PRACTICE QUIZ for CSR - paradisehomepages.paradise.net.nz/gettingustarted/Downloads/CSR Practice... · CSR PRACTICE QUIZ 1. What is meant by the term “Indications”? ... hypoglycemia

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PHARMACOLOGY


1. What is meant by the term

“Indications”?

PHARMACOLOGY


“Contra Indications”?

When the drug should be usedWhen the drug should be usedWhen the drug should be usedWhen the drug should be used


“Physiological action”?

When the drug should When the drug should When the drug should When the drug should NOTNOTNOTNOT be usedbe usedbe usedbe used

How does the drug workHow does the drug workHow does the drug workHow does the drug work

4. Name, order of absorption, the differentRoutes that a drug can be administered by

IIIIntavenousntavenousntavenousntavenous 30 to 60 Sec30 to 60 Sec30 to 60 Sec30 to 60 Sec

IIIInhalationnhalationnhalationnhalation 3 3 3 3 minsminsminsmins

EEEEndotrachaelndotrachaelndotrachaelndotrachael 3 3 3 3 minsminsminsmins

SSSSublingualublingualublingualublingual 3 to 5 3 to 5 3 to 5 3 to 5 minsminsminsmins

RRRRectalectalectalectal 5 to 30 5 to 30 5 to 30 5 to 30 minsminsminsmins

IIIIntramuscularntramuscularntramuscularntramuscular 10 to 20 10 to 20 10 to 20 10 to 20 minsminsminsmins

OOOOralralralral 30 to 90 30 to 90 30 to 90 30 to 90 minsminsminsmins

IIESRIOIIESRIOIIESRIOIIESRIO


1. What is the full name of Cardiprin?

ASPIRIN

AAAAspirinspirinspirinspirin

2. What effect does Aspirin have? Antipyretic, Antipyretic, Antipyretic, Antipyretic,

3. What is the correct dosage of Aspirin? 300mg300mg300mg300mg given orallygiven orallygiven orallygiven orally

4. Name 3 alternative names for Aspirin? SSSSolprinolprinolprinolprin, , , ,

5. What are the 3 contra-indications for Aspirin?a.a.a.a. AAAAllergicllergicllergicllergic

b.b.b.b. GGGGastrointestinal Bleedingastrointestinal Bleedingastrointestinal Bleedingastrointestinal Bleeding

c.c.c.c. AAAAsthmatic with previous worsening sthmatic with previous worsening sthmatic with previous worsening sthmatic with previous worsening

of asthma after aspirin or nonof asthma after aspirin or nonof asthma after aspirin or nonof asthma after aspirin or non----steroidal antisteroidal antisteroidal antisteroidal anti----inflammatory drugs.inflammatory drugs.inflammatory drugs.inflammatory drugs.

AGAAGAAGAAGA

AAAAAAAAAAAAAAAA Analgesic,Analgesic,Analgesic,Analgesic,

AntiAntiAntiAnti----inflammatory, inflammatory, inflammatory, inflammatory, AAAAntintintinti----platelet effectsplatelet effectsplatelet effectsplatelet effects

AAAAspecspecspecspec, , , ,

CCCCartiaartiaartiaartia, , , ,

CCCCardiprin, ardiprin, ardiprin, ardiprin,

AAAAsprosprosprospro, , , , EEEEcotrincotrincotrincotrin DDDDisprinisprinisprinisprin

SACCAEDSACCAEDSACCAEDSACCAED


1. What is Entonox?

ENTONOX

2. When would you give Entonox?

AAAAnalgesic gas made up of nalgesic gas made up of nalgesic gas made up of nalgesic gas made up of 50% Nitrous 50% Nitrous 50% Nitrous 50% Nitrous

Oxide and 50% Oxygen.Oxide and 50% Oxygen.Oxide and 50% Oxygen.Oxide and 50% Oxygen.

