Procedures And Skills Flashcards
1
Q
Arterial Tourniquet Complications
A
Compartment syndrome
Embolism
Fractures
Ischemia
Permanent nerve damage, muscle injury, vascular injury, and/or skin necrosis
Pain
Reperfusion injury when released
NOTE: All risks must be balanced against the risk of exsanguination
2
Q
Arterial Tourniquet Contraindications
A
Bleeding that can be controlled using simple measures such as direct AND/OR indirect pressure
3
Q
Arterial Tourniquet Indications
A
Life threatening haemorrhage not controlled by direct AND/OR indirect pressure
Multiple casualties with extremity haemorrhage and lack of resources to maintain simple measure of haemorrhage control
4
Q
BVM Sizes
A
BVM Sizes
Adult >23kg - 1500/1200mL
Paediatrics 6.5-23kgs - 550/330mL
Neonate _<_6.5kg - 300/160mL
5
Q
What are the Cardiopulmonary Resuscitation (CPR) Complications?
A
Using the presence or absence of a pulse as the primary indicator of cardiac arrest is unreliable
Injury to the chest may occur in some patients.
6
Q
Cardiopulmonary Resuscitation (CPR) Contraindications
A
Nil in this setting
7
Q
What are the Cardiopulmonary Resuscitation (CPR) indications?
A
There are no signs of life:
* Unresponsive
* Not breathing normally
* Carotid pulse cannot be confidently palpated within 10 seconds OR
There are signs of inadequate perfusion:
* Unresponsive
* Pallor or central cyanosis
* Inadequate pulse, evidenced by:
* Less than 40 BPM in an adult or child 1 year or older
* Less than 60 BPM in an infant less than 1 year old
* Less than 60 BPM in a newly born (following appropriate ventilation strategy)
8
Q
Care of an Amputated Body Part Complications
A
traumatic amputations can appear gruesome, the clinician must never be distracted from considering other hidden or less obvious injuries that may be more life threatening to the Pt
9
Q
Care of an Amputated Body Part Contraindications
A
Nil in this setting
10
Q
Care of an Amputated Body Part Indications
A
Traumatic amputation of a body part
11
Q
Cervical Collar Complications
A
Discomfort
Anxiety
12
Q
Cervical Collar Contraindications
A
Surgical airway
Penetrating neck trauma
13
Q
Cervical Collar Indications
A
Suspicion of a cervical spine injury (SCI)
14
Q
Chest Decompression Cannula Sizes
A
Chest Decompression Cannula Sizes
16 gauge <15kg or 3yrs
14 gauge 15-50kg, 4-14 years
15
Q
Chest Seal Complications
A
Occlusion of the 3-channel vented dressing, causing a tension pneumothorax
16
Q
Chest Seal Contraindications
A
Nil in this setting
17
Q
Chest Seal Indications
A
Open pneumothorax
18
Q
CombiCarrierII Complications
A
Pressure areas associated with prolonged use
19
Q
CombiCarrierII Contraindications
A
Nil in this setting
20
Q
CombiCarrier®II Indications
A
Patient extrication
Patient transfer
21
Q
Non-Invasive Ventilation - CPAP Procedure
A
- Place pt in seated position
- Explain procedure to the pt (their understanding and cooperation is essential for successful CPAP)
- Prepare equipment
- Select the appropriate size face mask ensuring the inner circumference of the air cushion encompasses the bridge of the nose, side of the mouth and inferior border of the bottom lip (with mouth slightly open)
- Size 4 - small adult (red)
- Size 5 - large adult (blue)
- Attach the vectored flow valve to the mask and the oxygen tubing, ensuring harness connector remains in place
- Connect the oxygen tubing to a standard 15 L/min oxygen flow metre
- Adjust oxygen flow rate to L/min to generate 5cm H2O continuous positive airway pressure
- Monitor patient’s response to treatment (resp rate, SpO2, BP, chest sound & WOB) and increase airway pressure every 3-5 mins to a maxiumum of 15 cm H2O
- If the pt shows evidence of deterioration, discontinue CPAP immediately and treat in accordance with appropriate CPG
22
Q
Non-Invasive Ventilation - CPAP Sizes
A
Red Harness Connector
size 4 - small adult mask
Blue Harness Connector
size 5 - large adult mask
23
Q
What are the defibrillation complications?
