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PHC Flashcards

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1
Q

RIDDOR

A

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations

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2
Q

Accident Reporting

A

Reporting responsibility lies with Line Manager/ individual in charge of area / activity where incident occurred and should be reported within 10 consecutive days. Death should be reported immediately. Line manager should seek advice from specialists as appropriate

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3
Q

Define Accident

A

Accident - Any injury or occupational disease to a person or which caused/had the potential to cause a RIDDOR (Reporting of Injuries Diseases and Dangerous Occurrence Regulations) dangerous occurrence.

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4
Q

Define Incident

A

Incident - a) An event which causes loss or damage to property, plant or equipment due to a shortfall in safety measures.
b) An intervention or enforcement notice from an internal or external regulatory body. c) Contamination of an individual or workplace by an article contaminated with Chemical, biological or radioactive (CBR) material,
d) A CBR contaminated article being lost from institutional control.

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5
Q

Define Near Miss

A

Near Miss - An event that, while not causing harm, has the potential to cause injury, damage or ill health but which was avoided by circumstance or through timely intervention

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6
Q

Accidents to Report

A

Death, injury or ill health:

Where in normal circumstances would cause greater than one hour loss of work time

Where cause attributable to MOD activities or has occurred on MOD property which can be linked to any failure in responsibility by the MOD

An environmental incident

Near miss which could have resulted in death injury or ill health
If a worker previously reported as injured or ill dies within one year of previously reported event

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7
Q

Waste Management Principles

A

Waste producer is responsible for ensuring waste can be safely disposed of by others in the disposal system

Must be segregated at the point of disposal

Clinical waste must be incinerated

Non-clinical waste disposed of by landfill at local refuse tips

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8
Q

Types of Waste

A

Domestic waste

Non-clinical dangerous waste

Clinical waste

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9
Q

Domestic Waste and Disposal

A

Waste generated in routine non-clinical work of the MRS/medical centre and non-clinical items discarded by patients.

Only placed in black waste bags. Must not be mixed with clinical waste. Secured at ¾ full in order to prevent spilling during transit. Removed to a recognised waste disposal area as frequently as possible

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10
Q

Non-Clinical Dangerous Waste and Disposal

A

Waste from a non-clinical source that may present a risk of injury to those disposing of it.

Rigid cardboard boxes
Stout brown paper sacks
Aerosols must be empty

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11
Q

Clinical Waste and Disposal

A

Waste generated from the treatment or nursing care of patients

Held in rigid foot operated bin whilst in use
Securely stored pending collection and disposal by an accredited waste disposal contractor
Gloves
Removed from clinical areas as frequently as possible
Secured when ¾ full to prevent spilling
Labelled with Med Centre/MRS name, location and date
Swan neck closure

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12
Q

Sharps Disposal

A

Disposed of at point of care. Date and initial on opening and closing the sharps box. Appropriate fill height

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13
Q

When are Vaccinations Offered to SP

A

On entry into the UKAF

To specific personnel groups

When boosters are required during service

Additional vaccinations based on certain situations

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14
Q

Why Vaccinate

A

Enhance immunity to disease as part of the MoD’s duty of care

Maintain operational effectiveness

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15
Q

Core Vaccinations on Entry

A

Hepatitis A
Hepatitis B
Meningitis ACWY
MMR
Low dose dip/tet/ polio
Yellow fever
Influenza
HPV – Females <25 years if not had or finished course/ Males <25 years if started the course and not completed. All men who have sex with men under age of 45 years.

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16
Q

Occupational Health Vaccinations

A

Personnel at particular risk from certain infectious diseases
Personnel who may present a risk to patients

Hepatitis B (now given to all, but proof of immunity needed for HCPs and revaccinating if serology not high enough)
Rubella (if pregnant and non-immune following serology testing – MMR given)
Varicella (if non-immune)
Tuberculosis (if from high prevalence areas following assessment/testing)

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17
Q

Vaccinations for High Risk Areas

A

Decision to immunise against diseases specific to travel based on an area-specific risk assessment for joint operations & exercises this is carried out by PJHQ.