3. Name 4 contra-indications of Entonox? a.a.a.a. Anyone who has been Anyone who has been Anyone who has been Anyone who has been SSSSCUBA CUBA CUBA CUBA

Diving in the last 24 hours or has Diving in the last 24 hours or has Diving in the last 24 hours or has Diving in the last 24 hours or has

suspected decompression illness.suspected decompression illness.suspected decompression illness.suspected decompression illness.

b.b.b.b. Anyone who is unable to Anyone who is unable to Anyone who is unable to Anyone who is unable to OOOObey bey bey bey

commands.commands.commands.commands.

c.c.c.c. Anyone with a suspected Anyone with a suspected Anyone with a suspected Anyone with a suspected PPPPneumothorax. neumothorax. neumothorax. neumothorax. (Enlarges)(Enlarges)(Enlarges)(Enlarges)

d.d.d.d. Anyone with a current diagnosed Anyone with a current diagnosed Anyone with a current diagnosed Anyone with a current diagnosed

BBBBowel Obstruction.owel Obstruction.owel Obstruction.owel Obstruction.

�Given to anyone to Given to anyone to Given to anyone to Given to anyone to self administerself administerself administerself administer to to to to

themselves, themselves, themselves, themselves, �that is in that is in that is in that is in PPPPain, including Chest Pain with ain, including Chest Pain with ain, including Chest Pain with ain, including Chest Pain with

the exception of the contrathe exception of the contrathe exception of the contrathe exception of the contra----indications.indications.indications.indications.

3. When is it NOT contra-indicated? CCCChest Injuries as long as breathing is hest Injuries as long as breathing is hest Injuries as long as breathing is hest Injuries as long as breathing is

OKOKOKOK

SOPBSOPBSOPBSOPB

SPSPSPSP


1. What is the generic name of GTN?

GTN

2. What does GTN do?

GGGGlyceryl Trinitrate.lyceryl Trinitrate.lyceryl Trinitrate.lyceryl Trinitrate.

3. What is preload?

� Widespread universal Widespread universal Widespread universal Widespread universal vasodilatorvasodilatorvasodilatorvasodilator

� used to used to used to used to decreasedecreasedecreasedecrease PreloadPreloadPreloadPreload and and and and

AfterloadAfterloadAfterloadAfterload on the heart and on the heart and on the heart and on the heart and

� therefore therefore therefore therefore decreasingdecreasingdecreasingdecreasing Cardiac Output Cardiac Output Cardiac Output Cardiac Output because of a decrease of Venous returnbecause of a decrease of Venous returnbecause of a decrease of Venous returnbecause of a decrease of Venous return

V, P, A, C/OV, P, A, C/OV, P, A, C/OV, P, A, C/O

� The amount of The amount of The amount of The amount of BBBBlood that returns back lood that returns back lood that returns back lood that returns back to the heartto the heartto the heartto the heart

� GTN affects preload byGTN affects preload byGTN affects preload byGTN affects preload by widespread widespread widespread widespread

VVVVasodilatationasodilatationasodilatationasodilatation therefore therefore therefore therefore

�IIIIncreasing venous poolingncreasing venous poolingncreasing venous poolingncreasing venous pooling andandandand

� RRRReducing the amount of blood that educing the amount of blood that educing the amount of blood that educing the amount of blood that returns back to the heartreturns back to the heartreturns back to the heartreturns back to the heart

B, V, I, RB, V, I, RB, V, I, RB, V, I, R


GTN

5. What dosage of GTN do you administer

for cardiac chest pain?

0.8mg0.8mg0.8mg0.8mg sublingually every sublingually every sublingually every sublingually every 5555 minutes minutes minutes minutes

provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure is >is >is >is >80808080mmHgmmHgmmHgmmHg


for CHF?