A
Patient Injury including burns
Arcing between electrodes if pads are incorrectly placed
Foreign bodies (including cardiac leads) between the pads and patient
Pads with insufficient or degraded conduction
Explosion
Discharge of the shock could initiate an explosion if there is a combustible gas or fluid in the vicinity
Transmitted shock to the operator or bystanders.
24
Q
What are the defibrillation contraindications?
A
Non Shockable rhythms:
- Asystole
- Pulseless Electrical Activity
- Perfusing Rhythms
25
What are the defibrillation indications?
Ventricular Fibrillation
Pulseless Ventricular Tachycardia
26
Direct Laryngoscopy Complications
Trauma to mouth or upper airway, particularly teeth/dentures
Laryngospasm
Exacerbation of underlying C-spine injuries
Hypoxia due to delays in oxygenation while performing procedure
Vomiting/regurgitation
27
Direct Laryngoscopy Contraindications
Suspected or known epiglottitis
28
Direct Laryngoscopy Indications
Visualisation of the glottis for the purpose of:
- Oral endotracheal tube insertion
- Removal of foreign body
29
Dislocation Reduction - Patella Complications
Iatrogenic injury
30
Dislocation reduction - Patella Contraindications
Patella dislocation other than lateral
31
Dislocation reduction- Patella Indications
Clinical lateral patella dislocation
32
What are the emergency chest decompression - cannula contraindications?
Obvious non-survivable injury in the traumatic cardiac arrest
33
What are the emergency chest decompression - cannula indications?
* Traumatic cardiac arrest (with torso involvement)
* Suspected tension pneumothorax with respiratory and/or haemodynamic compromise:
RESPIRATORY: chest pain, dysponea, tachypnoea, surgical emphysema, diminished breath sounds on affected side, tracheal deviation, cyanosis
CARDIOVASCULAR: Tachycardia, ALOC, hypotension, JVD (may not be present with hypotension)
34
What are the emergency chest decompression - pneumodart indications?
* Traumatic cardiac arrest (with torso involvement)
* Suspected tension pneumothorax with respiratory and/or haemodynamic compromise
RESPIRATORY: chest pain, dyspnoea, tachypnoea, surgical emphysema, diminished breath sounds on affected side, tracheal deviation, cyanosis
CARDIOVASCULAR: Tachycardia, ALOC, hypotension, JVD (may not be present with hypotension)
35
What are the emergency chest decompression - pneumodart complications?
* improper diagnosis and insertion can cause a simple pneumothorax or tension pneumothorax
* incorrect placement may result in life-threatening injury to the heart, great vessels, or damage to the lung
* bilateral pleural decompression in the spontaneously breathing Pt may result in significant respiratory compromise
36
What are the emergency chest decompression - pneumodart contraindications?
obvious non-survivable injury in the traumatic cardiac arrest
Patients less than 50 kg (≈ 14 years)
37
Equipment Required for Cannulation
Equipment Required for Cannulation
Top Shelf Cannultion Shall Be Organised and Fun
Tourniquet
Swab
Cannula
Sharps Kit
Bung
Op Site
Flush
38
Femoral Traction Splint - CT6 Complications
Iatrogenic injury due to poor application technique
39
Femoral Traction Splint - CT6 Contraindications
Fracture/dislocation of the knee
Ankle injury
40
Femoral Traction Splint - CT6 Indications
Mid shaft femoral fractures
41
Femoral Traction Splint - Slishman Femoral Traction Complications
Iatrogenic injury due to poor application technique
42
Femoral Traction Splint - Slishman Femoral Traction Indications
Femoral fractures involving the shaft
43
Femoral Traction Splint -Slishman Femoral Traction Contraindications
Fracture/dislocation of the knee
Ankle injury
44
General Discontinuation Criteria
General Discontinuation Criteria
CPR may be discontinued after 20mins of continuous resuscitation if ALL the following criteria are met:
• No return of ROSC at any stage during resuscitation
• Cardiac arrest was not witnessed by QAS personnel
• No shockable rhythm at any stage
If any of these have not been met, must call QAS Clinical Consultation and Advice line.
