Skills and Procedures - Indicators, Contraindicators and Precautions Flashcards
1
Q
Indications for an OPA
A
- Maintain airway patency
- Bite block for intubated patients
2
Q
Contraindications for an OPA
A
- Conscious Patient
- Patients with an intact gag reflex
3
Q
Precautions of an OPA
A
- Airway trauma
- Intolerance of OPA requiring removal
- Vomiting or aspiration in a patient with an intact gag reflex
- Incorrect size or placement can potentially exacerbate airway obstruction
4
Q
Procedure for inserting an OPA
A
- Measure the OPA from the centre of the patients mouth to the angle of their jaw
- Insert the OPA upside down
- insert the OPA 1/3 of the way, rotate 180 degrees and push until flush with patients lips
- check patient tolerates the airway
5
Q
Indications for an NPA
A
Potential or actual airway obstruction
6
Q
Contraindication for an NPA
A
Nil
7
Q
Precautions for an NPA
A
- Airway trauma, particularly epistaxis
- incorrect size or placement will compromise effectiveness
- exacerbate injury in a base of skull fracture
- Can stimulate gag reflex in sensitive patients - vomiting or aspiration
8
Q
Procedure for an NPA
A
- measure the NPA from the top of the nose to the earlobe
- lube
- insert the NPA so the bevel is facing the nasal septum
- slowly insert the NPA following the natural curvature
- if the NPA gets stuck give it a little wriggle and see if you can get past
- check the patient is tolerating the airway
9
Q
Indications for an Igel
A
Actual loss of airway patency and/or airway protection
10
Q
Contraindications for an Igel
A
- Conscious breathing patients
- Continuous use for more than 4 hours
11
Q
Precautions for an Igel
A
- Failure to provide adequate airway or ventilation
- Patient intolerance
- Hypoxia
- Can precipitate vomiting and aspiration in a patient with intact airway reflexes
- Oropharyngeal trauma
12
Q
Indications for a Direct Laryngoscopy
A
Visualisation of the glottis for removal of a foreign body
13
Q
Contraindications for a direct laryngoscopy
A
- suspected or known epiglottis (infection causing swelling of the epiglottis which can block the airway)
- Patients with an effective cough
14
Q
Precautions for a direct laryngoscopy
A
- Laryngospasm
- Hypoxia due to oxygenation delays while performing the procedure
- Trauma to the mouth or upper airway - particularly the teeth
- Exacerbation of underlying C-spine injuries
- Vomiting or regurgitation
15
Q
Indications for Magill Forceps
A
Removal of pharyngeal foreign bodies causing an airway obstruction
16
Q
Contraindications for Magill Forceps
A
Patients with an effective cough
17
Q
Precautions for Magill Forceps
A
- Trauma to the tissue surrounding the pharynx uvula and tongue
- Manilupating a particualrly obstructed airway may cause the object to totally occlude the airway
18
Q
Indications for Laryngeal Manipulation
A
Sub-optimal visulation of the larynx during direct laryngoscopy - only when asked by CCP
19
Q
Contraindications for Laryngeal Manipulation
A
Active vomiting
20
Q
Precautions for Laryngeal Manipulation
A
- Incorrect application
- May worsen visualization of the larynx
- Potential for airway trauma
21
Q
Indications for TAM
A
Patients unable to maintain airway patency
22
Q
Contraindications for TAM
A
Nil
23
Q
Precautions for TAM
A
- Potential C-spine Injury - DAM
- Infants have a soft trachea so keep head in a neutral position
24
Q
Indications for a 12 Lead ECG
A
Any patient requiring a details ECH analysis
25
Contraindications for a 12 lead ECG
Nil
26
Precautions for a 12 Lead ECG
Nil
27
Indications for a Chest seal
Open Pneumothorax
28
Contraindications for a chest seal
Nil
29
Precautions for a chest seal
1. Occlusion of the dressing can cause a tension pneumothorax, air has to be able to esacpe the dressing
30
Indicators of a BVM
Acute respiratory distress
Hypoventilation - resp rate less than 10
31
Contraindications of a BVM
Spontaneously breathing patients with adequate tidal volume and resp rate
32
Precautions of a BVM
Gastric inflammation
Pulmonary barotrauma
Undesirable cardiovascular effects such as hypotension secondary to cabal compression
33
Indications of Waveform Capnography
CPR
Sedation
Endicrital tube
Ongoing monitoring of ventilation
34
Contraindications of waveform capnography
Nil
35
Precautions of waveform capnography
When performing CPR don’t use it to adjust ventilation rates
36
Indications of oral drug administration
The administration of medications orally
37
Contraindications of oral drug administration
ALOC
Impaired ability to swallow
38
Precautions of oral drug administration
Aspiration and airway compromise
39
Indications of sublingual drug administration
Administer medications by the sublingual route
40
Indications for administering medications MDI
administering medications via the MDI Route
40
Contraindications of administering medications via the sublingual route
Nil
40
Precautions of administering medications by the sublingual route
Nil
41
Contraindications for administering MDI medication