0.40.40.40.4----8mg8mg8mg8mg sublingually every sublingually every sublingually every sublingually every 2222----5555 minutes minutes minutes minutes

provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure

is >is >is >is >80808080mmHgmmHgmmHgmmHg

4. What afterload? � The amount of The amount of The amount of The amount of PPPPeripheral eripheral eripheral eripheral RRRResistance esistance esistance esistance

created by the created by the created by the created by the � SSSSystemic ystemic ystemic ystemic SSSSystem that the ystem that the ystem that the ystem that the

� VVVVentricles has to eject against.entricles has to eject against.entricles has to eject against.entricles has to eject against.

PR, SS, VPR, SS, VPR, SS, VPR, SS, V


7. What are 2 contra-indications for GTN?

GTN

8. What are some of the side effects of GTN?

a.a.a.a. Patients who used Patients who used Patients who used Patients who used VVVViagra within the iagra within the iagra within the iagra within the

last 24 hourslast 24 hourslast 24 hourslast 24 hoursb.b.b.b. Systolic Systolic Systolic Systolic BBBBlood lood lood lood PPPPressure under ressure under ressure under ressure under

80mmHg80mmHg80mmHg80mmHg

DDDDizzinessizzinessizzinessizziness

HHHHeadacheseadacheseadacheseadaches

SlightSlightSlightSlight Increase in Increase in Increase in Increase in HHHHeart Rateeart Rateeart Rateeart RateHHHHypotensionypotensionypotensionypotension

PPPPalpitationsalpitationsalpitationsalpitations

DHHHPDHHHPDHHHPDHHHP

And the 2 “Use with cautions”?

a. If patient nearing a. If patient nearing a. If patient nearing a. If patient nearing 80808080mmHgmmHgmmHgmmHg

b. Known Hypersensitivity (b. Known Hypersensitivity (b. Known Hypersensitivity (b. Known Hypersensitivity (AAAAllergy)llergy)llergy)llergy)

V B/PV B/PV B/PV B/P

B/P AB/P AB/P AB/P A


1. How does Salbutamol work?

SALBUTAMOL

2a. What are the 3 pathophysiological

components of asthma?

It is a It is a It is a It is a ““““BBBBeta2eta2eta2eta2 specific specific specific specific sypathomimeticsypathomimeticsypathomimeticsypathomimeticAAAAgonistgonistgonistgonist BBBBronchodilatorronchodilatorronchodilatorronchodilator”””” meaning:meaning:meaning:meaning:

3. What is the correct dosage of Salbutamol

For children 3 years old?

2.5mg 2.5mg 2.5mg 2.5mg via a nebuliser, Repeat PRNvia a nebuliser, Repeat PRNvia a nebuliser, Repeat PRNvia a nebuliser, Repeat PRN

a.a.a.a. BBBBronchoconstrictionronchoconstrictionronchoconstrictionronchoconstriction

b.b.b.b. BBBBronchospasmronchospasmronchospasmronchospasm

c.c.c.c. MMMMucous plugging which causes ucous plugging which causes ucous plugging which causes ucous plugging which causes

narrowing of the airwaysnarrowing of the airwaysnarrowing of the airwaysnarrowing of the airways

4. What age range does this child dose of

Salbutamol apply to?2.5mg2.5mg2.5mg2.5mg for ages for ages for ages for ages 0 to 60 to 60 to 60 to 6, repeated PRN, repeated PRN, repeated PRN, repeated PRN

BBMBBMBBMBBM

2. What are the contraindications

of Salbutamol?

�Hypersensitivity (Hypersensitivity (Hypersensitivity (Hypersensitivity (AAAAllergy)llergy)llergy)llergy)

�TTTThreatened abortionhreatened abortionhreatened abortionhreatened abortion

1a. What are the indications for it’s use? AAAAsthma, sthma, sthma, sthma,

AABCSAABCSAABCSAABCS

BABBABBABBAB

MBBMBBMBBMBB It It It It MMMMimicsimicsimicsimics the sympathetic nervous system the sympathetic nervous system the sympathetic nervous system the sympathetic nervous system by by by by dilatingdilatingdilatingdilating the the the the BBBBronchioles and therebyronchioles and therebyronchioles and therebyronchioles and therebyrelievingrelievingrelievingrelieving BBBBronchospasmronchospasmronchospasmronchospasm

AAAAnaphylaxis, naphylaxis, naphylaxis, naphylaxis, BBBBronchitis, ronchitis, ronchitis, ronchitis,

CCCCORD, ORD, ORD, ORD, SSSSmoke Inhalationmoke Inhalationmoke Inhalationmoke Inhalation

ATATATAT


5. What is the correct dosage of

Salbutamol for adults?