Additional vaccinations that may be offered:
Japanese encephalitis
Typhoid
Rabies
Tick-borne encephalitis
Anthrax
Cholera
Influenza
Pneumococcal

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18
Q

Vaccination Procedure

A

Vaccination must be administered in accordance with a prescription
Staff must be appropriately trained
Completed every 3 years in all aspects to include contra-indications
Anaphylaxis training annually
MO must be present at all times – risk holder.
Written consent following education (offer PIL and educate via professional discussion) – via template on DMCIP or written in notes/FMED 965. Documented DMICP/FMED 965. Actions on refusal – inform individual of implications of refusal. Inform CoC.
Identity, form and expiry date of vaccine checked
Live vaccines – 4-week gap.
Assess patient for contra-indications and inform of adverse reactions
Ensure vaccines stored at 2-8°C – 373s /daily checks – if breaks cold chain need to inform pharmacy lead who will inform on next steps.
Educate patient

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19
Q

Specimen Guidelines

A

Appropriate container for infection being investigated
Adequate material to allow for examination
Aseptic technique
Sterile containers with tight fitting lids
Samples should be collected prior to treatment
Safe technique and practice

Explain and discuss procedure with patient, ensuring privacy whilst carrying out procedure
Wash hands/put on gloves
Place specimens/swabs in appropriate labelled containers
Dispatch promptly to laboratory with completed request forms

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20
Q

Specimen Documentation

A

Patients name, ward/department
Hospital/service number
Date/time of specimen collection
Diagnosis
Relevant signs and symptoms
Relevant travel
Antimicrobial drugs being taken by the patient
Type of specimen
Consultant/doctor name
Name of doctor who ordered investigation

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21
Q

Specimen Location Types

A

Eye
Nose
Peri-nasal (Whooping Cough)
Sputum
Throat
Vomit

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22
Q

Specimen Investigation Types

A

Bacterial
Viral
Serological
Mycosis
Mycobacteriological
Protozoa
Haematology

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23
Q

Specimen Transportation

A

Leak proof container
Placed in double self sealing bag
Transported to lab in container to prevent accident
Biohazard labels/doubled bagged if required for infectious conditions
Container must contain crystals to absorb any spillages
Biohazard spills kit

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24
Q

CMT Induction Procedure

A

Induction training describes the arrivals and induction process into a DPHC facility and aims to make this a seamless process whilst simultaneously ensuring all required needs are met for the individual and the medical centre, thus ensuring safe and efficient patient care.