Foreign body airway obstruction
42
Precautions of MDI administration
Poor procedural compliance limiter effectiveness, patient must be instructed well
43
Indications for nebulisation
Administering medications via nebulisation
43
Contraindications for nebulisation
Nil
44
Precautions for nebulisation
Nil
45
Indications for IM administration
Required IM drug administration
45
Contraindications for IM drug administration
Inadequate muscle mass at the injection site
Patient is in cardiac arrest
Ability to administer the medication by an equally effective and less invasive route
46
Complications for IM drug administration
Pain
Minor haemorrhage
Abscess formation
Cellulitis
Nerve and blood vessel damage
47
Indications for NAS drug administration
Administering medications via the NAS Route
47
Contraindications for NAS drug administration
Suspected nasal fractures
Blood/mucus obstructing the nasal passage
48
Complications for NAS drug administration
Underdosing if administered incorrectly
Mild short lasting nasal discomfort
49
Indications for subcutaneous drug administration
The administration of medications via the subcutaneous route
50
Contraindications of subcutaneous drug administration
Don’t inject into scar tissue, burns, infection, broken skin, etc
50
Complications of drug administration via the subcutaneous route
Pain
Bleeding
51
Indications of Alaris gravity flow giving set
Administration of fluids through a cannula for rehydration
52
Precautions for a Alaris gravity flow giving set
Air embolism
Infection
52
Contraindications for a Alaris gravity flow giving set
Nil
53
Spring fusor indications
administer medications over a period of time
53
spring Fusor contraindications
evidence of misplaced or dislodged access
54
springfusor precautions
pain or discomfort
Air embolism
Infection
Extravasation and possible tissue necrosis
55
Indicators for two way extension giving set
Can administer fluids and. medications at the same time
56
Complications of two way extension giving sets
Air embolism
Infection
56
Contraindications of two way extensions set with clamps
The the administration of simultaneous medications
56
Micro bore extension set indications
Administer of IV enoxaparin using a pre-filled graduated syringe
57
Micro bore extension set contraindications
Nil
57
Micro bore extension set complications
Air embolism
Infection
57
IV cannulation indications
Vascular access for the administration of medication, hydration and/or blood products
58
IV cannulation contraindications
Wherever possible avoid sites of burns, infection, trauma or significant oedema
59
IV cannulation complications
Redness, pain, swelling of the vein
Localised or systemic catheter or line related infection
Drug or fluid extravasation into superficial tissue
60
Contraindications for the administration of Salbutamol
Allergy and/or adverse drug reaction
Patients less than 1 year old
61
Precautions for the administration of Salbutamol
Acute pulmonary oedema
Ischaemic heart disease
62
Indications for the administration of Ipratropium bromide
Moderate bronchospasm - unresponsive to initial QAS salbutamol NEB
Severe bronchospasm
63
Contraindications for the administration of Ipratropium bromide
Allergy and/or adverse drug reaction
Patients less than 1 year old
64
Precautions for the administration of Ipratropium bromide
Glaucoma
65
Indications for Hydrocortisone
Asthma - excludes mild
Acute exacerbation of COPD - with evidence of respiratory distress
Refractory anaphylaxis with persistent wheeze
Suspected or at risk of acute adrenal insufficiency - adrenal crisis
66
Contraindications for Hydrocortisone
Allergy and/or adverse drug reaction
67
Precautions for Hydrocortisone
Hypertension
68
Indications for Glucose Gel
Symptomatic hypoglycaemia with the ability to self-administer oral glucose
69
Contraindications for Glucose Gel
Unconsciousness
Patients with difficulty swallowing
Patients less than 2 years old
70
Precautions for Glucose Gel
Nil
71
Indications for Glucagon
Symptomatic hypoglycaemia with inability to self-administer oral glucose
72
Contraindications for Glucagon
Allergy and/or adverse drug reaction
73
Precautions for Glucagon
Nil
74
Indications for Midazolam
Generalized seizures
Focal seizure with a GCS of 12 or less
75
Contraindications for Midazolam
Allergy and/or adverse drug reaction
76
Precautions for Midazolam
Reduce dose if the patient has low body weight, older, cachectic or frail patients, chronic renal failure, congestive cardiac failure or shock (If unsure, give a half dose and call consult line)
Can cause severe respiratory depression in patients with COPD
Myasthenia gravis
Multiple sclerosis
77
Indications for Paracetamol
Mild to moderate pain
Fever - causing distress
78
Contraindications for Paracetamol
Allergy and/or adverse drug reaction
Patients less than 1 month old
79
Contraindications for Paracetamol
Hepatic (renal) dysfunction
Soluble tablets - sodium restrictions (heart failure, chronic kidney disease, sodium restriction and phenylketonuria
