TAMECT Clearing

  • Scope of Practice

    • what a health care provider can do when delivering patient care - limited by their license

  • Duty to Act

    • our duty to provide care without abandonment while ON SHIFT

  • Abandonment

    • ending care to a patient without the assurance of continuing later

  • Expressed Consent

    • a verbal or non-verbal signal from patient allowing care

  • Implied Consent

    • when patient cannot express consent, you must act under the mentality that they would have wanted care given to them

  • HIPAA

    • basic privacy protection for all patients

  • PHI

    • protected health Information,anything that can be linked to a patient, part of HIPAA

  • Body Substance Isolation

    • never recap needles, wear PPE, eash hands, —> BSI SCENE IS SAFE

  • Panic Attack

    • unexpected fight-or-flight response

  • Anxiety Attack

    • feeling of anxiety without any physical symptoms

      • best way to help is by coaching breathing

  • AVPU

    • Alert, Verbal, Pain, Unresponsive

  • A & OX4

    • Person - what is your name?

    • Place - where are you right now?

    • Time - What is today’s date?

    • Event - what were you doing 5 mins ago?

    • If they cant answer above questions, they cannot refuse treatment

  • SAMPLE

    • S = sign and symptom

    • A = Allergies

    • M = Medication

    • P = Past Medical History

    • L = Last Oral Intake

    • E = Events Leading up to Emergency

  • OPQRST

    • O = Onset

    • P = Provocation

    • Q = Quality

    • R = Radiation

    • S = Severity

    • T = TIme

  • Blood pressure

    • 120/80

  • Glucose reading

    • 80/120

  • cABC

    • cervical spine

    • Ariway

    • Breathing

    • Circulation

  • Apnea

    • period of not breathing

  • Hypoxia

    • body tissue does not receive oxygen

  • Dyspnea

    • difficulty breathing/shortness of breath

  • Cyanosis

    • blue coloring on skin

  • Respiratory distress

    • tripod position

  • Respiratory Failure

    • Decreasing oxygen saturation

  • Asthma

    • Wheezing

    • Duoneb is treatment

  • COPD treatment

    • low oxygen via nasal cannula

  • Hyperventilation Treatment

    • Coach patient to calm respiratory rate

  • Nasal Cannula

    • 1 - 6 L/min

  • Nebulizer

    • 6 - 8 L/min

  • NRB - non-re-breather

    • 10 - 15 L/min

  • BVM - bag valve mask

    • 15+ L/min

  • Vitals

    • Level of Consciousness (AVPU)

    • SpO2

      • normal range = 95% or greater

    • Pulse

      • Normal rate = 60-100 bpm

    • skin condition

      • normal = warm and dry, normal coloring

    • Respiiration

      • normal rate = 12 -20 breaths per minute

    • Capillary Refill

      • normal = nailbed turns from white to red in 2 seconds

    • Temperature

      • normal rate = 98.6

  • PEARRL

    • pupils equal and round reactive to light

  • Orthostatic Vital Signs

    • measuring blood pressure taking in supine, sitting, and standing position

  • Significant Orthostatic Vital Signs

    • decrease of 20 mmHg in systolic pressure

    • increase of 10 mmHg in diastolic pressure

    • increase of heart rate of 20 beats per minute

  • Mild Allergic Reaction

    • rash/hives

    • skin itching

    • treatment: benadryl

  • Moderate Allergic Reaction

    • some mild reactions like rash and hives

    • dyspnea

    • treatment: duoneb or nebulizer

  • Anaphalaxis

    • moderate allergic reactions

    • low blood pressure

    • difficulty swallowing

    • swelling

    • treatment: epinephrine

  • Low Blood Sugar (HYPOglycemia)

    • shaky, headache, dizzy/fainting

    • pale, cool, clammy

    • treatment: oral glucose or food

  • High Blood Sugar (HYPERglycemia) - higher than 180 mg/dL

    • Altered mental status

    • flushed, warm and dry

    • treatment: hospital

  • Heart Attack

    • symptom: chest pain, sweating, clammy skin

    • treatment: aspirin, oxygen, prepared to start CPR

  • Capillary Abrasions = Scrapes

  • Capillary Lacerations = Cuts

  • Venous = steady flow of blood

  • Arterial = bright red, spurting/pulsating flow

  • How to treat bleeding you can see

    • apply direct pressure and elevate injury

    • pressure to proximal pressure points

    • transport if bleeding cannot be stopped

  • How can hemorrhage present itself

    • pain in chest or abdomen after injury

    • shortness of breath

    • coughed up blood

  • Methods of how to stop bleeding

    • direct pressure

      • compresible sites

    • tourniquets

      • extremities

    • packing

      • junctional sites for/on deep wounds

  • Symptoms of Shock

    • rapid + shallow breathing, pale, cool, clammy skin, dizziness or fainting, weakness

  • Shock

    • body is not getting enough blood flow, also means lack of oxygen

  • Treatment for Shock

    • blue patient down, keep them warm, lift patient feet (trengelenburg position)

  • Hypovolemic shock

    • condition where severe blood or fluid loss makes heart unable to pump blood

    • treatment = falling blood pressure

  • PMS

    • Pulse, Motor, Sensory

  • FAST

    • used to determine stroke

    • Face Drooping, Arm weakness, Slurred Speech, time to call 911

  • Seizures

    • treatment: support cABC’s, Oxygen - NRB, call 911

  • Fainting

    • Syncope

    • possible causes: blood sugar, dehydration, heat emergency, short seizure