-
Describe BVM, NRB and NC
- - BVM 90-100% at 10-15LPM
- - NRB 60-90% at 10-15LPM
- - NC 25-30% at 2-6LPM
-
Thoracic Trauma
- - tracheal deviation
- - Asymmetrical movement
- - Neck veins distended
- - Abnormal breath sounds
- - Shock
- - Subcutaneous emphysema
- - chest wall contusion / open wounds
- - Cyanosis, chest pain, SOB
-
Open pheumothorax
- - open chest wound, air enteres into plural space, squishes lung to collapse, then possible tension pneumothorax
- - Hypoxia
- - shallow breathing
- - guarging wound
- initial=hand on wound
- secondary=3 sided occlusive dressing
-
Flail Chest
- - 3+ ribs broken in 2+ places in succession
- - paridoxical motion
- - SOB
- - guarding
- - pulse up
- - BP up
- Watch out for pulinary contusion / Hemothorax / pneumothorax
-
Tension Pneumothorax
- - Lungs popped, air fills plural space and begins to push on other chest cavity organs
- - SOB, fast and shallow
- - Breath sounds diminished
- - JVD
- - tracheal deviation
- - Tacypnea
- - Anxiety
- - Dyspnea
-
Massive Hemothorax
- - Blood fills the plural space
- - anxiety and confusion
- - neck veins flat = hypovolemia
- - breath sounds decreased
- - Shock
-
Cardiac Tamponalde
- - blood fills the sac around the heart
- -Becks Triad (hypotension, neck veins distended, heart sounds muffled)
- - peridoxical pulse
- - breath sounds equal
- Watch out for hemothorax and pneumothorax
-
Myocardial Contusion
- - blunt chest injury
- - similar to MI and Angina
- Watch for cardiac tamponalde, hemothorax and pneumothorax
-
AAA and Tramatic Aortic Rupture
- - MVC's and falls from height (90% immidiate death)
- - scene size up and history is extremely important
- (no obvious sign of chest trauma, hypertension in upper extremities
-
What is shock?
- Inadequate perfusion of tissues
-
What are the 4 causes of shock?
- - pump problem (heart)
- - fluid volume issue
- - air exchange issue
- - Vascular system issue
-
What are the 2 types of shock?
- Compinsated - Body is trying to fix itself
- Decompinsated - Body gives up
-
Signs and symptoms of Compinsated shock?
- - thirst
- - diaphoresis (sweaty)
- - Breathing fast
- - fast pulse
- - periferal pulses weakened
-
Signs and symptoms of decompinsated shock?
- - Altered mental status
- - Acidosis (less O2in body makes it acidic)
- - Leads to cardiac arrest
-
What Are the Vital signs all FF's must know?
- - Pulse
- - BP
- - Respirations
- - Pupils
- - LOC
- - SPO2
- - Skin
- we dont check but we should know:
- - BGL
- - EtCO2
-
What 7 places can we check the patients pulse?
corodid (neck), breakeal (bicep), radial (wrist), femorial, popliteal, dorsalis pedis, posterior tibialis
-
What is the normal pulse range for an adult, child and infant?
- Adult - 60-100
- Child - 80-120
- Infant - 120-140
-
What is EtCO2?
- the amount of Co2 being exhaled
-
What is the normal range of EtCO2?
35-40mmHg
-
How does EtCO2 help you?
- It tell you during CPR if you are:
- - If the EtCO2 reads high, speed up ventilations (hyperventilation)
- - If the EtCO2 reads low, slow down ventilations (hypoventilation)
-
SpO2 is...
How many O2 is sticking to the hempglobin in the blood.
-
What is the range of SPo2 readings?
90-100%
-
What are the two substances that will give your SPO2 a false reading?
- carbon monoxide and cyonide
-
How do you check LOC?
- AVPU - Alert, verbal, pain, unresponsive
- Orientation - Name, time, place, event
- A + O X 3
-
What is the BP normal range?
100/76 - 140/90
-
What are you checking on the skin?
Temperature, condition, colour
-
What does it mean if the pupils are not even or reactive?
- swelling in your head. Possible head trauma.
-
What is the normal temperature of a human?
- 36.9 or 98.6 degrees
-
What is a normal BGL?