45
Haemostatic QuickClot Combat Gauze Complications
nil
46
Haemostatic QuickClot Combat Gauze Contraindications
Wounds involving exposed organs (e.g. bowels)
Sucking chest wounds
Injuries to the eyes and airways
47
Haemostatic QuickClot® Combat Gauze Indications
Traumatic (external) wounds requiring haemostasis
48
Helmet Removal Complications
Possible exacerbation of cervical injury
49
Helmet Removal Contraindications
Nil in this setting
50
Helmet Removal Indications
removal of a motorcycle helmet in the setting of trauma
51
I-Gel Sizes
**I-Gel Sizes**
52
Intramuscular Injections Complications
abscess formation
cellulitis
minor harmorrhage
nerve and blood vessel damage
pain (minor discomfort immediately following the injection is normal)
53
Intramuscular Injections Contraindications
Inadequate muscle mass at the selected injection site
Pts in cardiac arrest
ability to administer the medication by an equally effective and less invasive route
54
Intramuscular Injection Indications
required IM drug administration
55
Intranasal Drug Administration Complications
underdosing if not administered correctly
mild, short lasting nasal discomfort (typically burning) from the drug itelf
56
Intranasal Drug Administration Contraindications
suspected nasal fractures
blood/mucous obstructing the nasal passage
57
Intranasal Drug Administration Indications
the administration of medicaions via the NAS route
58
What are the intravenous cannulation (IV) complications?
drug/fluid extravasation into superficial tissue
localised or systemic catheter or line related infections (most commonly staphylococcus aureus)
redness, pain or swelling of the vein
59
What are the intravenous cannulation (IV) contraindications?
Whenever possible avoid sites of burns, infection, trauma or significant oedema
Pre-existing medical conditions that exclude particular limbs from being used include:
axillary lymph node clearance
lymphoedema
arteriovenous fistula
60
What are the intravenous cannulation (IV) indications?
Vascular access for the administration of medications, hydration fluids and/or blood products
**Note:** Is there a clinical requirement for this procedure?
Will it add value?
Do the benefits outweigh the risks?
Is there a simpler, less invasive alternative?
Can it be justified at this point in time?
61
Intravenous Drug Administration Complications
Air embolus
Infection, bacteraemia or sepsis
Misplacement or dislodgement resulting in extravasation and possible tissue necrosis
Pain or discomfort on medication administration
62
Intravenous Drug Administration Contraindications
Evidence of a misplaced or dislodged IV cannula
63
Intravenous Drug Administration Indications
Administration of medications via the IV route
64
Laryngeal Manipulation Complications
Incorrect application
May worsen visualisation of the larynx
Potential for airway trauma
65
Laryngeal Manipulation Contraindications
Active Vomiting
66
Laryngeal Manipulation Indications
Sub-optimal visualisation of the larynx during direct laryngoscopy
67
Laryngoscope Sizes
Laryngoscope Sizes
* Infant - Miller Size 0
* Small child - Miller Size 1
* Large child - Macintosh size 2
* Small adult - Macintosh size 3
* Large adult - Macintosh size 4
68
Magill Forceps Complications
Trauma to the tissue surrounding the pharynx uvula and tongue
Manipulating a partially obstructed airway may cause the object to totally occlude the airway
69
Magill Forceps Contraindications
Patients with an effective cough
70
Magill Forceps Indications
Removal of pharyngeal foreign bodies causing airway obstruction in an obtunded patient
To facilitate the insertion of an orogastric tube
71
Manual In-Line Stabilisation (MILS) Complications
Difficult Laryngoscopy
72
Manual In-Line Stabilisation (MILS) Contraindications
Nil in this setting
73
Manual In-Line Stabilisation (MILS) Indications
Stabilisation of the head and neck in a patient with suspected cervical spine injury
74
Medication Labelling
Medication Labelling
* Medication label must be fixed to syringe
* Label must not prevent reading the volume markers
* Ampoule must be secured to syringe
* Tape should cover the sharp edge of the vial
75
What are the Modified Valsalva Manoeuvre Complications?
