - poisoning by toxic substances.
Tension pneumothorax - air between chest wall & lung = reduced blood flow back to the heart.

Question 8

Indicators the four Hs

Answer 8

Hypoxia: ??
Hypovolaemia: blood loss, diarrhoea, sepsis or anaphylaxis.
Hypo/Hyperkalaemia: review ABG/lab results.
Hypothermia: low core body temperature.

Question 9

Indicators the four Ts

Answer 9

Thrombosis: ??
Tamponade: penetrating chest trauma or following cardiac surgery.
Toxins: review administered medications.
Tension Pneumothorax: look out for intubated tube position, unilateral chest expansion, shift of trachea or subcutaneous emphysema. Detect using pleural ultrasound.

Question 10

Treating the four Hs

Answer 10

Hypoxia: patent airway, bag mask, high flow oxygen.
Hypovolaemia: infuse intravenous fluids.
Hyperkalaemia: calcium chloride and insulin/dextrose infusion.
Hypothermia: re-warming techniques (bair hugger).

Question 11

Treating the four Ts

Answer 11

Thrombosis: ACS: percutaneous coronary angiography & intervention, PE: fibrinolytic drugs.
Tamponade: needle pericardiocentesis or resuscitative thoracotomy.
Toxins: consider reversal?
Tension Pneumothorax: needle decompression and chest drain insertion.

Question 12

DRSABC

Answer 12

Danger - check for danger
Response - check for a response
Shout - shout for help
Airway & Breathing - 10 seconds, head tilt chin lift, chest movement?
Compressions - 30/2, 1/3 of chest, 100-120pm
Consider an airway eg. tracheal intubation?