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85 Cards in this Set

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What Is Done Before The Scene Survey Starts?
Put On BSI (PPE) Which Includes Gloves, Goggles, Mask, And Gown
Once BSI Is On, What's The First Part Of The Scene Survey?
SPERM
What Does SPERM Stand For?

S - Is The SCENE SAFE For Myself, Partner, Bystanders And The Patient?


P - How Many PATIENTS Are There?


E - Is There Anything In The ENVIRONMENT That Could Impede My Approach Or Affect Safety?


R - I Would Like The Following Resources:


M - What Is The Mechanism Of Injury?

What Resources Could I Ask For?

EMR, Fire, Police, Poison Control, HazMat, Utilities: Power Company
When Must Spinal Precautions Be Taken?
Any Trauma And All Unconscious Patients
After SPERM, What Is The Next Step?
Delegate Partner To INTERVIEW BYSTANDERS
After My Partner Is Sent To Interview Bystanders, What's Next?
Gather A General Impression
What Does A General Impression Include?
Age, Gender, Weight, Height, Position Found, Angulations, Bleeding, Patients Behaviour, Are They Aware Of My Presence?
What Starts After The General Impression?
Primary Survey

How Do I Start The Primary Survey

Introduction And Consent. Say: My Name Is Andrew, I Am An EMR, May I Help You?
Immediately After The Introduction, What Is Done?

If The Patient Is Unconscious Or Has Experienced Trauma, Tell The Patient To Lay Still And Delegate C-Spine Stabilization To My Partner




If They Are Conscious And There Are No Signs Of Trauma, Say: I Will Rule Out C-Spine Stabilization As There Is No Evidence Of Trauma

After C-Spine Stabilization Is Taken Or Ruled Out, What Is Done Next?
Assess The Patients Level Of Consciousness
How Do You Assess The Patients LOC?

AVPU - Are They Alert? Responsive To Verbal? Responsive To Pain? Unresponsive To Pain?

If They Are Not Alert, What Is Done?
Assess Their Response To Verbal, If Unresponsive To Verbal Then Assess Response To Pain By Pinching Webbing Between Their Fingers And If There Is Still No Response The Patient Is Unresponsive
If They Are Alert, What Is Done?

Ask Them: Do You Know Your Name? Do You Know Where You Are? Do You Know What Time It Is? Do You Remember What Happened?




A And O x 4

After LOC Has Been Assessed, What Is Done Next?
Assess ABCD's
What Do You Ask To Assess Airway?
Is The Airway Open And Clear?
If The Patient Is Unconscious, How Do I Open The Airway?
Head Tilt/Chin Lift Or Jaw Thrust (Trauma)
What Are The Interventions For Airway?
Gurgling, Snoring, Stridor, Wheezing

What Is Done For GURGLING?

Suction For 15 Seconds For Adult, 10 Seconds For Child, 5 Seconds For Infant. Give Oxygen Between Suctioning.




If The Person Is Unconscious And Suctioning Doesn't Remove Large Debris, Turn Patient Over And Do A Finger Sweep



What Is Done For SNORING?

Head Tilt/Chin Lift Or Jaw Thrust If There's Trauma


Add OPA if Unconscious, Add NPA If Conscious

What Is Done For STRIDOR?
Monitor

What Is Done For WHEEZING?
Monitor
After Assessing Airway, What Is Next?
Assess Breathing
How Do You Assess Breathing?
Look, Listen And Feel For Up To 10 Seconds, Asking: What Is The Rate, Rhythm, Depth, Quality And Effort Of Breathing?
When Do You Give Oxygen?
Directly After Assessing Breathing
If The Patient Isn't Breathing, What Do You Do?
Use A BVM: 1 Ventilation Every 5 Seconds For Adult, And 1 Ventilation Every 3 Seconds For Children
When Do You Use A BVM And When Do You Use A NRB?