Syncope
Prolonged hypotensive state
76
What are the Modified Valsalva Manoeuvre Indications?
Haemodynamically stable Supraventricular Tachycardia (SVT)
77
What are the Modified Valsalva Manoeuvre steps?
1. Obtain a baseline ECG (12 lead if authorised)
2. Explain the procedure to the pt
3. Postion the patient in a semi-recumbent position
4. Instuct the pt to perform a forced expiration into a sterile 10 mL syringe for 15 seconds
5. Remove syringe and lay pt supine with legs raised straight to 45 degrees for 15 seconds
6. Reposition pt to semi-recumbent position for 45 seconds
7. Repeat 12 Lead ECG
8. Confirm if modified valsalva has been successful, if not, consider repeating the procedure to a maximum of 3 attempts
78
What are the Modified Valsalva Manoeuvre Contraindications?
Glaucoma
Retinopathy
Atrial fibrillation/flutter
Aortic stenosis
AMI in past 3 months
SBP \<90mmHg
Requirement for cardioversion
3rd trimester pregnancy
79
Nasopharyngeal Airway Complications
airway trauma, particularly epistaxis
incorrect size or placement will compromise effectiveness
exacerbate injury in base of skull fracture, with NPA potentially displacing into the cranial vault
can stimulate gag reflex in sensitive Pts, precipitating vomiting or aspiration
80
Nasopharyngeal Airway Contraindications
nil in this setting
81
Nasopharyngeal Airway Indications
Potential or actual airway obstruction
82
What are the nebulisation complications?
Nil in this setting
83
What are the nebulisation contraindications?
Nil in this setting
84
What are the nebulisation indications?
Nebuliser Mask:
The administration of medications via the NEB route
T-Piece Nebuliser:
the administration of medications via the NEB route in Pts requiring posive pressure ventilation via a BVM
the administration of medications via the NEB route in Pts receiving O2 CPAP
85
What are the non-invasive ventilation - CPAP complications?
corneal drying
aspiration
barotrauma
hypotension
gastric distension
86
What are the non-invasive ventilation - CPAP contraindications?
pts \<16 years
GCS ≤ 8
hypotension (SBP \<90 mmHg)
facial trauma
epistaxis
inadequate ventilatory drive
pneumothorax
87
What are the non-invasive ventilation - CPAP indications?
acute pulmonary oedema
88
Non-Invasive Ventilation - CPAP O2 Concentration
8L/min 5.0cm H20 54% O2
12L/min 10.0cm H2O 62% O2
15L/min 15.0cm H2O 67% O2
89
NPA Sizes
NPA Sizes
90
OPA Size 9
adult male - yellow
91
What are the oral drug administration complications?
Aspiration & airway compromise
92
What are the oral drug administration contraindications?
Impaired conscious state or swallowing ability
93
What are the oral drug administration indications?
