The primary Survey

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  • Created by: Louisa
  • Created on: 07-10-19 17:37
What is the primary survey
It is a crucial element in any initial assessment designed to identify and rule out any seious clinical presentation whuch may impact life
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D
Danger - always check for danger, becuase it might occur whereyou didn't expect it
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What are universal precautions
Such as gloves when we are going to do an invasive procedure
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Look for signs of trauma
such as a patient lying at the bottom of a ladder
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consider access
can you easily get to the patient, and what will you have to do so access them safely
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What should we ask the patient
Any significant history
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How do we introduce ourselves
HI my name is louisa and i am a student paramedic and introduce other collugues, including other services, e.g. police
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When do you ask for consent
Priorto conducting a patint consultation when the patient does not fall into CNS impared, life threatening or a vulnerable catergory
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Your apperance and Demeanour impacts what?
Many patients are influenced by how practitioners present themselves. the medical profession has a level of respect becuase of expectations of the public, if you do not conform to this, you may not gain the patients trust
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A clincial interview involves?
The establishment of a relationship between two people in specifit roles such as paramedic and patient
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D
Danger - always check, even if it seems silly
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R
Response - hi my name is louisa and i'm a student paramedic, are you alright, if you can hear me can you open your eyes, and shake the patient by their shoulders
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c
Catastrophic haemorrage - check for signsof major internal or external breathing
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A
Air way - check that their is noting in their airway, are they speaking?
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B
Breathing - check auscultation upper lobes in chest with a stethoscope
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C
Circulation - assessment of the central pulse - using the carotid artery, and check capillary refill. if they are fine, go for a radial pulse instead
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D
Disability - Neurological status, AVPU inspect pupils are equal and reacting. Is the patients brain working as expected? AVPU scale is what does it take for the patient to respond to you. Alert, verbal, pain, unresponsive. Or GCS. Glasgow coma score.
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E
Exposure - if indicated reveal injury
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What is the cirle of life resus system?
If you are at the head of the patient make sure the defib is placed next to the person using it, which is the person doing CPR. if you swap over doing chest compressions, switch places, so you dont have to move the defib
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Protocal for Adult basic life support
Unresponsive and not breathing normally Call 999 and as for an ambulance 30 chest compressions 2 rescue breaths Continue cpr 30:2 As soon as an aed arrives switch it on and follow instruction
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Protocal for child basic life support
Unresponsive Shout for help Open airway Not breathing normally 5 rescue breaths No sign of life 15 chest compressions 2 rescue breaths and 15 chest compressions Call resuscitation team (1 min CPR first, if alone)
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Defibrillation requres what?
Clear leadership, good and effective CPR, post resus care and audit and research
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The majority of cardiac arrest cases are due to
cardiac disease
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Good chest compressions deoth at, and at the rate of and ratio of
depth of 5-6cm, 100-120 per minute and 30:2 cycle of 2 minutes
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Ventilation requires
• Vent with 100% oxygen • 1 second ventilation • Chest must rise and fall • After advanced airway, EtCO2 must be checked to confirm tube placement. (this is to ensure the tube has gone into the lungs) • Ventilate at no more than 12 breaths per minute
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Defibrillation is defined as
The stopping of the fibrillation of the heart by administering a controlled electric shock in order to try and restorehre normal rhythm
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Shockable cadiac arrest rhythms that are shockable include
VF - ventricular fibrillation and VT - pulseless ventricular tachycardia
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What does vt look like
Very irregular and bumpy
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What does VT look like
It is regular and quite spread out. the ventricle beat so fast you cant find a pulse
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What are non shockable rhythms
PEA and Asystole
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What is PEA
The ECG may look normal, but they might not have a pulse, its not the hearts electrical rhythm that is the issue, so we don't shock
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What is Aystole
Aystole means there is no wave, in which case you continue CPR. if in doubt, shock them
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When isn't advised to shock
When the person is concious
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What is a monophasic defib
direction of voltage in one direction between the pads/ paddles
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What is a biphasic Defib
direction on travel from negative to positive and the other way around. So less trauma, less energy and longer battery life
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Defib safety
Check for signs of a pacemaker or ICD Wipe any water/sweat away Shave excess hair Avoid direct or indirect contact – visual sweep and verbalise stand clear Charge only with pads on casualty’s chest Remove high-flow oxygen (BVM)
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Card 2

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D

Back

Danger - always check for danger, becuase it might occur whereyou didn't expect it

Card 3

Front

What are universal precautions

Back

Preview of the front of card 3

Card 4

Front

Look for signs of trauma

Back

Preview of the front of card 4

Card 5

Front

consider access

Back

Preview of the front of card 5
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