BVM Is Used When Respirations Are Less Than 10 And More Than 30




NRB Is Used When Respirations Are Between 10 And 30

What Is Done After Breathing Is Assessed?
Assess Circulation
How Do You Assess Circulation?
If The Patient Is Unconscious, Take The Carotid Pulse And If The Patient Is Conscious, Take The Radial Pulse
When Assessing Circulation, What Do You Ask?
What Is The Rate, Rhythm And Quality Of The Pulse? Then Say Noted
What Do You Do If There Is No Pulse?

Start CPR At 30 To 2 For Adults, 30 To 2 For a Child Or 15 To 2 If There Are Two Rescuers And 3 To 1 For Newborns

After Circulation Has Been Assessed, What's Next?
Assess For Shock
How Do You Assess For Shock?
Ask: What Is The Patients Skin Colour And Condition?
What Do You Do If The Patients Skin Is Pale, Cool And Clammy?
Cover The Patient With A Blanket
What Do You Do If The Patients Skin Is Red, Hot And Dry?

Cool The Patient
After The Patient Has Been Assessed For Shock, What's Next?
Look For Deadly Or Life-Threatening Bleeds
If There Are Deadly Or Life-Threatening Bleeds, What Do You Do?
Treat Bleeds Immediately By Applying Direct Pressure. If It Doesn't Work, Try Again. If It still Doesn't Work, Apply A Tourniquet
After LOC And ABCD's Have Been Assessed, What Is Done?
Make A Decision To Load And Go And Explain Why
What Starts After The Primary Survey Has Been Completed?
Primary Head To Toe
What Are You Looking/Feeling For During Primary Head To Toe?
Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Lacerations, Swelling And Feeling For: Tenderness, Instability And Crepitus
Primary - Head

Looking For DCAPP-BLS And Feeling For TIC




Also Looking For: Raccoon Eyes, Battle's Sign, Drainage From The Eyes, Ears, Nose, Mouth, Lost Teeth, Colour Of The Mucosa




Reassess Airway. If An Airway Was Inserted, Check If It Is Still In Place. If Airway Was Suctioned, Check If It Is Still Clear

Primary - Neck

Looking For DCAPP-BLS And Feeling For TIC




Also Looking For: Jugular Venous Distention, Tracheal Deviation, Stoma, Medical Alerts




If The Person Is Unconscious Or Has Suffered Trauma, Apply CERVICAL COLLAR Now

Primary - Chest

Looking For DCAPP-BLS And Feeling For TIC




Also Looking For: Symmetrical Rise And Fall of The Chest, Sucking Chest Wound, Flail Chest


Determine Stability Of Chest By Placing Side Of Your Hand On Sternum While Pressing Into The Chest Wall On Both Sides




Auscultate The Lungs At The Apices And Bases, Asking: Is Air Entry Present, Equal And Clear Bilaterally?

If There Is A SUCKING CHEST WOUND, What Do You Do?
Apply An Occlusive Dressing, Taped On Three Sides

What Do You Do If There Is A FLAIL SEGMENT?
Tape A Bulky Dressing Over The Flail Segment To Stabilize It
Primary - Abdomen

Looking For DCAPP-BLS, Evisceration And Pulsating Mass. Feeling For Distention, Rigidity And Tenderness




If There Is An Evisceration Or Pulsating Mass, Do Not Palpate The Abdomen One Quadrant At A Time




Ask: Does The Patient Guard? Did I Palpate Any Pulsating Mass?



If There Is A Pulsating Mass Found In Primary, What Do You Do?


Remember Not To Palpate Again During Secondary Survey
If An Evisceration Is Found, What Do You Do?
Cover The Organs With A Moist Sterile Dressing With An Occlusive Dressing Over Top
Primary - Pelvis

Look For DCAPP-BLS, Then Check Stability Of Pelvis By Pushing In, The Pushing Down And Ask For Each Movement, Is The Pelvis Stable? Then Feel For TIC




Ask: Is There Any Incontinence, Bleeding Or Priapism?