administration of medications by the oral route
94
Oropharyngeal Airway (OPA) Complications
Airway trauma from incorrect OPA Placement
Intolerance of OPA requiring removal
Can precipitate vomiting/aspiration in a patient with an intact gag reflex
Incorrect size or placement can potentially exacerbate an airway obstruction
95
Oropharyngeal Airway (OPA) Contraindications
conscious Pts
Pts with intact gag reflex
96
Oropharyngeal Airway (OPA) Indications
Maintain airway patency
Bite block for intubated patients - CCP only
97
**Oxygen Mask Flow Rates**
**Oxygen Mask Flow Rates**
nasal prongs = 2-4l/min
hudson mask = 6-8l/min
NEB = 6-8l/min
CPAP = 8, 12 15l/min
non-rebreather = 15l/min
BVM = 15l/min
98
Pelvic Circumferential Compression Device - SAM PELVIC SLING Indications
Suspected pelvic fracture with evidence of haemodynamic compromise
99
Pelvic Circumferential Compression Device SAM PELVIC SLING Contraindications
suspected isolated neck of femur fracture
suspected traumatic hip dislocation
100
Phases of valsalva manouvre
1 - increased intrathoracic pressure increases BP
2 - decreased venous return reduces BP and increases systemic vascular resistance
3 - decrease intrathoracic pressure and BP and compensatory increase HR
4 - increased venous return causes increased cardiac output and BP
= reflex bradycardia
101
What are the positive end expiratory pressure (PEEP) contraindications?
Absolute
- Hypotension (SBP \<90mmHg)
Relative
- Broncho-pleural fistula
- Hypovolemia
- Pneumothorax
- Uni-lateral lung disease
102
What are the positive end expiratory pressure (PEEP) indications?
* Pulmonary oedema (cardiogenic and non-cardiogenic)
* Asthma and COPD patients (with Sp02 <90% on a FiO2 >65%)
* Profound hypoxaemia associated with:
- Flail segment(s)
- Pulmonary contusions
- Aspiration
* Newborn resuscitation
103
What are the positive end expiratory pressure (PEEP) complications?
Caution in asthma and obstructive lung disease due to increased risk of air trapping and causing a pneumothorax. PEEP levels should be kept low (\<5cm H20) for this group of patients
Hypotension
104
Priming of a (Gravity Flow) Giving Set Complications
Air embolism
Infection
105
Priming of a (Gravity Flow) Giving Set Contraindications
Nil in this setting
106
Priming of a (gravity flow) Giving Set Indications
To prepare a giving set prior to the administration of fluids via an appropriately placed cannula
107
Priming of a Microbore Extension Set Complications
air embolism
infection
108
Priming of a Microbore Extension Set Contraindications
nil
109
Priming of a Microbore Extension Set Indications
To prepare a Microbore Extension set prior to the administration of IV enoxaparin using a pre-filled graduated syringe
110
Priming of an Alaris™ two-way extension set (with clamps) Indications
administration of simultaneous medications
111
Priming of an Alaris™ two-way extension set (with clamps) Complications
air embolism
infection
112
Priming of an Alaris™ two-way extension set (with clamps) Indications
To prepare an Alaris™ 2-way extension set (with clamps) prior to the administration of medications and/or fluids through an appropriately placed cannula.
113
Prometheus Pelvic Splint Complications
pressure areas
tissue necrosis
114
Prometheus Pelvic Splint Contraindications
Suspected isolated:
neck of femur fracture; or
hip dislocation
115
Prometheus Pelvic Splint Indications
Mechanism of injury suggestive of pelvic fracture(s) with any of the following criteria:
- Haemodynamic compromise (HR\>100 or SBP \<90mmHg)
- GCS \<13
- Distracting injury
- Abnormal clinical assessment of the pelvis with high likelihood of fracture
116
Rapid Discontinuation Criteria
Rapid Discontinuation Criteria
CPR may be discontinued before the expiration of 20mins if:
* Pt is unresponsive and pulseless for at least 10mins prior to the arrival of the paramedic
* No CPR was provided during this period
* Role criteria satisfied
* Asystole or PEA \<40/min.