SALBUTAMOL

6. What are some of the side effects

of Salbutamol?

5mg5mg5mg5mg repeated PRNrepeated PRNrepeated PRNrepeated PRN

7. Other than asthma, what other 2 reasons

would we give Salbutamol for?

1.1.1.1. SSSSmoke Inhalationmoke Inhalationmoke Inhalationmoke Inhalation

2.2.2.2. AAAAnaphylaxis when presented with a naphylaxis when presented with a naphylaxis when presented with a naphylaxis when presented with a

wheeze.wheeze.wheeze.wheeze.

a.a.a.a. TTTTremorsremorsremorsremors

b.b.b.b. Mild increase in Mild increase in Mild increase in Mild increase in HHHHeart rateeart rateeart rateeart ratec.c.c.c. HHHHeadacheeadacheeadacheeadache

8. What other procedure would you consider

in your treatment of an Asthma Patient?

a. a. a. a. IVIVIVIV access if not improvingaccess if not improvingaccess if not improvingaccess if not improving

b. b. b. b. APAPAPAP for administration of adrenalinefor administration of adrenalinefor administration of adrenalinefor administration of adrenaline

9. If respiratory arrest occurs, what should

you do?

VVVVentilate at rate of entilate at rate of entilate at rate of entilate at rate of 6 breaths/min6 breaths/min6 breaths/min6 breaths/min

THHTHHTHHTHH

SASASASA


1. When would we administer Glucagon?

GLUCAGON

2. What is the normal blood sugar range?

Diabetes patient who:Diabetes patient who:Diabetes patient who:Diabetes patient who:a.a.a.a. Have a lowered Have a lowered Have a lowered Have a lowered LLLLOCOCOCOC

b.b.b.b. Have a Have a Have a Have a BBBBlood Sugarlood Sugarlood Sugarlood Sugar normally below normally below normally below normally below

3.5mmol/l3.5mmol/l3.5mmol/l3.5mmol/l

c.c.c.c. When the patient is unable toWhen the patient is unable toWhen the patient is unable toWhen the patient is unable to SSSSwallowwallowwallowwallow

drinks or fooddrinks or fooddrinks or fooddrinks or food

d.d.d.d. When When When When unableunableunableunable to obtainto obtainto obtainto obtain IIIIVVVV accessaccessaccessaccesse.e.e.e. It is It is It is It is unsafeunsafeunsafeunsafe to obtainto obtainto obtainto obtain IIIIVVVV access.access.access.access.

3. How does Glucagon work?

3.5 to 83.5 to 83.5 to 83.5 to 8 mmol/lmmol/lmmol/lmmol/l

2a. What is the upper range when we are

required to treat the patient and with what ?

a.a.a.a. 20202020mmol/lmmol/lmmol/lmmol/l

b.b.b.b. And the have anAnd the have anAnd the have anAnd the have an AAAAltered LOC ltered LOC ltered LOC ltered LOC orororor

TTTTachycardiaachycardiaachycardiaachycardia

GIVEGIVEGIVEGIVE::::a.a.a.a. 1000mls1000mls1000mls1000mls of 0.9% of 0.9% of 0.9% of 0.9% NaClNaClNaClNaCl as a bolusas a bolusas a bolusas a bolusb.b.b.b. GGGGive a further ive a further ive a further ive a further 20ml/Kg20ml/Kg20ml/Kg20ml/Kg enrouteenrouteenrouteenroute

a. a. a. a. RRRReleases all stored glycogen in the liver eleases all stored glycogen in the liver eleases all stored glycogen in the liver eleases all stored glycogen in the liver

and converts to glucose.and converts to glucose.and converts to glucose.and converts to glucose.

