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BAA REFRESHERBAA REFRESHER 17/09/200217/09/2002

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PRESENTERS:Me Van Wyk

Mr. Smith

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OBJECTIVES

PATIENT ASSESSMENT AIRWAY OBSTRUCTION CARDIAC PULMONARY

RESUSCITATION MEDICO-LEGAL ISSUES

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PATIENT ASSESSMENT

DO NO HARM RETURN THE PATIENT TO NORMAL

FUNCTIONAL LIFE DEVIDED INTO FOUR SECTIONS

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PATIENT ASSESSMENT (CONT)

* INITIAL ASSESSMENT * PRIMARY SURVEY * SECONDARY SURVEY * PHYSICAL ASSESSMENT

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INITIAL ASSESSMENT

QUICK SCENE SIZE UP HAZARDOUS MATERIAL PROTECTIVE GEAR AVPU THE NEED FOR CPR

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PRIMARY SURVEY(CONT)

AIRWAY- PATENT/ IF NOT ATTEND BREATHING-IF ABSENT/ ASSIST

VENTILATIONS CIRCULATION- PULSE/ IF ABSENT

CPR

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SECONDARY SURVEY

SAMPLE HISTORY VITAL SIGNS GCS / RTS PHYSICAL ASSESSMENT

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SECONDARY SURVEY(CONT)

SAMPLE HISTORY- SIGNS & SYMPTOMS ALLERGIC REACTION MEDICATIONS PREVIOUS ILLNESSES LAST ORAL MEAL EVENTS LEADING TO EPISODE

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VITAL SIGNS

BLOOD PRESSURE/ BP PULSE HEAMOGLUCO TEST/ HGT RESPIRATIONS TEMPARATURE CAPPILARY REFILL

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GLASCOW COMA SCALE (GCS)

EYE OPENING VERBAL RESPONSE MOTOR RESPONSE

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REVISED TRAUMA SCORE (RTS)

RESPIRATORY RATE RESPIRATORY RETRACTION SYSTOLIC BLOOD PRESSURE CAPILLARY REFILL

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PHYSICAL ASSESSMENT

HEAD -EARS- EYES- / LACERATIONS, etc

NECK- LACERATIONS/ BRUISES, etc SHOULDERS -FRACTURES,

LACERATIONS etc CHEST - LACERATIONS, STAB.

BULLET WOUNDS etc

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PHYSICAL ASSESSMENT (CONT)

ABDOMEN - TENDERNESS, BRUISES

PELVIC REGION- BRUISES, LACERATIONS, etc

UPPER EXTREMITIES - FRACTURES, DEFORMITIES, DISLOCATIONS etc

LOWER EXTREMITIES- FRACTURES, etc.

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AIRWAY OBSTRUCTION

TONGUE / MUSCLE

FOREIGN BODY/ SOLID

OBJECT

SWELLING/ TRAUMA , ANAPHYLAXIS

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AIRWAY ADJUNCTS

ARTIFICIAL AIRWAYS/ OP TUBES, etc

TWO FUNCTIONS, namely, KEEP THE TONGUE FROM BLOCKING

MAKING SUCTIONING EASIER

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SUCTIONING TECHNICQUES

CHECK THE UNIT TURN ON SELECT & ATTACH CATHETER MEASURE THE CATHETER TURN PT ON LATERAL SIDE

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SUCTIONING (cont)

OPEN PT MOUTH INSERT THE CATHETER’S TIP RELEASE THE CLAMP ON THE

TUBE SUCTION FOR NOT MORE THAN 15

SECONDS

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SUCTIONING (cont)

REMOVE THE CATHETER

RINSE THE CATHETER WITH WATER

REPEAT SUCTIONING IF NECESSARY

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OPENING MANEOUVER

HEAD TILT-CHIN LIFT

FINGER SWEEP

JAW THRUST

TONGUE TUCK -JAW PULL

HEAD TILT NECK LIFT

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THERE ISN’T A SECOND TO SPARE IN

TREATING A CHOKING VICTIM

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OPENING TECHNIQUES

BACK SLAPS

HEIMLICH MANEOUVER

ABDOMINAL THRUST

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CARDIAC PULMONARY RESUSCITATION

WHY? BRAIN DAMAGE

WHEN ? CARDIAC ARREST

CHAIN OF ARREST- AIRWAY OBSTRUCTION, RESPIRATORY ARREST & CARDIAC ARREST

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CPR (cont)

LANDMARKS/ LOCATIONS

CARDIAC COMPRESSIONS / DEPTH AND RATE

LATEST ALGORITHM

CHANGES IN ALGORITHM

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“..Breathed into his nostrils the breath of life; and man became a living soul”

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DON’T LET YOUR CPR SKILLS GET RUSTY, A PATIENT’S LIFE MAY

DEPEND ON THEM

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MEDICO-LEGAL ISSUES ABANDONMENT/ TERMINATION OF

CARE

CONSENT/ PERMISSION TO TREAT

NEGLIGENCE/ FAILURE TO PROVIDE CARE.

BASED ON FOUR FACTORS

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MEDICO-LEGAL (CONT)

DUTY TO ACT- RESPONSIBILITY

BREACH OF DUTY- NOT PROVIDING CARE

DAMAGE- HARMED THE PATIENT

CAUSE- DROPPING THE PATIENT

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MEDICO-LEGAL (cont)

CONFIDENTIALITY

“WHAT U HEAR HERE, WHAT U SEE HERE ,WHEN U LEAVE HERE, LET IT STAY HERE”

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MEDICO-LEGAL ISSUES(CONT)

THE RULE OF THUMB

“IF IT WASN’T WRITTEN DOWN , IT WASN’T DONE”

“IF YOU DIDN’T DO IT, DON’T DOCUMENT IT “

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MEDICO-LEGAL (CONT)

ETHICAL RESPONSIBILITY- CARING FOR ALL PATIENTS WITH A SENCE OF EXCELLENCE.

YOU SHOULD REVIEW YOUR PERFORMANCE FROM TIME TO TIME.

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MEDICO-LEGAL (CONT) SCOPE OF PRACTICE- OUTLINES

THE CARE

YOU MUST PRACTICE YOU SKILLS TO THE POINT OF MASTERY

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MEDICO-LEGAL (CONT)

“DISCRIMINATION OF ANY KIND HAS NO PLACE IN THE EMS “

“ I WILL NOT PERMIT CONSIDERATION OF RELIGION, NATIONALITY, RACE, POLITICAL PARTY OR SOCIAL STANDING TO INTERVENE BETWEEN MY DUTY AND PATIENT ”

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1.- Tilt your head onto your right shoulder.

2.- Move your face about 2 feet in front of the screen and look closely.

3.It should take 30 seconds for your eyes to focus

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STOP LOOKING LIKE A BLANK PAGE & GET BACK TO WORK …!