117
Recognition of Life Extinct
* No palpable carotid pulse
* No heart sounds heard for 30 continual seconds
* No breath sounds heard for 30 continual seconds
* Fixed dilated pupils
* No response to central stimuli
118
Respiratory/Bag Valve Mask Ventilation Complications
Gastric inflation
Pulmonary barotrauma
Undesirable cardiovascular effects such as hypotension, secondary to caval compression
119
Respiratory/Bag Valve Mask Ventilation Contraindications
spontaneously breathing patients with adequate tidal volume and an appropriate respiratory rate (RR\>10)
120
Respiratory/Bag Valve Mask Ventilation Indications
Acute respiratory distress, hypoventilation (RR\<10) or arrest requiring positive pressure ventilation
121
SAM Splint Complications
iatrogenic injury due to poor splint application technique
122
SAM Splint Contraindications
Nil
123
SAM® Splint Indications
suspected fractures and dislocations of the upper limbs
124
Simple Bandaging and Slings Complications
Compromised perfusion due to restricted circulation
125
Simple Bandaging and Slings Contraindications
Nil in this setting
126
Simple Bandaging and Slings Indications
Wound cover and limb support
127
Skin Closure - Steri-Strip Complications
Wound dehiscence
Infection
Cosmetic (e.g scarring)
128
Skin Closure - Steri-Strip Contraindications
Deeper wounds unable to easily approximated
Wounds on mucosal surfaces or mucocutaneous junctions
Wounds under tension
Wounds on mobile parts of the body (eg joints)
129
Skin closure - Steri-Strip Indications
Uncontaminated simple lacerations that are:
- ≤ 2cm in length; AND
- have easily apposed wound edges
130
Spring Infusion Pump - Springfusor 30
Air embolism
Pain or discomfort on medication administration
Infection
Extravasation and possible tissue necrosis
131
Spring infusion pump - Springfusor 30 Indications
intermittent IV infusion of small volumes as specified in QAS DTS’s
132
Spring Infusion Pump - Springfusor 30 Contraindications
Evidence of misplaced or dislodged access
133
What are the subcutaneous injection (SUBCUT) complications?
Pain
Bleeding
134
What are the subcutaneous injection (SUBCUT) contraindications?
injection of medications into scar tissue, burns, bruises, infection or broken skin
135
What are the subcutaneous injection (SUBCUT) indications?
Administration of medications via the SUBCUT route
136
What are the sublingual drug administration contraindications?
Nil in this setting
137
What are the sublingual drug administration complications?
Nil in this setting
138
What are the sublingual drug administration indications?
The administration of medication via the SUBLING route
139
**Suction Rates**
**Suction Rates**
Neonates 60-80mmHg
Paediatrics 80-100mmHg
Adults 80-120mmHg
140
Supraglottic Airway I-gel Complications
Failure to provide adequate airway or ventilation
Patient intolerance
Hypoxia
Can precipitate vomiting and aspiration in a patient with intact airway reflexes
Oropharyngeal trauma
141
Supraglottic Airway I-gel Contraindications
Conscious breathing patients
Continuous used for \> 4 hours
142
Supraglottic Airway I-gel Indications
Actual loss of airway patency and/or airway protection
143
The Emergency Bandage Complications
nil in this setting
144
The Emergency Bandage Contraindications
nil in this setting
145
The Emergency Bandage Indications
Traumatic wounds requiring haemostasis
146
Tooth Replantation Complications
Haemorrhage
Pain
Rejection
Tooth fusion to the bone
147
Tooth Replantation Contraindications
Prioritisation of other traumatic injuries
Primary (baby) tooth
Out of socket time \>60ins
Distressed patient
Compromised integrity of the avulsed tooth or supporting tissues (obvious deformity, decay)
Compromising medical condition (immunocompromised, severe congenital cardiac abnormalities, severe uncontrolled seizure disorders, severe mental disability, severe uncontrolled diabetes)
148
Tooth Replantation Indications
Permanent (adult) tooth that is:
- Avulsed tooth
- Grossly mobile luxated nearing avulsion
149
Triple Airway Manoeuvre Complications
Potential C-spine injury
150
Triple Airway Manoeuvre Contraindications
Nil in this setting
151
Triple Airway Manouevre Indications
Patients unable to maintain patency
152
Vacuum Splint Complications
Vacuum splints may require further extraction of air to maintain rigidity during aeromedical transport
153
Vacuum Splints Contraindications
Nil in this setting
154
Vacuum Splints Indications
Suspected fractures and dislocations of arms, legs, or joints
Spinal immobilisation or full body splinting where appropriate for infants or small children
155
Waveform Capnography Complications
When performing effective CPR during cardiac arrest, EtCO2 values are not to be used to vary IPPV from the recommended rate
156
Waveform Capnography Contraindications
nil in this setting
157
Waveform Capnography Indications
CPR
Ongoing monitoring of ventilation
sedation
158
Y Suction Catheter Sizes
6, 8, 12, 16 FG
159
OPA Size 3
neonate - lilac
160
OPA Size 4
infant - pink
161
OPA Size 5
toddler - blue
162
OPA Size 6
small child - black
163
OPA Size 7
child - white
164
OPA Size 8
adolescent/adult female - green
165
Modified Valsalva Manouevre Pathophysiology
Straining increases intrathoracic pressure, compresses the aorta and increases systolic BP by ≥ 15mmHg for approximately 5 seconds. Venous return, preload and BP decreases which then increases cardiac output causing arterial vasoconstriction and increasing venous return and heart rate.
