ccma unit 5

emergency

unforeseen circumstance that requires immediate attention

seizure

uncontrolled muscle activity that can be caused by high body temp, head injuries, drugs, epilepsy

strain

stretched or torn muscle or tendon

sprain

stretched or torn ligament

first aid

immediate care given to the victim of injury or sudde3n illness to sustain life and prevent deat

cardiopulmonary resuscitation

CPR; lifesaving technique that consists of chest compressions combined with artificial ventilation

surgical asepsis

techniques to eliminate pathogenic and other potentially harmful microbes related to invasive procedures

sterile field

area free of microorganism and is used as a work area during a surgical procedure; must be maintained before and during the procedure

autoclaving

primary method of sterilization; process of using high-temp steam to kill any micro-organisms; all items must have indicators to confirm it has been properly sterilized

mayo stand

movable stainless steel instrument tray on a stand; where the sterile field is often set up; should be slightly voce the waist and positioned at least 12 inches from the body

if creating the sterile field with individually wrapped items

sterile drape is placed on the mayo stand to create the sterile field

when opening a sterile packet on the mayo stand, the flap

furthest away from ma should be opened first, followed by the sides; then the flap closest should be opened last without reaching over

steps for creating a sterile field

disinfect the mayo stand, place packet on mayo stand, open flap farthest away, pull both side flaps open, open flap closest to ma

biopsy

surgical removal of tissue for later microscopic examination

removal of a foreign object

surgical removal of an object, such as splinter, larger object, etc; splinter forceps are commonly used here

removal of a wall growth (wart, cyst, mole)

surgical removal of a small growth from the body

endoscopy

procedure that uses an endoscope to view a hollow organ or body cavity, such as the larynx, bladder, colon, sigmoid colon, stomach, abdomen, some joints

colposcopy

examination of the vagina and cervix performed using a colposcope which is a specialized type of endoscope ; pt is in lithotomy position

cryosurgery

procedure using local application of intense cold liquid or special instrument called a cry-probe to destroy unwanted tissue

incision and drainage

lancing a pressure buildup cased y pus or any other fluid under the skin

suturing

the use of any device to close or sew together tissue after an injury or surgery; absorbable (dont need to be removed, occurs 5-20 days after); non-absorbable (used on skin surfaces where they can be easily removed- remain in place 5-6 days and then take out)

size of suture material

the more o’s the smaller the gauge; (o is thicker than 6-o (oooooo)); face and neck- 5-0 to 6-0 ; chest or abdomen- 2-0

surgical staples

made of stainless steel and applied with a stapler; allow for the closure of wounds under high tension- trunk extremities or scalp; need to be removed 4-14 days

removing surgical staples

soak the area with saline, begin with the second staple of the wound and carefully place the lower tip of the sterile staple remover under the staple, advance the Lower jaw under the staple, squeeze the handle together until closed, pull the edges of the staple out of the skin, dont lift staple remover when squeezing handles; remove every tiger stroke

benefits of wound closure

minimizes scarring, prevents infection, aids in healing

how should post op medications instructions be given

writing and verbally to pt and possibly family members

post-surgical discharge instructions for pt who had biopsy of the breast

change the dressing, observe signs of infection, apply medication to the wound

pt should notify health care provider in the case of the following (postop)

unusual pain or burning, swelling, redness, or discoloration, bleeding or other drainage, unpleasant odor, fever of 100F or greater, nausea and vomiting

the a pt or pt family member calls the office stating they are experiencing an emergency, MA needs to obtain critical info: (3)

pt name, contact info, location; situation and when did it start; status of the pt— conscious, breathing, presence of pulse

ems

emergency medical services; info reported will be told to this

severe hypoglycemia

low blood glucose levels; consume food/liquid high in glucose

hypovolemic shock

when pt loses an excessive amount of body fluid or blood; thirst, muscle cramping, lightheaded; treat: control of blood loss, IV

heat exhaustion or stroke

body temp varies too much over its normal range; muscle cramping, pale clammy skin; that: remove from warm temps, apply cold compressions