If The Pelvis Is Found To Be Unstable In The Primary, What Do You Do?

Have Your Partner Manually Stabilize The Pelvis, A Scoop Stretcher Will Be Used To Place Patient On Spinal Board




Pelvis Will Not Be Reassessed In Secondary Survey

Primary - Lower Extremities

Look For DCAPP-BLS And Feel For TIC




Assess Pedal Pulses Bilaterally, Assess Motor Function By Having Patient Push Down And Up Into Your Hands, Assess Sensation By Squeezing A Common Toe And Having The Patient Identify It



If There Is A Fracture Of The Lower Extremities, What Do You Do?
Have A Partner Manually Stabilize It. If It Is A Bilateral Femur Fracture, A Scoop Stretcher Will Be Used To Place Patient On Spinal Board
Primary - Upper Extremities

Look For DCAP-BLS And Feel For TIC




Assess Circulation By Checking Radial Pulses Bilaterally, Assess Motor Function By Having Patient Squeeze Your Hands Bilaterally And Assess Sensation By Squeezing A Common Finger And Having Them Identify It






If There Is A Fracture, Have Your Partner Manually Stabilize It

Primary - Back

Look For DCAPP-BLS




If Patient Is Unconscious Or Has Suffered Trauma, The Back Will Be Assessed By Rolling Patient Onto Their UNINJURED Side. Spinal Board Is put Into Position And Patient Is Rolled Onto Board.

How Do You Load A Patient Into The Ambulance?

With An Extremity Lift Onto The Stretcher Or By Placing Them On A Spinal Board If There's Trauma And Securing Torso, Hips/Legs And Head. Then Lifting Them Onto The Stretcher.




Make Sure Patient, All EMR's And Any Bystanders Get Into The Ambulance As Well

What Do You Do With The Oxygen When The Patient Is Loaded Into The Ambulance?

Switch Over From The 'D' Tank To The 'M' Tank
What Should The Patient Have With Them Right Before They Enter The Ambulance?
Any And All Medication
After You Move The Patient Into The Ambulance, What's The First Thing You Do?
Reassess The Patient's LOC, ABC's And Any Interventions

After Reassessing The Patients LOC, ABC's And Any Interventions After Entering The Ambulance, What Do You Do Next?


Say: While I Obtain The Patient History, My Partner Will Assess The Vital Signs
What Are The Vitals You Will Be Looking For?
Blood Pressure, Breathing, Pulse, SPO2, Body Temperature, BGL, Pupils, SCC, LOC
Using SAMPLE, What Questions Will You Ask The Patient/Bystander?
S - What Are The Signs And Symptoms? A - Any Allergies? M - Any Medications? P - Past Medical History? L - Last Oral Intake? E - Events Leading Up To Chief Complaint?
After Obtaining A Patient History Using SAMPLE, What Do You Do?
Assess Pain Or Distress Using OPQRST
What Do You Ask To Assess Pain Or Distress Using OPQRST?

O - Onset. Did It Come On Suddenly Or Gradually? P- Provocation. What Makes Things Better Or Worse? Q - Quality. Can You Describe The Pain/Distress? R - Where Is The Pain/Distress, Does It Radiate Anywhere Else? S - Severity. On A Scale Of 0-10, 0 Being No Pain And 10 Being The Worst Pain Ever, How Would You Rate Your Pain? T - Time. When Did This Start?

After Assessing Pain/Distress With OPQRST, What Do You Do?

Request Vital Signs From My Partner
If The Patient's Blood Pressure Is High, Pulse Rate Is Low And Breathing Is Irregular, What Do You Do?

Patient Has Cushing's Triad, Ventilate At 1 Ventilation Every 3 Seconds

If Medication Is Necessary, What Must You Say Before Administering Anything?
8 Rights And CCCCE

What Medications Can Be Given?
Oxygen, Glucose, Aspirin and Assisting With Ventolin, Atrovent And Epinephrine
What Are The 8 Rights And CCCCE?