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25
Scope of Practice Definition
The HCPC: ‘The area of someone’s profession in which they have the knowledge, skills and experience to practice [lawfully], safely and effectively, in a way that meets [appropriate professional] standards and does not present any risk to the public or the health and care professional’ DMS: ‘The boundaries within which a fully qualified practitioner with appropriate training, knowledge and experience may practise within a field of medicine or surgery or other specifically defined field’.
26
CMT Code of Conduct
‘Sets out attitudes ad behaviours expected of Combat Medical Technicians in order to maintain the trust and confidence of patients and the chain of command in the profession and wider military health support system (…) ’ ‘CMT Code of Conduct augments and is underpinned by existing British Army Values and Standards and the Army Leadership Code and is supported by the Fitness to Practice (FtP) policy’
27
CMT Competency Checklist
Clinical competency checklist - Signed off annually / at set intervals or arrival at a new working environment to ensure they are current and safe to practice. Ensures you work to your skills and are appropriately trained
28
Clinical Training Types
Formalised Induction Continuous Additional skills
29
Training Shortfall Definition
A training gap is identified where training provided has not met the needs of unit/individuals
30
CMT CCE and Clinical Training Hours
CCE 60hrs Clinical Training Hours 30hrs
31
AGAI 78
AGAI 78 is an official document, of approximately 197 pages that covers all aspects of service medical employment standards
32
JMES - PULHHEEMS
Joint Medical Employment Standards P – Physical Capacity U – Upper Limbs L – Locomotion / Lower Limbs H – Hearing - Right H – Hearing - Left E – Eyes - Right E – Eyes - Left M – Mental Capacity S - Emotional Stability
33
Purpose of PULHHEEMS
Functional assessment of the individual's capacity for work Expresses the physical and mental attributes appropriate to individual’s employment and fitness for deployment Assists in posting people to the employment for which they are most suited Provides an easy to administrate system
34
3 JMES Categories
MFD – Medically Fully Deployable MLD – Medically Limited Deployable MND – Medically Not Deployable
35
JMES - A, L, M, E
Air, Land, Maritime, Environment and Medical Support
36
Appendix 9
Form for Notifying Functional or Medical Restrictions to Unit
37
PULHHEEMS Recording
Electronic Personnel Record – via DMICP Pre-Service and During Training (RG8) FMed 1 - Pre Release Medical Record FMed 23 – Fitness for Work Assessment Record
38
Termination of Service
All service personnel reassessed and assessment notified, published and recorded Termination on medical grounds: President of med board completes F/Med/19 Officers unfit for service on medical grounds/ medically unfit for service – retired under the Pay Article Warrant Medical 6 - 8 weeks prior to leaving date Final medical immediately prior to departure on terminal leave or discharge Documentation required: F/Med/1, F/Med/133 Patient gets F/Med/133 and DMICP summary printout for GP
39
Spectacles Forms
MOD form 1003 & FMed 79
40
Medical Centre Access
Opening hours clearly stated Non-urgent cases seen within one working day Named doctor or nurse normally seven working days Patients visited at home if condition requires Entitled to all necessary medical treatment
41
Reporting Sick Procedure
Every soldier has a right to see the MO and not be denied opportunity to report sick Must report to their Unit orderly – each unit will have their own policy/procedure Must inform Chain of Command – No medical confidence information to be disclosed. If Unit is concerned by frequency of attendance, this is to be raised through the chain of command to the MO via UHC
42
Requirement for Continuing Care
Rehab or other long term medical conditions requiring further care –DMRC, RRU Home visit depending on medical condition and type of care required – As per policy. Aim to get best possible care for individual to return back to duty
43
Documentation Routine Referrals
Initiated by professionally qualified practitioner e.g. MO Must be legible Copies required - Stats, Hospital letter Entry recorded in DMICP under read code
44
Documentation for Emergency Referrals
Letter - either hand written or typed – Needs to be on headed paper with stamp Include request for information returned to referring person as soon as possible Contact emergency services
45
FMED100
Daily fluid balance chart
46
FMED 660/661
Obtaining patient consent for investigations or treatments
47
FMED5
Attendance and Record Card
48
FMED 965
Used for deployed personnel
49
FMED1
Pre-release medical record
50
FMED 23
Fitness for work assessment record
51
