First Aid and CPR (LS 2750)- Final Practical Exam- Chris Loomis, Clemson University

what are the 3 terms of the Good Samaritan law?

1. need to be a layperson

2. need patient consent

3. cannot exceed level of training

what 2 questions should be asked in the scene survey?

1. is it safe for me to be here?

2. is it life threatening?

what are the two care-first emergencies?

1. life-threatening bleeding

2. choking/airway blockage

what is the most commonly broken bone the body & why?

clavicle b/c of seat belts in car accidents

what are the 3 signs of cardiac arrest/clinical death?

1. no pulse

2. no breathing

3. unconscious

how long do you have to revive someone who has gone into cardiac arrest?

5-7 minutes

what are the steps to revival in the case of cardiac arrest?

1. 911

2. CPR

3. AED

how do you administer CPR?

30 compressions at a rate of 120/minute & a depth of 2"; alternate with 2 breaths; check pulse every 5 circuits

what do you do if the chest does not rise when administering breaths?

if first breath does not rise: re-tilt head to open airway and try again

if second breath does not rise: restart compressions and try to "finger sweep" airway to remove potential blockage for next breaths

what are the 5 reasons to stop performing CPR?

1. regain a sign of life (breathing, pulse, talking)

2. AED arrives

3. paramedic/higher medical authority arrives

4. 30 minutes of continuous CPR have gone by with no signs of life

5. scene becomes unsafe/physical exhaustion is reached

where do AED pads go on an adult?

upper right, lower left

where do AED pads go on an infant?

front and back

what are the 3 types of patient consent?

1. expressed

2. implicit

3. underage

what are the imminent threats to life? (ABCDE)

A- open airway

B- are they breathing?

C- circulation

D- deformity

E- safe environment

who are the most likely candidates to choke?

children, the elderly, and intoxicated people

what are the signs of choking?

may or may not have associated noise, color change of nail beds/inner lips (cyanosis), unconsciousness, & panic

how do you treat a choking patient?

alternate abdominal thrusts and back blocks (5 of each)

what do you do if patient is able to speak when choking?

light to moderate back blows in the small of the back between shoulder blades

what are the signs/sx of a breathing emergency?

qualitative degradation, cyanosis, panic respiratory rate outsider of normal range

what is the treatment for a breathing emergency?

keep them in a calm and comfortable position (sitting and leaning forward), mimic their breathing, & keep the patient calm

what are the signs/sx of cardiac distress?

chest pain, radiating pain in left arm, cardiogenic shock

what are the sx of cardiogenic shock?

dizziness, nausea, vomiting, sweating, gray/ashen skin, lightheadedness, trouble breathing, fatigue

what is the treatment for a cardiac emergency?

call 911, locate AED, keep patient calm and in a position of comfort (on back), loosen clothes, and can administer 325mg of aspirin or or any pre-prescribed medications for cardiac emergencies

what are the 3 parts of the patient assessment?

1. vital signs

2. medical history

3. physical exam ("head to toe")

what are the 4 vital signs we use?

1. heart rate

2. respiratory rate

3. skin condition

4. level of consciousness

what is normal heart rate?

60-100 bpm; we use the radial pulse if the patient is conscious, we use the carotid pulse if the patient is unconscious

what is normal respiratory rate?

12-20 rpm; we can count the # of times the chest rises for 20s and x3

what is normal skin condition?

pink, warm, and moist; blue means deoxygenation, gray means cardiogenic shock, yellow means hepatic issues, black means dead tissue/burns

what is normal L.O.C.?

A & O x3= patient knows their name, where they are, and what time it is

what do we use for medical history?

S- signs and symptoms of primary complaint

A- allergies

M- medications

P- past medical history

L- last intake of food & water

E- events leading to complaint

what are the signs/sx of shock?

elevated/weak heart rate, increased/shallow respiratory rate, gray/cool/clammy skin, and decreased LOC

when does a patient enter shock?

when their systolic BP drops below 100

what do we do for minor-moderate bleeding?

1. apply direct pressure

2. clean wound once the bleeding is controlled with soap and water

3. apply dressing (bandaid/pressure dressing)

4. monitor for infection

when does a patient require stitches?

if the wound goes deeper than the epidermis and/or if it doesn't stay closed

what the signs of mild infection?

redness, puffiness, tenderness

what are the signs of moderate infection?

yellow pus

what are the signs of bad infection?

fever, black skin, smell, red streaking, significant heat radiating

how do we treat life-threatening/arterial bleeding?

1. direct pressure

2. stop blood flow to an area with tourniquet (tourniquet limbs/pack junctions) time stamp when applied

3. hemostatic gauze

4. hospital

what medication is to be worried about with trauma?

blood thinners (ex: Wofrin)

how do you treat burns?

1. remove the heat source

2. cool the burn with cold running water for 10 minutes

what is a first degree burn and how is it treated?

sunburn; red, dry, painful, & hot; treat with aloe vera

what is a second degree burn and how is it treated?

blistering; let the blister be- if it does need popped, sterilize a needle and then allow to drain before bandaging

what is a third degree burn and how is it treated?

full-thickness burn; black, charred, and open; apply dressing that has been run under sterile water; wrap loosely!

what is a strain?

a hyperextension of muscles/tendons in straight portion of body w/ potential tear

what is a sprain?

hyperextension of ligaments w/ potential tear

what are the signs/sx of a sprain/strain?

pain, swelling, discoloration, change in range of motion, deformity, and crepitus (popping sound)

what are the differentiations of a fracture?

point specific pain, immediate swelling that levels off, immediate discoloration, hard deformity, noise is potentially repeatable

what are the differentiations of a sprain/strain?

generalized pain, gradually onset swelling that progressively worsens, gradual discoloration, soft deformity, noise only occurs at the time of an injury

what is the treatment for a sprain/strain?

