Initial Approach Flashcards
Primary Survey.
> Purpose: identify any immediate life threats w/in first 60-90s, correct as you go. (JRCALC, 2022).
> Danger: scene safety, PPE.
> Response: AVPU.
> Catastrophic Haemorrhage: external? Internal (abdo).
> Airway: currently patent? Risk of impending obstruction?
> Breathing: Rate/Rhythm/Depth, WOB.
> Circulation: colour, clammy, temp, pulse.
> Disability: GCS, 4limbs, posture, FAST.
> Expose/Examine/Environment: rashes, wounds, abdo distention, what’s in the environment (property like etc?).
Why is it important to gain consent in healthcare?
> Reflects an individuals right to determine what happens to their bodies.
> Professional obligation under the HCPC Standards of Proficiency (2014).
> Outlined in Mental Capacity Act (2005).
Why is privacy, dignity and respect important?
> Upholds the personal beliefs and views.
> Set out in the Health & Social Care Act (2008).
Adult Observation Parameters.
> RR: 12-20 (British Journal of Nursing, 2018).
> SpO2: 94%+, 88-92% in hypercapnic RF (BTS).
> HR: 60-100 (British Heart Foundation), Tachy -Why? Relative Bradycardia (Till, 2021).
> BP: 90/60-140/90 (BP UK).
> BGL: Non-DM 3.0-5.6, DM 4.0-7.0. 10.0+ why? ECG? (JRCALC, 2022).
> NEWS 2: >7 - high risk for deterioration (Royal College of Physicians).
Assessment - SOCRATES.
Site.
Onset.
Character.
Radiation.
Associated symptoms.
Timing.
Exacerbating/relieving factors.
Severity (/10).
(Ambulance Care Essentials, Pilbery & Lethbridge, 2019).
PMHx.
MI.
Jaundice.
HTN/hypotension.
Rheumatic Fever (heart valve damage WHO ‘20).
Epilepsy.
Asthma.
DM.
Stroke.
Social History.
> Smoking: what? How long for? How much?
> Alcohol: units and pattern.
> Recreational drugs.
> Living Situation: who with, POC, property type, stairs, bathroom location.
> Exercise: any reduction in tolerance?
> Sexual Hx: who with, when, protection?
> Travel: infective causes of PC.
> Employment: occupational exposure?
Medical Model.
> PC.
HPC: SOCRATES etc.
Meds: inc OTC, prescribed, herbal, allergies.
FHx.
SHx.
PMHx: inc surgical.
O/E.
RoS: Resp, CVS, Neuro, GI, GU, MSK, Endocrine, Psych, ENT.
Imp/Differentials/Plan.