RAMP-TRED Right Route, Right Amount, Right Medication, Right Person, Right Time, Right Reason, Right Effect, Right Documentation




CCCCE - Colour, Clarity, Concentration, Expiry

After You Give Medication, What Do You Do?
Take Another Set Of Vital Signs
Secondary - Head

Look For DCAPP-BLS And Feel For TIC




Also Look For: Raccoon Eyes, Battle's Sign, Drainage From The Eyes, Ears, Nose, Mouth, Lost Teeth, Colour Of The Mucosa


Reassess Pupils And Airway




If OPA Or NPA Was Inserted, Ask: Is It Still In Place?




Treat Any Bumps, Or Contusions With A Padded Cold Pack

Secondary - Neck

Look For DCAPP-BLS And Feel For TIC




Also Look For: Tracheal Deviation, Jugular Venous Distention




If Collar Was Applied, Check If It Is Still Secure



Secondary - Chest

Look For DCAPP-BLS And Feel For TIC




Also Look For: Symmetrical Rise And Fall Of The Chest, Sucking Chest Wounds, Flail Chest. If A Dressing Was Applied, Ask: Is It Still Intact?




Determine Stability Of Chest Wall By Placing The Side Of Your Hand On The Sternum While Pressing Into Each Chest




Auscultate The Lungs At Apices And Bases And Ask: Is Air Entry Present, Equal And Clear Bilaterally?




Also Check For Intercostal Indrawing, Accessory Muscle Use, Implants, Patches, Scars And Needle Marks

Secondary - Abdomen

Look For DCAPP, Evisceration And Pulsating Mass, If There Is None Then Feel For Distention, Rigidity And Tenderness By Palpating The Abdomen One Quadrant At A time




If A Dressing Was Provided To Cover Evisceration, Ask If It Is Still Intact




Ask: Does The Patient Guard? Are There Any Needle Marks Or Scars?

Secondary - Pelvis

Look For DCAPP-BLS And Feel For TIC




Reassess Stability Of Pelvis By Pushing In And THEN Pushing Down




Is There Any Incontinence, Bleeding Or Priapism (Male)

Secondary - Lower Extremities

Look For DCAPP-BLS And Feel For TIC




Assess Circulation By Checking Pedal Pulses Bilaterally, Assess Motor Function By Having The Patient Push Down And Then Up Into Your Hands, Assess Sensation By Squeezing A Common Toe And Having The Patient Identify It




Check Capillary Refill If No Pedal Pulse Is Found




Splint Any Fractures, Dress And Bandage Any Non-Life Threatening Wounds

Secondary - Upper Extermities

Look For DCAPP-BLS And Feel For TIC




Assess Circulation By Checking Radial Pulses Bilaterally, Assess Motor Function By Having The Patient Squeeze You Hands Bilaterally, Assess Sensation By Squeezing A Common Finger And Having The Patient Identify It




Splint Any Fractures, Dress And Bandage Any Non-Life Threatening Wounds

Secondary - Back
Look For DCAPP-BLS And Feel For TIC
After The Secondary Head To Toe Is Completed, What Is Done Next?
Reassess LOC, ABCD's, Vitals, Interventions, Signs And Symptoms
After The Post Secondary Head To Toe Assessment, What Is Done Next?

Contact The Hospital Using PATCH

What Does PATCH Stand For?

P - Patient. Age And Gender


C - Chief Complaint


H - History


A - Assessment. Signs, Symptoms And Vitals


T- Treatment. List Interventions

After P-CHAT, What Do You Do?
Get Another Set Of Vitals
After Getting The Last Set Of Vitals, What Do You Do?
Ask: Can I Be At The Hospital? If Yes, Does The Hospital Accept The Patient?
What's The Very Last Thing You Do?
Document Everything
What Is A Normal Body Temperature?
Between 36.5 And 37.5 C