R- rest/immobilize

I- 20 min on/20 min off ice

C- compression with tight ACE bandage

E- elevation to reduce swelling

what can be given to a patient with a strain/sprain?

200 mg (x4) or 800 mg (x1) of Ibuprofen

what do we check with a fracture?

CSMs:

C- circulation

S- sensation

M- movement

what is necessary to make a splint?

1. splinting device

2. padding

3. tie straps

how do you apply a splint?

make a figure 8 with splinting device, apply a surgeon's knot with tie straps, immobilize nearby joints, wrap over the top with an ACE bandage

how do you treat an open fracture?

1. cover with a bandage soaked in sterile water

2. deal with traumatic bleedings and then fracture

3. can use tourniquet, not pressure

4. ER

what are the signs/sx of a minor concussion?

headache, degradation in vision/light sensitivity, dizziness/lightheadedness, nausea/vomiting, decline in LOC

what is the treatment for a minor concussion?

avoid activity that could cause further injury, avoid strong sensory stimuli, no sleep for 4-6 hours

how do you know if a head injury is more severe?

D- disoriented beyond A & O x2

I- irritable

C- combative

C- confused (repetitive questions)

what are the symptoms of intracranial pressure?

blown pupils, blood from facial orifices, unconscious for >1 min, decreasing/bounding heart rate, decreased/agonal breathing, decreased respiratory rate, diverging systolic/diastolic BP (getting closer together)

what is the treatment for intracranial pressure?

hospital immediately

who do you immobilize in the case of a spinal cord injury?

those with direct impact to the head, sudden deceleration, fell 3x higher than body height, those showing neurological decline

what are the signs/sx of a spinal cord injury?

burning, tingling, "pins and needles" sensation in extremities

what do we check in the case of a spinal cord injury?

CSMs

how do we check sensation in a spinal cord injury?

look away and identify the region being touched

how do you know when a patient has a sudden illness?

if they have signs/sx of shock or an altered level of consciousness with no signs of trauma

what the categories of sudden illness?

S- sugar

T- toxins/temperature

O- oxygen

P- pressure

S- seizures

what is a normal blood sugar level?

100 mg/dL

what is hyperglycermia and how is it treated?

patient needs insulin; take them to the hospital

what are the signs/sx of hypoglycemia?

low BP, decreased blood sugar, high resting heart rate, confusion/agitation, slow LOC (umbles), low energy, gray/cool/clammy skin

what is the treatment for a hypoglycemic patient?

20-30g of oral glucose (juice/frosting)

how do we treat a seizure?

monitor airway/breathing, remove anything dangerous around patient, box in the patient to make sure the are safe, but not immobilized, remain calm, do patient assessment after seizure

when is a seizure potentially life threatening?

in result of a head injury, if it lasts > 10 min., if they have 2 seizures without regaining consciousness

what are the signs/sx of a heart attack?

cardiogenic chock, chest pain/pressure, radiating left arm pain

what is the treatment for a heart attack?

325mg of aspirin, prescribed meds, call 911/find AED

what are the signs/sx of a stroke?

B- bilateral symmetry

E- eyes drooping

F- face drooping

A- arms

S- speech slurred

T- time (first notice and last notice sx)

what is the treatment for a stroke?

call 911/take patient to hospital, can administer 325mg of aspirin

what is the treatment for fainting?

help patient to the ground, leave supine for 5 min., leave sitting for 5 min., administer oral glucose

what are the signs/sx of heat exhaustion?

internal temp is around 98.6, skin is red/hot/moist, HR/RR normal, LOC in tact, dizzy, nausea/vomiting, headache, passing out, increased thirst

what is the treatment for heat exhaustion?

take out of sun/heat, administer 20-32 oz. of liquid w/ electrolytes

what are the signs/sx of a heat stroke?

internal temp is above 98.6, skin is dry/red/hot, increased HR & RR, decreased LOC

what is the treatment for a heat stroke?

submerge in cold water, place ice packs in armpits/groin

what are the signs/sx of early hypothermia?

shivering, full body shivering, diminished fine motor skills

what are the signs/sx of mid-level hypothermia?

diminished gross motor skills, decreased LOC

what are the signs/sx of late-stage hypothermia?

convulsive shivering, unconsciousness

what is the treatment for early stage hypothermia?

add a layer of clothing, and give additional calories/sugar to patient

what is treatment for mid-late stage hypothermia?

remove clothing if wet, wrap in any kind of insulation, and share body heat

what is the treatment for poisoning?

call poison control for home remedies

what happens with a patient who has tried to commit an act of self harm?

they lose the right to refuse medical treatment as they are not of sound mind

what are the signs/sx of an asthma attack?

increased respiratory rate, wheezing

what is the treatment for an asthma attack?

albuterol inhaler, mimic breathing exercises

what are the signs/sx of an allergic reaction?

hives, watery/itchy/swollen eyes, runny nose, itchy throat/tongue

what is the treatment for an allergic reaction?

antihistamines (Benadryl)

how do you treat a patient in anaphlyaxis?

administer epi pen (hold in upper thigh for 5 seconds) and then give Benadryl right away