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WFR Flashcards

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1
Q
A
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2
Q

Initial assessment

A

ABCDE

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3
Q

ABCDE

A

Airway
Breathing
Circulation
Disability (or Decision)
Environment (or Expose)

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4
Q

Initial assessment:
Airway, if patient responsive

A

Check for diminished level of responsiveness
Look/listen for airway issues
Consider recovery position
Drain fluids & sweep material from mouth if found

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5
Q

Initial assessment:
Breathing, if patient responsive

A

Quickly assess for adequate breathing
If inadequate, consider rescue breaths

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6
Q

Initial assessment:
Circulation, if patient responsive

A

Scan body for heavy bleeding; if found, control it immediately
Check skin signs; if shock suspected, tx for it

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7
Q

Initial assessment:
Disability aka Decision, if patient responsive

A

If MOI causes suspicion for spinal injury, initiate spinal precautions

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8
Q

Initial assessment:
Environment or expose, if patient responsive

A

Environment: Will environmental conditions impact survival? If so, move or protect patient

Expose: Expose and treat life threatening injuries

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9
Q

Initial assessment:
Airway, if patient unresponsive

A

Check for response - tap and ask “Are you alright?”

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10
Q

Initial assessment:
Breathing, if patient unresponsive

A

Position pt face up on firm, flat surface
Look at face/chest for normal breathing - take no more than 10 seconds; if unsure, assume not normal
Weak, irregular gasping, snorting, or gurgling is not normal

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11
Q

Initial assessment:
CDE for unresponsive patient

A

If not breathing or only gasping, do CPR
If normal breathing + uninjured, recovery position
Resume initial assessment only if circumstances allow

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12
Q

Focused assessment (aka secondary assessment) consists of

A

chief complaint
physical exam
SAMPLE history
vitals

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13
Q

Goal of focused assessment (aka secondary assessment)

A

Find every problem that requires medical care

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14
Q

What order do the steps of focused assessment go in?

A

If it’s looking like an injury: Physical exam > VS > SAMPLE

If it’s looking like an illness: SAMPLE > VS > Physical exam

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15
Q

What are you looking for when doing physical exam?

A

DOTS

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16
Q

Physical exam:
What does DOTS stand for?

A

Deformity
Open wounds
Tenderness
Swelling

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17
Q

Physical exam:
Head

A

Inspect head/scalp - look for blood
Check eyes, ears, nose
Check mouth, teeth, jaw
Check for unusual odors & breathing sounds

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18
Q

Physical exam:
Neck

A

Feel sides & back of neck
Look for stoma
Check for medical alert necklace

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19
Q

Physical exam:
Shoulders & chest

A

Press shoulders together
Feel collarbones
Press gently on sternum
Press both sides of ribcage while pt takes breath
Inspect chest wall

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20
Q

Physical exam:
Abdomen & pelvis

A

Press 4 quadrants of abd
Place hands on hips & press inward
Inspect for incontinence & priapism

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21
Q

Physical exam:
Extremities

A

Feel full length of each leg & arm, front & back
Check each hand & foot for CSM

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22
Q

Physical exam:
CSM

A

Circulation
Sensation
Motion

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23
Q

Physical exam:
Back

A

Log roll pt & inspect back

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24
Q

Vital signs

A

level of responsiveness
HR (which also tells you about BP)
RR
skin signs
pupil response

