Clinical Skills Year 1

What are the steps in assessing an unconcious patient?

Call for help

Shake and shout

Assess breathing

Check airway for blockages and breathing

Carry out a Primary Survey

Describe how you would check a patient’s airways

Listen for abnormal sounds

Hold maxilla down and pull down tongue

Remove any obstructions with the index finger

Describe how you would carry out a primary survey

Check for circulation using pulse palpation (femoral artery or dorsal metatarsal artery)

When should CPR be performed?

If the patient has stopped breathing (pulmonary arrest) or the heart has stopped beating (cardiac arrest)

What is the aim of CPR?

To achieve return of spontaneous circulation (ROSC)

What are the two CPR theories?

Cardiac pump theory and thoracic pump theory

Describe the cardiac pump theory

Ventricles directly compressed

Between sternum and spine (dorsal recumbency)

Between ribs ( lateral recumbency)

Blood forced out of the ventricles to lungs and periphery

Relaxation of the ventricles returns blood to the heart

Describe the thoracic pump theory

Intrathoracic pressure increased

compresses the aorta

collapses vena cava

Blood flow out of the heart

Elastic recoil

Describe the technique for carrying out CPR

Put shoulders directly over the wrists

Place the heel of the hands overlapping with fingers

Compressions 100-120 beats per minute

Depress chest by a third

Allow full recoil before continuing compressions

How do you carry out ventilation when doing CPR?

10 breaths per min

Tidal volume of 10ml/kg

Endotracheal intubation and intermittent positive pressure

If doing CPR alone do 30 compressions followed by two breaths

How do you place an ET tube

Visualise the larynx

Pass the tube between the vocal folds

Inflate the cuff to ensure the tube fits

Tie in place

Check placement using ambubag

Describe the changeover process and the CPR cycles

2 minutes of uniterrupted CPR

Changeover gives time to observe the patient

After 2 mins change personnel

When should you cease CPR?

If there is no ROSC after ten minutes

What is a packed cell volume?

Shows the proportion of red blood cells in the blood

What are the advantages of a PCV?

Quick

Cheap

Easy

Can monitor patient changes quickly