- 4-8
-
Medical
- - Miocardial Infarction, AAA Abdominal Aortic anuerizm, Angina, Ateriosclerosis,
- Congestive Heart Failure, Stroke, Trans ischemic attack, Sepsis, Pericarditis.
-
What is an MI?
- - Miocardial Infarction
- - death of tissue surrounding the heart
-
What are some signs and symptoms of an MI?
- - Pain (clutching of the chest)
- - Reffered Pain (radiating) to the left arm, shoulder jaw.
- - Rapid Breathing, and increased heart rate.
- - irregular Pulse
- - Described like bad indigestion
- - BECKS TRIAD muffeled heart sounds, increased
-
What two things make you think MI?
- 1. pain or discomfort in the chest/left arm/neck
- 2. SOB
-
Angina?
- A temporary blockage around the heart, (fake MI)
- MI is imminant (sooner or later), take to hospital
-
Stroke?
Blockage around the brain (MI of the brain)
-
TIA?
- Temporary blockage around the brain.
- Stroke is imminant (sooner or later), take to hospital
-
CHF?
- Conjestive heart failure (Fluid in Lungs)
- - usually smokers with COPD
- - do not lay them down
-
Sepsis?
- - blood infection throughout body
- - look like shit and stink
-
Aortic Dissection?
- Tearing of Aorta due to trauma
- trauma version of Abdominal Aortic anurism
- - good pulse above heart, poor pulse below heart
-
Cardiac Tamponade
- - sqeezing of heart due to swelling
- - JVD is apparent
-
How many compressions:breaths for 1 Rescuer Adult CPR.
- 30:2
-
How many compressions:breaths for 2 Rescuer Adult CPR.
- 30:2
-
How many compressions:breaths for 1 Rescuer Child CPR.
- 30:2
-
How many compressions:breaths for 1 Rescuer Infant CPR.
- 30:2
-
How many compressions:breaths for 2 Rescuer Child CPR.
- 15:2
-
How many compressions:breaths for 2 Rescuer Infant CPR.
- 15:2
-
What are battle signs?
Brusing behind the ears. Sign of head trauma and bleeding.
-
What are raccoon eyes?
Immidiate Black eyes. Sign of head trauma and bleeding.
-
What is the secondary injury when you have a brain injury?
Hypoxia and decreased perfusion.
-
What are some signs and symptoms of a concussion?
- - sometimes no visible trauma
- - retrograde short term amnesia
- - dizziness, headache, ringing in ears, nausea
-
What are some signs and symptoms of a cerebral contusion?
- - Altered LOC
- - confusion
- - personality changes
- - focal neurological signs
-
Acute Epidural Hematoma
- - Arterial bleed
- - initial LOC
- symptoms - one dialated fixed pupil, increased ICP, uncoscious, paralysis, death
-
Acute Subdural Hematoma
- - venous bleed
- - Altered LOC
- - Headache
- - Focal neurologic signs
- HIGH RISK: Alcoholics, elderly, ppl on blood thinners
-
Cerebral Hemorrage
- - Arterial or venus
- - Altered LOC
- Symptoms - Headache, vomiting, pattern similar to stroke
-
Increasing pulse, ~ resps and decreasing pulse means?
- - Cerebral Herniation Syndrome
- - herniation outweighs hypoxia
- - must hyperventilate to restrict vessels in brain and give space to swell
- - (AND GET TO HOSPITAL QUICK)
-
You must hyperventilate in what circumstances?
- - TBI, GCS<9, decerebrate posture
- - TBI, GCS<9, dialated or non reactive pupils
- - TBI, GCS<9, then drops another 2 points
- **If these symptoms resolve themselves, stop hyperventilating**
-
What are a few signs and symptoms of a spinal injury?
- - neck and pack pain
- - guarding (not moving)
- - numbness and tingleing
- - PMS check
- - Priaprism
- - neurogenic shock
- - loss of bowels and bladder control
- - deformity
-
Emergency rescue
- - Pull the patient to safety by any means possible to safe their life
- - seconds to get oout
- - c spine is not a factor
-
Rapid extraction
- - you have a little longer time to place c-collar and put on backboard quickly then move to safety.
- - 1-2 mins
-
Ligament
- bone to bone attachment
-
-
-
-
Neurogenic Shock
- - hypotension
- - normal skin temp and colour
- - inappropriately slow heart rate
-
Ked strap procedure saying...