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25
VS - LOR: Orientation questions
What's your name? Do you know where you are? Do you know when it is? Do you know what happened to you?
26
VS - LOR: How it's described
AVPU Alert: Alert & openly responsive Verbal: Responsive to verbal stimulus; e.g. they respond when you ask them a question or say their name Physical: They respond only to physical stimulus such as shaking or squeezing U: Unresponsive
27
VS - HR: How to check pulse
Check radial pulse in thumb size of wrist for 15 seconds Or check carotid if needed: Find adam's apple, slide 2 fingers into groove on either side of neck between bony cartilage & neck muscle Note how strong the pulse is and how regular it is
28
VS - BP: How to check
If they have a radial pulse, then BP is at least reasonably decent
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VS - RR: How to check respirations
Don't tell the pt you're counting their breath Notice rhythm: Regular or irregular Notice effort: Easy or labored, shallow or deep Listen for unusual breath sounds
30
VS - RR: Normal RR
12-20 breaths/min
31
VS - Skin signs: What you're looking at
TCTM
32
VS - Skin signs: TCTM
tissue color (skin) temperature (skin) moisture
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VS - What do skin signs indicate?
How well pt is perfusing
34
VS - What does tissue color indicate?
Light pink: Normal Pale: Blood loss or shock Bluish: Lack of oxygen Red or flushed: May indicate serious underlying issue
35
VS - Where to check tissue color for pt with darker skin?
palm fingernails inside lip inside eyelid
36
VS - How to check temperature?
back of your hand on their forehead
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VS - Pupils: What you're looking for
PERRL: Pupils should be equal, round, and reactive to light
38
VS - How frequently to check VS?
q15min; more often if pt seriously ill/injured
39
What does SAMPLE stand for?
Symptoms Allergies Medications Past medical history Last ins & outs Events leading up to current situation
40
SAMPLE: Symptoms
How do you feel? Where does it hurt? Can you describe the pain? How bad is the pain?
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SAMPLE: Allergies
Are you allergic to anything? What happened when you had the allergy?
42
SAMPLE: Medications
Do you take any medications? What are the medications for? Have you been taking them as directed? Have you had any alcohol or recreational drugs?
43
SAMPLE: Past medical history
What medical problems do you have? Do you see a doctor for anything? What medical problems have you had in the past?
44
SAMPLE: Last input & output
What was the last thing you had to eat or drink? When was that? Was that out of the ordinary for you? When did you last pee and poop? Was that normal for you?
45
SAMPLE: Events leading up to current situation
What were you doing just before this happened? Were you doing anything out of the ordinary for you?
46
Definition of shock
Body's inability to meet oxygen demand, due to illness or injury
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Causes of shock
Fluid loss - due to bleeding, vomiting, diarrhea, sweating, burns Heart not pumping adequately - due to breathing difficulty, HF, heart attach Abnormal dilation of blood vessels - due to spinal injury, anaphylaxis, poisoning, drugs, infection
48
Initial sxs of shock
Pt uneasy, restless, worried
49
Later sxs of shock
confusion, drowsiness skin pale, cool, sweaty rapid/weak pulse rapid/shallow breathing
50
What to feed pt in shock
Nothing, even if they want food
51
Shock - fast or slow evac?
Fast
52
Bright red blood that might be spurting
arterial
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Dark red blood that's flowing steadily
venous
54
How to control bleeding?
Direct pressure
55
What do you do before applying direct pressure to wound?
Quickly expose the wound to try to identify the point of bleeding
56
How to use direct pressure to control bleeding
Use pad/dressing; if not available just use clean fabric or gloved hand Apply firm pressure with fingers or palm directly on bleeding site; push hard if needed, even if painful
57
Bleeding: What do you do if blood soaks through the pad?
Leave initial pad in place to maintain clot Add a second pad Replace second pad if needed - too much padding can reduce effectiveness of pressure
58
What do you do once bleeding is controlled?
Maintain direct pressure until higher level of care Check frequently to ensure bleeding remains controlled
59
How to use pressure bandage
Place it: Put hard embedded pressure piece over point of bleeding Wrap it: Wrap around limb, overlapping first wrap to secure the pad & pressure piece in place. Tightly apply additional wraps on top of pressure piece; use twists in bandage to apply focused pressure. Secure it: Using hook at the end Monitor it: Check frequently to ensure bleeding remains controlled.
60
Where to put tourniquet
A few inches above the wound Not on a joint
61
How to use commercial tourniquet
Place it. Apply compression: Use cinching mechanism to tighten til bleeding stops. Secure it: Lock cinching mechanism in place.
62
How to use improvised tourniquet
Wrap snugly around limb & tie half knot to secure. Apply compression: Place stick-like object on top of half knot & twist to tighten til bleeding stops. Secure it: Wrap tails of band around stick to prevent unwinding & tie stick in place.
63
What do you do after placing tourniquet?
Document time of application & inform when handing off pt. Check frequently to ensure bleeding remains controlled. Don't loosen or remove unless directed by medical personnel.
64
When would you do a packed dressing?
When direct pressure doesn't control bleeding & a tourniquet can't be used effectively.
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WFR (2 decks)

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