FMED 79
Spectacle Procedure
52
FMED 143
Periodic and special medication examination record
53
FMED 4
Medical record with full history of care throughout their military career
54
FMED 85
Notification of infectious disease
55
Information to be Documented on a FMED 5
Number Rank Name Sex (where not indicated by number) Age (DOB) Unit Allergies – to be written in red PC or C/O, Full Hx, Examination, query diagnosis and treatment / disposal Time and Location of Consultation Print name and sign
56
Entitlement of Serving members
Full range of PHC and Occupational Health services Whether on or off duty Irrespective of location or where DMICP registered Also, any NHS GP practice on a temporary basis
57
Entitlement of FTRS
Full Commitment (FC) FTRS(FC) are entitled to receive the same medical and dental treatment from Service sources as their regular counterparts. Limited Commitment (LC) FTRS(LC) are only entitled to medical and dental treatment from Service sources when they are deployed. However, in all cases of emergency at the place of duty in the UK, they may be treated by Service medical or dental staff. Home Commitment (HC) FTRS(HC) are only entitled to receive medical care from Service sources in the event of an emergency at work.
58
Entitlement of MOD Civilians
Those deployed on operations overseas are eligible to be given recommended vaccinations and malarial prophylaxis as per JSP 950 civilian operational deployment assessment (CODA) for MOD employees deployed overseas.
59
Entitlement of Service Families
NHS Responsibility unless eligible to register at a Families practice.
60
Entitlement of Diplomacy staff and their dependents
Entitled to receive advice and support where their needs cannot be met locally.
61
Why does Equipment Fail
Inadequate levels of operator skills Poor servicing, maintenance or standards of inspection Age or other slow deterioration Defects Neglect, misuse or damage Wear and tear Equipment care means ensuring all equipment is clean, serviceable and that all staff are confident in its use.
62
Basic Principles of Equipment Care
Commitment Correct usage Tools, equipment and documentation Understand it’s purpose Understand the consequences of poor practice
63
Equipment User Responsibilities
Responsibilities: Pre, during and post use checks using an MOD Form 373 Competency & training Fault reporting
64
MOD Form 373
Medical and Dental Equipment Record of Pre-use/Post-use/Operations checks
65
Frequency of Equipment Checks
Daily Post/Pre user checks (in use) Monthly/weekly (when not in use) 6 monthly/Periodic Mandatory Equipment Inspections (MEI) Practice Manager Snap inspections (10% weekly using Annex A to DPHC ECD chapter 4)
66
Lines of Equipment Support
1st Line / Departments 2nd Line / MDSS 3rd Line / MDSS / Defence support Agencies (DSA) 4th Line / Contract holder
67
Why Report Equipment Faults
Prevent the fault from worsening Allow for timely repair Reduce the possibility of accidents Reduce repair costs Improve clinical effectiveness Reduce risk of legal action against MOD IF IN DOUBT REPORT IT!
68
Equipment Failure Reporting
Not to be confused with fault reporting It is for when the equipment has prematurely failed Neglect, Misuse and Damage Reports.
69
MDSS
Medical and Dental Servicing Section Cleanliness User needs to be present Relevant documentation: FMED 993 - Maintenance Request Form FMED 767 – Infection Prevention Certificate
70
FMED 993
Equipment Maintenance Request Form
71
FMED 767
Equipment Infection Prevention Certificate
72
Purpose of an Equipment Care Inspection
Report on the effectiveness of the medical centres EC and management systems Recommends improvements where necessary Ensure compliance
73
Preparing for an ECI
You will receive a Warning Order Assessment Matrix Unit preparation guide Unit confirmation form
74
Manual Handling Definition
Transportation or support of a load by hand or bodily force Including: Lifting/lowering Pushing/pulling Holding/carrying Throwing/dropping.
75
Manual Handling Reasons
Provide safe working environment for colleague and or employees Reduce cost to MOD/ Industry Decrease the prevalence of back pain and work related Muscular-Skeletal Disorders (MSD’s) It’s the law
76
Manual Handling Legislation
Health and Safety at Work Act 1974 (HASAWA) Management of Health and Safety at Work Regulations 1999 (MHSWR) Manual Handling Operations Regulations 1992
77
Manual Handling TILE
Task, Individuals Capabilities, Load, Environment
78
Manual Handling Employer’s responsibilities
Avoid risk where possible Assess risk and manage Train, inform, supervise Conduct manual handling risk assessments Report manual handling accidents to CoC/SHEF when applicable
79
Manual Handling Employee’s responsibilities