- My baby likes to party hard
-
Decorticate posture
- - arms flexed posture
- - GCS of 3
-
Decrebrate posture
- - arms extended posture
- - GCS of 2
-
Prone position
- on stomache
-
-
Helmet removal procedure
- 1.Manual C spine
- 2. Cut strap
- 3 change c spine control
- 4. pull helmet
- 5. remove by rocking (avoid noise)
- 6. Pause prior to removal / taking weight off head
- 7. check helmet for damage
-
Types of Open fracture (compound)
-
Types of closed fracture
- - greenstick
- - spiral
- - simple
- - transverse
-
How much blood is lost when you fracture 1 femur?
- 1 liter
-
How much blood is lost when you have a pelvic fracture
- 500cc for each fracture
-
What do you check on a patient if you find a dislocation or fracture?
- check distal pulse
-
Do you try to reset a dislocation if you dont find a distal pulse?
NO!
-
Do you try to reset a fracture if you dont find a distal pulse?
Yes!
-
What do you do if you find a fracture that has a distal pulse?
- splint it
-
What do you check after splinting?
- Distal PMS
-
What do you do with an amputation?
- - Deal with the patient first.
- - Put amputated parts in bag, then that bag into bag#2 full of ice.
-
What should the splint secure?
- the joint above and below the fracture
-
With extreme non stop bleeding what is the process you follow?
gauze,wipe for 1 look, gauze, more gauze, more gauze, try to put pressure above the wound, LAST RESORT tournaque
-
If extenuating blood loss is prevelent, what must you remember?
- CAB
-
What is compartment syndrome?
- - pain + paresthesia (numbnesss)
- - pain, pallor, pulselessness, paresthesia, paralysis
-
What splint do you use with an open fracture?
- rigid splint
-
What types of splints are there?
- - Rigid
- - Pneumatic "air"
- - Vaccum
- - Pillow
-
What is wrong if there is external rotation of the leg and that leg is shorter than the other?
- - granny broken hip
- - also known as broken femoral neck and broken hip
-
What makes a "load and go"?
- - LOC
- - Airway compermise
- - Breathing
- - irculation
- - Unstable pelvis
- - 2 femur brakes
- - Tender / Distended abdomen
- - 3m+ fall
-
When checking breath sounds what does it mean if you find or ?
- - Hypo_tympany is for hemo (blood)
- - Hyper_tympany is for air
-
AVPU orientation questions, What does it mean and when do you use it?
- - testing LOC
- - Alert, Voice, Pain, Unresponsive
- - name, place, time, event
-
DIRT What does it mean and when do you use it?
- - distention
- - injection sites
- - rigidity
- - tenderness
-
AEIOU and TIPS What does it mean and when do you use it?
- - Alcohol, epilepsy, insulin, overdose, uremia
- - Trauma, infection, poisoning, shock
-
RRQ What does it mean and when do you use it?
- - pulse
- - rate, rhythm, quality
-
RRD What does it mean and when do you use it?
- - breathing
- - rate, rythem, depth
-
SAMPLE What does it mean and when do you use it?
- - start of secondary survey
- - signs and symptoms
- - allergies
- - medications
- - past medical history
- - last oral intake
- - events prior
-
OPQRSTU What does it mean and when do you use it?
- - after sample in secondary survey
- - onset
- - provokes (anything make it worse?)
- - Quality (describe the pain)
- - Radiates (pain anywhere else?)
- - Severity (out of 10)
- - Treatment (has anyone tried to help you?)
- - What do U think it is?
-
What locations do you have to know about the brain?
- Frontal lobe - frontal bone
- temporal lobe - temporal bone
- occipital lobe - occipital bone
- parietal lobe - parietal bone
-
Acute Epidural Hematoma
- - Arterial bleed
- - initial LOC
- symptoms - one dialated fixed pupil, increased ICP, uncoscious, paralysis, death
-
Acute Subdural Hematoma
- - venous bleed
- - Altered LOC
- - Headache
- - Focal neurologic signs
- HIGH RISK: Alcoholics, elderly, ppl on blood thinners
-
Cerebral Hemorrage
- - Arterial or venus
- - Altered LOC
- Symptoms - Headache, vomiting, pattern similar to stroke
-
Bradycardia?