Releasing strain decreases intrathoracic pressure and BP below baseline for a few seconds and increases heart rate. Blood rushes back into the heart increasing cardiac output, stimulating the vagus nerve resulting in reflex bradycardia and BP returning to baseline
166
What are the 12-Lead ECG low threshold circumstances?
* ALOC
* Syncope
* Overdose
* Envenomation
* Electrolyte disorders
* Grossly altered vital signs
167
What are the 12-Lead ECG acquisition indications?
Any patient requiring detailed ECG analysis:
- suspected ACS
- cardiac dysrhythmias
- conduction disturbances
- electrolyte imbalances
- drug toxicity
168
What are the 12-Lead ECG acquisition contraindications?
Nil
169
What are the 12-Lead ECG acquisition complications?
Nil
170
What are the ECG electrode placement locations?
V1 - 4th Intercostal space, right of the sternum
V2 - 4th Intercostal space, left of the sternum
V4 - 5th Intercostal space, on left midclavicular line
V3 - Midway between V2 and V4
V5 - Midway between V4 and V6
Optional - V4R - 5th intercostal space, on the right midclavicular line (annotate printout)
171
How do you do a 12 Lead on a Lifepak 15?
1. Press 12-LEAD button
2. Enter age into AGE menu
3. Enter sex into SEX menu
12 lead is then acquired, analysed and printed
172
How do you do EtCO2 monitoring on a Lifepak 15?
1. Select EtCO2 accessory for the patient
2. Open CO2 port door and insert FilterLine connector and turn clockwise until tight
3. Verify CO2 area is displayed
4. Display CO2 waveform in Channel 2 or 3
5. Connect FilterLine set to the patient
6. Confirm the EtCO2 waveform is displayed
173
How do you do a 12 Lead on a Corpuls3?
1. Press the Monitor Key
2. Press the D-ECG soft-key
3. Confirm that the diagnostic frequency of 0.05–150 Hz is displayed
4. When ‘Ready for D-ECG’ is displayed, press the Start soft-key
5. When requested, enter the patient’s gender and age, press the OK soft-key
6. Press the Print soft-key
174
What are the most frequent PEA rhythms?
sinus bradycardia
junctional
idioventricular
175
What are the Corpuls3 joules for adults and children 9yrs and older?
200j
176
What are the Corpuls3 joules for a paediatric Pt?
4j/kg
177
What are the Lifepak 15 joules for adults and children 9yrs and older?
200j
300j
360j
178
When doing CPR when is the heel of one hand used?
children 1-8 yrs of age
179
When doing CPR when is the two hand technicque used?
children 9-12 years
adults
180
When doing CPR when is the two finger technique used?
children less than 1 year incl newly born
181
When doing CPR when is the two thumbs method used?
newly born
children less than 1 year
182
How many direct laryngoscopy attempts are each officer allowed?