Co-operate Report shortcomings Report all accidents or near misses If equipment is provided to reduce risk, employee has legal obligation to use it Use correct procedures (taught in training)
80
Manual Handling Disclaimer
Recognise your own limitations Do you have any existing injuries or feel unable to participate in practical activity? If yes inform your CoC This applies both at home and work Lastly, this is your responsibility
81
Manual Handling Weight vs Force
1kg weight close to the body exerts 10kg force onto muscles of the back (1:10) 1kg weight held at arms length exerts 100kg force onto the muscles of the back (1:100)
82
Manual Handling Practical Aspects with Patients
Communication and co-operation: Why they are being moved Where to Proposed method of movement Patients role What to do if they feel unsteady
83
The Freedom Of Information (FOI) Act 2000 - Pertaining To Military Medical Centres
The Rights under the Freedom of Information Act, to request information held by public authorities, known as the Right to Know, came into force Jan 05 Act allows you to access recorded information (such as e-mails, meeting minutes, research or reports) held by public authorities in England
84
Responding to Freedom Of Information Request
We have a duty to provide what is being asked Clearly identifies the applicant’s contact details; and the information asked We have 20 working days to reply
85
State The definition of medical confidentiality
Statutory and professional duty to safeguard personal information by preventing improper disclosure Personal information is information about people which health professionals learn professionally and from which individuals can be identified, directly or indirectly
86
State the principles of medical confidentiality / Caldicot Principles (8)
Justify purpose for using confidential information Use confidential information only when it is necessary Use minimum necessary patient identifiable information Access to patient identifiable information should be strictly need to know Everyone with access to confidential information should be made aware of their responsibilities. Comply With The Law Duty To Share Information Can Be As Important As Duty To Protect Patient Confidentiality Inform Patients And Service Users About How Their Confidential Information Is Used
87
Data Protection Act
Seeks to strike a balance between the rights of the individual and the sometimes competing interests of those with legitimate reasons of using personal information
88
Principles of Data Protection
Used fairly, lawfully and transparently Used for specified, explicit purposes Used in a way that is adequate, relevant and limited to only what is necessary Accurate and, where necessary, kept up to date Kept for no longer than is necessary Handled in a way that ensures appropriate security, including protection against unlawful or unauthorised processing, access, loss, destruction or damage
89
Clinical Governance Definition
Framework through which individuals and healthcare delivery units are accountable for continually improving the quality of their services and safeguarding high standards of care by creating the environment in which excellence in clinical care will flourish Ethos: Ensuring patients receive the highest standard of care in a facilitative environment within an open and fair culture
90
HAF Domains
Safe Effective Caring Responsive Well Led
91
Chain of Command Roles and Responsibilities with Clinical Governance
Ensure subordinates are aware of Healthcare Assurance Ensure education and training is conducted Ensure everyone complies with Healthcare Assurance and Subsequent Policies Apply Clinical Governance
92
New HAF
Online system for which HCG is tracked and checked. Everyone’s responsibility to contribute to HAF. Inspected at regular intervals through: Foundation: Self Ax Lv 1 Assurance visit: DPHC Regional Team Lv 2 Assurance visit: DPHC HQ, DMG HQ, sS, PJHQ Lv 3 Assurance visit: DMSR, CQC, GMC, OFSTED, DIA
93
State the Mental Health Service Support Requirements to DPHC
4 main roles: Effective care and EBP, Provide Education, Undertake Research, Act in command liaison role
94
Acute & Operational Stress Reactions
Event + meaning = stress reaction Meaning relates to past experiences & coping strategies ASR also known as operational stress reaction Transient, temporary psychological reaction Normal response to an abnormal event Likely to return to duty fairly quickly Avoid evacuation syndrome Most people cope extremely well and few develop serious reactions Even fewer develop PTSD PTSD rates vary in certain groups who have deployed
95
Battlefield Mental Health Care Aims
Provide timely & effective forward mental health care Keep personnel soldiering and not creating patients Return combatant to front line duty ASAP Avoid medical evacuation whenever possible Keep it simple
96
PTSD
