individual skills and CPI

signs for pneumothorax

• Chest injury (internal or external)

• worsening respiratory distress

• more altered consciousness

• worsening perfusion

• Increased jugular venous pressure (JVDistension)

• sub cutaneous emphysema

• decrease spo2

• tracheal deviation

• difficulty bagging

• uneven rise and fall

location of tension

• second intercostal space

• above third rib

• go in 45 degrees then 90 until give

• mid clavicular line

location of additional tension

1cm lateral to first

what do you need for tension

• pen

• iodine swab

• catheter (

• syringe

• drawing up needle

• saline

• sharps container

• tape

• (IV cannula for small people)

Performing laryngoscopy

if a patient has signs of choking or anything obstructing the airway upon assessment

• may have difficulty inserting i-gel

be careful if patient has suspected trauma

1. check if light is working (press on globe)

2. prepare suctioning and equipment

3. handle pointing towards right ear as insert into right side of patients mouth (lips, teeth)

4. rotate handle and sweep blade left to displace tongue until reach midline

5. slide blade down tongue until vallecular groove

6. lift blade upwards and forwards to lift gonue

7. find epiglottis and vocal cords

8. suction if necessary or use magill forceps

i-gel performing

need correct sizing i-gel for adequate seal

may be impacted by airway obstruction

may not tolerate (move to OPA/NPA)

attach BVM and filter, check for rise and fall (stethoscope)

secure igel

troubleshoot

advance airway further

assess for obstruction or soiling

reassess igel

lubricant

otherwise basic airway device

Performing suction

Yankauer suction (normal):

• finger off port

• inside as far as can see

• finger on port

• can be used with laryngoscope

Y-suction catheter (tubing in blue kit):

• measure same as OPA/NPA or 10cm for igel

• guide tip into airway

• igel through gastric channel

• cover suction port with pointer finger when ready to suction

• withdraw with rotating motion maintaining suction

• reassess airway

IV cannulation performing

1. attach tourniquet

2. 10ml saline (drug check)

3. 16g preferably cannula

4. prepare equipment and stickers

5. locate vein and palpate (bouncy)

6. swab the site

7. pull skin distal to insertion site downwards to stabilise vein

8. 10-30 degree angle until flashback

9. reduce angle (more parallel to skin)

10. push index finger forwards and retract needle

11. click

12. release tourniquet

13. ring finger on vein

14. index finger on cannula

15. remove needle and cannula

16. screw bung on and release fingers

17. tegaderm attachment (one on bung, one on needle

18. sticker on top

19. date

what do you need for IV

• PPE

• alcohol swab

• tourniquet

• cannula (depending)

• bung

• tegaderm

• sodium chloride flush

• sharps container

  ^ All found in yellow kit

what do you need for IO

1. PPE

2. Betadine swab (iodine)

   2. IO kit

   3. sodium chloride flush

   4. 3 way tap

   5. tape

   6. sharps container

perform IO

when 2 failed IVs

1. prepare equipment on clean surface

2. prime 3 way tap

3. required flush volume for IO cannula is 8ml (10ml syringe)

4. thoroughly swab site

5. drill check

6. selected needle

7. sharps out

8. insert at 90 degrees

9. check black line is still visible

10. feel loss of resistance

11. disconnect drill from IO needle

12. sharps away

13. secure with IO stabiliser (remove backing)

14. attach 3 way tap and flush by screwing into IO cannula hub

15. collect 2ml of bone marrow in saline syringe

16. flush all contents HARD

17. use saline to flush (20ml)