2
183
What can you see the Cormack-Lehane airway Grade I classification?
complete glottis
184
What can you see the Cormack-Lehane airway Grade II classification?
anterior glottis not seen
185
What can you see the Cormack-Lehane airway Grade III classification?
epiglottis seen, but not glottis
186
What can you see the Cormack-Lehane airway Grade IV classification?
epiglottis not seen
187
What is the appropriate position of the head for direct laryngoscopy?
neutral position - with MILS if c-spine suspected
infant - slight elevation of the shoulders
small child - slight extension of the head
older child/adult - extension of the head (possibly elevation)
188
What are the movements for the BURP positioning in laryngeal manipulation?
backwards (towards spine)
upwards (towards jaw)
rightwards (the Pt's right)
189
Which way does the bevel (shorter edge) of an NPA face when inserting?
nasal septum
190
OPA size 10
large male - red
191
What age Pt can an ACPII insert an i-gel?
>8 yrs
192
What are the BGL indications?
POC glucose assessment
193
What are the BGL contraindications?
routine use in newly borns unless clinically indicated
194
What are the BGL complications?
nil in this setting
195
What are the pulse oximetry indications?
to determine Pt oxygen saturation
assessment of the newborn
196
What are the pulse oximetry contraindications?
nil in this setting
197
What are the pulse oximetry complications?
reliability depends on:
correct sensor size and placement
adequate arterial blood pulsation through the sensor site
excessive Pt movement
ambient light
dirt/mailpolish
methaemoglobinaemia
carbon monoxide
insifficient amplitude on the pulsing pleth wave
198
What are the tympanic temperature indications?
monitoring of temperature when clinically indicated
199
What are the tympanic temperature contraindications?
blood or drainage in the ear canal
acute or chronic inflammatory conditions of the external ear canal
perforated tympanic membranes
200
What are the tympanic temperature complications?
nil
201
What colour syringe do you use for the oral administration of liquid drugs?
purple
202
What are the locations for emergency chest decompression - cannula and pneumodart?
2nd intercostal space midclavicular line of the affected side
203
What age are paediatric patients?
12 or less
204
How do you calculate paediatric's weight?
(age x 3) + 7 = weight in kgs
205
What is the weight of a neonate?
3.5 kgs
206
What are the HR, RR and SBP of a neonate?
HR 100 - 160
RR 25 - 50
SBP 60 - 70
207
What is the weight of a 6 month old?
7 kgs
208
What are the HR, RR and SBP of a 6 month old?
HR 100 - 160
RR 25 - 50
SBP 70 - 100
209
What are the HR, RR and SBP of a 1 year old?
HR 90 - 150
RR 25 - 50
SBP 70 - 100
210
What are the HR, RR and SBP of a 2 - 5 year old?
HR 80 - 140
RR 20 - 30
SBP 80 - 110
211
What are the HR, RR and SBP of a 6 - 12 year old?
HR 70 - 120
RR 15 - 25
SBP 90 - 115
212
Inhalation − Metered Dose Inhaler (MDI) Indications
For the delivery of MDI medications
213
Inhalation − Metered Dose Inhaler (MDI) Complications
MDI with spacer
- Poor procedural compliance reducing
drug delivery
MDI with connector (22M−22F)
- Nil in this setting
214
Inhalation − Metered Dose Inhaler (MDI) Contraindications
MDI with spacer
- Foreign body airway obstruction
MDI with connector (22M−22F)
- Nil in this setting
215
What are the emergency chest decompression - cannula complications?
* Improper diagnosis and insertion may cause a simple or tension pneumothorax
* Incorrect placement may result in life-threatening injury to the heart, great vessels or damage to the lung
* Bilateral pleural decompression in the spontaneously breathing patient may result in significant respiratory compromise
216
What are the components of the falls assessment tool?
Fall History - within previous 12 months
Medications - more than 4
Medical History - Stroke or Parkinson's Disease
Stability - problems with balance
Core Strength- stand on their own without arms