Predisposing and precipitating factors Often co-exists with other problems If effectively treated, other issues often resolve Complex PTSD – often develops after numerous traumatic events Complex PTSD & CSA – particularly problematic as affects development of beliefs about self, world and others
97
TRiM Assessment
Peer support Not psychotherapy / counselling TRiM assessor from same unit More known to individual involved the better Able to recognise changes in personality Process initiated by command Assessment - spotting early signs of poor adjustment following exposure to traumatic/combat event Initial assessment – 72 hrs after event Assessment includes Risk Factor & ASR checklists Must avoid re-traumatisation Before – during - after discussions to include facts, feelings and thoughts on the future 28 day follow-up 3 month follow-up if required
98
Mental Health - Re-Experiencing Symptoms
Thoughts, images, sights, sound, smells Dreams and nightmares Feels as if back in scenario Psychological distress on reminders Physical distress on reminders
99
Mental Health - Avoidance Symptoms
Amnesia For Part Of Event Feeling Different/Detached Emotionally Blunt Loss Of Interest In Things Sense Of Foreshortened Future Avoids Thoughts, feelings or conversations that remind & upset Avoids People and situations that remind & upset Physical distress on reminders
100
Mental Health - Arousal Symptoms
Disturbed sleep Irritability & anger Hypervigilance Increased startle response Poor concentration
101
Evacuation Syndrome
Removal of soldiers from fighting group can lead to: Fixation of symptoms Loss of self esteem/pride Loss of unit cohesion Negative effect on leadership, command & morale
102
Mental Health Treatment
7Rs: Recognition – Of Reaction Respite – From Worst Of The Fighting Rest Recall – Their Tales Reassurance – That Reaction Is Normal Rehab - Keep In Role Return – To Duty PIES: Proximity– as close to the front as possible Immediacy – ASAP Expectancy – they will return to duty Simplicity – utilising the 7 Rs
103
Mental Health and Impact of the Team
Teamwork is psychologically protective Individuals work for their team Effective teams support each other Realistic training helps team performance Good leadership is key in management of MH issues
104
Leadership and PTSD
Good leadership helps in prevention of PTSRs Need to know team to spot changes & know weaknesses Look for indications through selection, training and adversity Gut reactions to changes are important clues
105
PTSD Diagnostic Criteria
Perceived life threatening event - witnessed/involved Caused intense fear, helplessness or horror 1 or more re-experiencing symptoms 3 or more avoidance symptoms 2 or more arousal symptoms All for more than one month Significant distress/impairment in social, occupational functioning Acute < 3/12, Chronic > 3/12, Delayed > 6/12 Onset occurs after symptom free for least 6 months
106
PTSD Prevention
Can’t prevent Early intervention essential – 1 -2 months Recognise, identify & monitor those exposed to severely traumatic events
107
PTSD NICE Guidelines
Brief, single session interventions should not be routine Symptoms mild and <4 weeks – ‘watchful waiting’ with monthly review Severe symptoms should be offered treatment Sometimes medication is used as an adjunct to therapy 8 - 12 sessions of trauma focussed psychotherapy: - Cognitive behavioural therapy - Eye movement desensitizing & reprocessing
108
TRiM Risk Assessment Checklist
Person felt they were out of control during the event Person felt that their life was threatened during the event Person blamed others for what happened    Person feels ashamed about their behaviour during the event Person experienced acute stress following the event Person exposed to substantial stress since the event Person has had problems with day to day activities since the event Person has been involved in previous traumatic events Person has poor social support Person has been drinking alcohol excessively to cope with distress
109
Catheterisation Definition
Passing of a urethral catheter into the bladder by the urethral or supra pubic route for diagnostic or therapeutic reasons
110
Catheterisation Indications
Monitoring of fluid balance Unable to pass urine Abdominal/ pelvis injuries Head injuries Post anaesthetic Unmanageable incontinence
111
Catheterisation Contraindications
Major pelvic fractures Urethral bleeding
112
Catheterisation Complications
Damaged urethra Ureteric catheterisation Local urinary tract infection
113
Catheterisation Pre-Procedure
PPE Cleaning solution Gauze swabs Sterile towels Foley catheter 10 ml syringe sterile water Soluble lubricant containing anaesthetic Closed drainage system Tape / Ties
114
Catheterisation Post-Procedure
Secure catheter Record urine output Monitor bag
115
Emergency Childbirth Assessment - History