hypothermia or frostbite

exposure to cold temps; tissue and skin are exposed to freezing temps and temp is not able to get oxygen supply; redness, tingling, pale, numbness; treat: removed from cold, remove wet clothing, blanket

obstructed airway or choking

chewed food enters the trachea; placing hands on throat; that: abdominal thrusts, back blows

syncope

fainting, episode of unconsciousness; pale, perspiring, nausea, dizziness; that: aromatic capsules

dislocation

bone end slips out of the socket

fracture

closed (simple, dont penetrate the skin) or open (bone breaks through the skin and is exposed)

shock

response of cardiovascular system to adrenaline, capillary constriction, decreased bp

anaphylactic shock

response of the body to an allergen; call 911; epi pen

poisoning

discoloration, burns on lips, unusual odor, vomiting; treat: call 911 and try to remove any poison present on pt; do CPR if needed

abrasion

outer layers of skin are rubbed away bc of scraping; generally heals without scarring

incision

smooth cut resulting from scalpel or sharp material

laceration

edges torn in an irregular shape

puncture

made by a sharp pouted instrument such as a bullet , needle; minimal

arterial bleeding

most severe; bleeding in bright red spurts; put pressure on wound and elevate

venous bleeding

steady flow of dark red blood; pressure with sterile gauze

bandage

non sterile; cover dressings

dressing

sterile; cover wounds

three phases of wound healing

inflammatory (3-4 days, pain, swelling, and loss of function at the site, blood clot formation), proliferative(4-21 days, wound begins to heal, new cells form), maturation(21 days-2 years, new tissues cover wound, scar tissue forms)

first degree burn

affect only the outer layer of skin tissue; red and discolored, slight swelling; caused by sunburn or hot water

second degree burn

breaks the surface of the skin and injures the underlying tissue; blisters; caused by severe sunburn and elongated time of liquid and heat

third degree burn

deep enough to damage the nerves and bones, tissue burned is charred and white; causes less pain bc nerves are damaged; results from fire, hot water, hot objects, electricity

fourth degree burn

goes through both layers of the kin and underlying tissue as well as deeper tissue, possibly involving muscle and bone; no feeling; caused by flames and chemicals, hot iron, fireplace, building fire

caring for major burns

call 911; dont try to remove clothing stuck in the burn; remove jewelry, belts, tight items

caring for minor burns

apply cool wet cloth (face) or cool water , dry, apply lotion, cover with clean bandage

crash cart

portable cart stocked with emergency supplies

symptoms of MI (heart attack)

chest pain, pain or discomfort in one or both arms, back, shoulders, neck , jaw, shortness of breath, excessive sweating, unusually tired, nausea and vomiting, lightheadedness, rapid or irregular heartbeat

cardiac arrest

heat suddenly and unexpectedly stops pumping; collapse suddenly, lose consciousness, stop breathing no pulse

CPR numbers

30 compressions 2 in(adults) at 100bpm then 2 breaths

DME or DMEPOS

durable medical equipment (prosthetics, orthotics, and supplies); medical devices and supplies that can be used repeatedly (dialysis machine, ventilators)

what is necessary to qualify as a DMEPOS

primarily serve a medical purpose, prescribed by or ordered by a health care provider, able to be used repeatedly, lifetime of at least 3 years, be used in the home, only be useful to pts who have injury or disability

how can a pt be eligible for DMEPOS

health care provider must order the claim through a claim or medical order form to be submitted to a supplier; some require a face-to-face encounter

DMEPOS and CMS (center for medicare and Medicaid)

CMS created a list of items considered DMEPOS called the master list; CMS created a subset of items requiring prior authorization

prior authorization for DMEPOS

process through which a request for provisional affirmation or approval of coverage is submitted for review before DMEPOS item is furnished to a pt and before a claim is submitted for payment; provider will submit forms and information to durable medical equipment medicare administrative contractor (DMEMAC) for review

what DMEPOS requires prior authorization

power wheelchairs, powered air flotation bed, powered pressure reducing air mattresses