1 BAA REFRESHER 17/09/2002

2 PRESENTERS: Me Van Wyk Mr. Smith

3 OBJECTIVES  PATIENT ASSESSMENT  AIRWAY OBSTRUCTION  CARDIAC PULMONARY RESUSCITATION  MEDICO-LEGAL ISSUES

4 PATIENT ASSESSMENT  DO NO HARM  RETURN THE PATIENT TO NORMAL FUNCTIONAL LIFE  DEVIDED INTO FOUR SECTIONS

5 PATIENT ASSESSMENT (CONT) * INITIAL ASSESSMENT * PRIMARY SURVEY * SECONDARY SURVEY * PHYSICAL ASSESSMENT

6 INITIAL ASSESSMENT  QUICK SCENE SIZE UP  HAZARDOUS MATERIAL  PROTECTIVE GEAR  AVPU  THE NEED FOR CPR

7 PRIMARY SURVEY (CONT)  AIRWAY- PATENT/ IF NOT ATTEND  BREATHING-IF ABSENT/ ASSIST VENTILATIONS  CIRCULATION- PULSE/ IF ABSENT CPR

8 SECONDARY SURVEY  SAMPLE HISTORY  VITAL SIGNS  GCS / RTS  PHYSICAL ASSESSMENT

9 SECONDARY SURVEY (CONT) SAMPLE HISTORY-  SIGNS & SYMPTOMS  ALLERGIC REACTION  MEDICATIONS  PREVIOUS ILLNESSES  LAST ORAL MEAL  EVENTS LEADING TO EPISODE

10 VITAL SIGNS  BLOOD PRESSURE/ BP  PULSE  HEAMOGLUCO TEST/ HGT  RESPIRATIONS  TEMPARATURE  CAPPILARY REFILL

11 GLASCOW COMA SCALE (GCS)  EYE OPENING  VERBAL RESPONSE  MOTOR RESPONSE

12 REVISED TRAUMA SCORE (RTS)  RESPIRATORY RATE  RESPIRATORY RETRACTION  SYSTOLIC BLOOD PRESSURE  CAPILLARY REFILL

13 PHYSICAL ASSESSMENT  HEAD -EARS- EYES- / LACERATIONS, etc  NECK- LACERATIONS/ BRUISES, etc  SHOULDERS -FRACTURES, LACERATIONS etc  CHEST - LACERATIONS, STAB. BULLET WOUNDS etc

14 PHYSICAL ASSESSMENT (CONT)  ABDOMEN - TENDERNESS, BRUISES  PELVIC REGION- BRUISES, LACERATIONS, etc  UPPER EXTREMITIES - FRACTURES, DEFORMITIES, DISLOCATIONS etc  LOWER EXTREMITIES- FRACTURES, etc.

15 AIRWAY OBSTRUCTION  TONGUE / MUSCLE  FOREIGN BODY/ SOLID OBJECT  SWELLING/ TRAUMA, ANAPHYLAXIS

16 AIRWAY ADJUNCTS  ARTIFICIAL AIRWAYS/  OP TUBES, etc TWO FUNCTIONS, namely, KEEP THE TONGUE FROM BLOCKING  MAKING SUCTIONING EASIER

17 SUCTIONING TECHNICQUES  CHECK THE UNIT  TURN ON  SELECT & ATTACH CATHETER  MEASURE THE CATHETER  TURN PT ON LATERAL SIDE

18 SUCTIONING (cont)  OPEN PT MOUTH  INSERT THE CATHETER’S TIP  RELEASE THE CLAMP ON THE TUBE  SUCTION FOR NOT MORE THAN 15 SECONDS

19 SUCTIONING (cont)  REMOVE THE CATHETER  RINSE THE CATHETER WITH WATER  REPEAT SUCTIONING IF NECESSARY

20 OPENING MANEOUVER  HEAD TILT-CHIN LIFT  FINGER SWEEP  JAW THRUST  TONGUE TUCK -JAW PULL  HEAD TILT NECK LIFT

21 THERE ISN’T A SECOND TO SPARE IN TREATING A CHOKING VICTIM

22 OPENING TECHNIQUES  BACK SLAPS  HEIMLICH MANEOUVER  ABDOMINAL THRUST

23 CARDIAC PULMONARY RESUSCITATION  WHY? BRAIN DAMAGE  WHEN ? CARDIAC ARREST  CHAIN OF ARREST- AIRWAY OBSTRUCTION, RESPIRATORY ARREST & CARDIAC ARREST

24 CPR (cont)  LANDMARKS/ LOCATIONS  CARDIAC COMPRESSIONS / DEPTH AND RATE  LATEST ALGORITHM  CHANGES IN ALGORITHM

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

26 DON’T LET YOUR CPR SKILLS GET RUSTY, A PATIENT’S LIFE MAY DEPEND ON THEM

27 MEDICO-LEGAL ISSUES  ABANDONMENT/ TERMINATION OF CARE  CONSENT/ PERMISSION TO TREAT  NEGLIGENCE/ FAILURE TO PROVIDE CARE.  BASED ON FOUR FACTORS

28 MEDICO-LEGAL (CONT)  DUTY TO ACT- RESPONSIBILITY  BREACH OF DUTY- NOT PROVIDING CARE  DAMAGE- HARMED THE PATIENT  CAUSE- DROPPING THE PATIENT

29 MEDICO-LEGAL (cont)  CONFIDENTIALITY “WHAT U HEAR HERE, WHAT U SEE HERE,WHEN U LEAVE HERE, LET IT STAY HERE”

30 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 “

31 MEDICO-LEGAL (CONT)  ETHICAL RESPONSIBILITY- CARING FOR ALL PATIENTS WITH A SENCE OF EXCELLENCE.  YOU SHOULD REVIEW YOUR PERFORMANCE FROM TIME TO TIME.

32 MEDICO-LEGAL (CONT)  SCOPE OF PRACTICE- OUTLINES THE CARE  YOU MUST PRACTICE YOU SKILLS TO THE POINT OF MASTERY

33 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 ”

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