Quick history! Duration of pregnancy Age of expectant mother Number of deliveries Previous complications / pregnancies Any known abnormalities/pre-existing health conditions (maternal or foetal) Any illnesses during pregnancy
116
Emergency Childbirth Assessment: Observations
Does she look pregnant Has she lost mucous plug? When and what colour? Have waters broken? What colour were they? Is she having regular, powerful contractions? Time from the start of one contraction to the start of the next. Are there signs of breathlessness / shock? Are there signs of anaemia? Is the baby moving/kicking? Are Foetal heart sounds present? BP and urine test – protein in urine and high BP may indicate Pre-Eclampsia (medical emergency in pregnancy)
117
Emergency Childbirth Treatment Aims Mother
Prevent infection Prevent trauma Relieve pain
118
Emergency Childbirth Treatment Aims Baby
Resuscitate Maintain body heat Prevent trauma
119
Emergency Childbirth Aims Post Birth
Keep assessing vital signs of both mother and baby. Both Checked by midwife or obstetrician as soon as possible Both kept warm and dry Mother observed for excessive vaginal bleeding – indication of incomplete placenta delivery. KEEP PLACENTA for inspection by trained personnel if have cut cord (try not to cut until trained personnel in presence). Keep a record to handover
120
Emergency Childbirth First Stage of Labour
Onset of regular, rhythmic and painful contractions to full dilation of the cervix
121
Emergency Childbirth Second Stage of Labour
From the full dilation of the cervix to the complete delivery of the baby
122
Emergency Childbirth Second Stage of Labour Management
- If cervix not fully dilated, encourage woman to pant - If cervix fully dilated at 10cm (contractions 2-3mins apart and lasting 60s min), encourage the woman to push WITH contractions - Baby’s head begins to move down the birth canal (‘crowning’) - Holding dressing pad, place one hand over anus, supporting the perineum and one over baby’s head - Allow head to emerge slowly - Head should emerge face down then rotate to one side - Place hands gently on either side of the baby’s head - With next contraction, guide the head downwards - When uppermost shoulder visible, guide baby upwards - Clear baby’s mouth and nose of mucus - suction - Ensure umbilical cord is not around baby’s head/neck
123
Emergency Childbirth Third Stage of Labour
From the birth of the baby to the complete expulsion of the placenta and membranes
124
Emergency Childbirth Third Stage of Labour Management
Observe for blood flow and umbilical cord appearing at vaginal entrance Encourage mother to push with each contraction until placenta is delivered Ease placenta out with membranes Apply umbilical clamp Placenta and membranes kept for examination by a midwife/obstetrician – retained placenta can cause life-threatening PPH.
125
Emergency Childbirth Post Birth Care Baby
Lay onto mother’s abdomen or a clean warm cloth. Do asap before placenta is delivered unless medical reason not to. Baby should go from blue to pink when on first breaths Wrap in warm protective covering and hand to mother Encourage mother to feed baby as this can help encourage contractions to assist placental expulsion.
126
Why is there an need for Observations
Gather information on pattern Determine baseline Monitor change
127
Pulse Rates
Normal adult pulse is: 60 – 100 per min Abnormal pulse rates: Tachycardia - over 100 Bradycardia - below 60
128
Blood Pressure
Systolic BP (Normal 120) Peak pressure in arteries caused by contraction of the left ventricle Diastolic BP (80) Minimum pressure of blood against vessel walls when ventricle is not contracting
129
Blood Pressure Ranges
Normal pressure ranges from: 100/60mmHg to 140/90mmHg Hypotension: Systolic pressure below 100mmHg Hypertension: Diastolic pressure above 100mmHg Sustained Systolic pressure > than/equal to 160mmHg.
130
Tempterature
Body temperature represents the balance between heat gain and heat loss All tissues produce heat as a result of metabolism and this is increased by exercise and activity.
131
Temperature Ranges
Hypothermia: Core temperature below 35C 36 - 37.5C = normal 37.5 – 38C = low grade pyrexia 38 - 40C = high grade pyrexia 40C + = hyperpyrexia. Pyrexia: Significant rise in temperature
132
SpO2
Measure the percentage of haemoglobin molecules saturated with oxygen Normal range is approximately 96-100%
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PEFR - Peak Expiratory Flow Rate
Measurement of highest rate air can be expelled from the lungs through an open mouth In asthma patients peak flow readings vary over time & in response to medication Normal adult male = 500 – 650 l/min Normal adult female = 400 – 500 l/min

CMT1 PHEC Flashcards (11 decks)

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