- Lower HR than normal range
-
Tachycardia?
- Higher HR than normal range
-
-
Hypertensive?
- Lower BP than normal range
-
Hypotensive?
- Higher BP than normal range
-
-
Deformaties, contusions, abrasions, penetrations, burns, lacerations, swelling
Tenferness, intsability, crepitis, subcutaneous emphasema
-
-
When the heart contracts
Top # on a BP reading
-
-
When the heart relaxes
Bottom # on a BP reading
-
cyonotic?
Blueish colour - lack of O2
-
Jaundice?
Yellowing of the body
-
LLL refers to:
Left Lower lung
-
RML refers to:
Right middle lung
-
RUQ refers to?
Right upper quadrent
-
-
What is it called when somebody has BGL above 8?
Hyperglycemia
-
What is hypoglycemia?
BGL below the average of 4-8
-
What is the difference between a sign and a symptom?
- Sign - you can see what is happening
- Symptom - Is what the patient feels
-
Angina is to MI as TIA is to...
- Stroke.
- TIA and Angina are temporary blockages
-
JVD is:
Jugular Vein Distention
-
Tacypnea
Rapid breathing, above 20 resps/min
-
-
Diaphoresis
profuse sweating
-
Airway adjuncts
- In order to ensure an open airway
- - oropharyngeal airway
- - nasopharyngeal airway
-
What is the difference between oxygenation and ventilation?
- Oxygenationation = put o2 in blood for body = SpO2 measurement
- Ventilation = us breathing for someone = EtCO2 measurement
-
APGAR What does it mean and when do you use it?
Appearance, Pulse, Grimace, Activity, Respiration
-
What is type 1 diabetes
- insulin dependent
-
What is type 2 diabete
- sugar dependent
-
Irregular Resperations, Increased BP, Decreased pulse
- - Cushings Response, Cerebral hemorrahage, incresased icp
- -treated by hyperventilation to contract the cerebral arteries and veins
-
JVD, Muffled heart sounds, Low Blood Pressure
- -Becks Triad = Cardiac Tamponade
- Watch out for: hemothorax / pneumothorax
-
Shallow breathing, guarding around chest, sucking chest wound
- - Open pneumothorax
- initial - hand on hole
- Secondary - 3 sided occlusive
-
3+ ribs broken in 2+ places in succession
- - Flail chest
- initial - support with hand
- secondary - ball of gauze, pushed in slightly to support the flail section
- Watch for: Pulminary contusion / hemothorax / pneumothorax
-
Breath sounds decreased (hypertympany when percussed), SOB fast and shallow, dimished breath sounds, JVD, tracheal deviation
- - Tension pneumothorax
- - give low flow O2, careful not to make the problem worse
-
Breath sounds decreased (hypotympany when percussed), shock, confusion
- - Massive Hemothorax
- initial - possible o2
- Secondary - treat for shock
-
chest pain, dysrythmias, cardiagenic shock
- - myocardial contusion (very similar to MI)
- initial - possible O2
-
MVC's or falls from height, pulsating mass in the abdomen
- - Traumatic Aortic rupture (or AAA)
- Nothing you can do!
-
Altered LOC, confusion, amnesia, personality changes, focal neurological signs
- - Cerebral contusion
- - deal with secondary injuries (shock, LOC, CAB)
-
Increased ICP symptoms are:
increased BP, decreased pulse and ~ resps
-
Absolute hypovolemia
- - fast pulse
- - flat neck veins
- - weak radial pulse
- - pale skin
-
Relative Hypovolemia (high space) shock
- Injury - low pulse, pink, Flat neck veins, absent PMS in extremities
- Poisoned - fast heart, pale, flat neck veins
-
Mechanical (Obstructive/cardiogenic) shock
- - caused due to:
- - Tension pneumothorax
- - cardiac tamponade
- - myocardial contusion
- S/S
- - quick resps
- - weak pulse
- - pale, cool, diaphoretic
-
Diabetes is:
- - a group of metabolic diseases in which a person has high blood sugar
- - the body does not produce enough insulin, or because cells do not respond to the insulin that is produced
- - Symptoms of frequent urination, increased thirst and increased hunger
|
|