b. b. b. b. LLLLimited to the storage of glycogen in imited to the storage of glycogen in imited to the storage of glycogen in imited to the storage of glycogen in

the liver at that point of time.the liver at that point of time.the liver at that point of time.the liver at that point of time.c. c. c. c. GGGGluconeogenesis (converts glucose luconeogenesis (converts glucose luconeogenesis (converts glucose luconeogenesis (converts glucose

from amino acids).from amino acids).from amino acids).from amino acids).

LBSIILBSIILBSIILBSII

RLGRLGRLGRLG


GLUCAGON

Adult:Adult:Adult:Adult: 1mg1mg1mg1mg

Child:Child:Child:Child: 0.5mg0.5mg0.5mg0.5mg

4. What are the adult and child dosages

of Glucagon?


1. When would we administer I.V Dextrose

to a patient?

DEXTROSE

2. How much 10% Dextrose would we

Initially administer to a patient who is suffering

hypoglycemia and can not take oral fluids?

To a Hypoglycemic patient which has:To a Hypoglycemic patient which has:To a Hypoglycemic patient which has:To a Hypoglycemic patient which has:

a.a.a.a. An An An An altered LOCaltered LOCaltered LOCaltered LOC

b.b.b.b. UnableUnableUnableUnable to swallowto swallowto swallowto swallow

c.c.c.c. IV accessIV accessIV accessIV access CANCANCANCAN be gainedbe gainedbe gainedbe gained

Adults:Adults:Adults:Adults: 100mls100mls100mls100mls followed by a further followed by a further followed by a further followed by a further

100mls100mls100mls100mls, , , , depending on how the BM depending on how the BM depending on how the BM depending on how the BM reading are after 5 minutes.reading are after 5 minutes.reading are after 5 minutes.reading are after 5 minutes.Child:Child:Child:Child: 2mls/Kg2mls/Kg2mls/Kg2mls/Kg

3. What must you do to the IV cannula after

It is inserted and before you

administer Dextrose?

A running line of NaCl is required as A running line of NaCl is required as A running line of NaCl is required as A running line of NaCl is required as

dextrose is very sclerosing if injected into dextrose is very sclerosing if injected into dextrose is very sclerosing if injected into dextrose is very sclerosing if injected into

interstitial tissueinterstitial tissueinterstitial tissueinterstitial tissue


AIRWAY MANAGEMENT

RESPIRATORY PROBLEMS



1. What can cause

Shortness of BreathShortness of BreathShortness of BreathShortness of Breath (SOB) ?

1)1)1)1) RRRRespiratory Problemsespiratory Problemsespiratory Problemsespiratory Problems

2)2)2)2) CCCCardiac Problemsardiac Problemsardiac Problemsardiac Problems

3)3)3)3) SSSSepsisepsisepsisepsis

4)4)4)4) PPPPsychogenicsychogenicsychogenicsychogenic

2. What can cause RespiratoryRespiratoryRespiratoryRespiratoryShortness of Breath?

a)a)a)a) Upper AirwayUpper AirwayUpper AirwayUpper Airway� Foreign Body ObstructionForeign Body ObstructionForeign Body ObstructionForeign Body Obstruction

� CroupCroupCroupCroup

� EpiglottitisEpiglottitisEpiglottitisEpiglottitis

b)b)b)b) Lower AirwayLower AirwayLower AirwayLower Airway� AsthmaAsthmaAsthmaAsthma

� CORDCORDCORDCORD

� BronchioltisBronchioltisBronchioltisBronchioltis

c)c)c)c) Lung TissueLung TissueLung TissueLung Tissue� PneumoniaPneumoniaPneumoniaPneumonia

� Pulmonary EmbolismPulmonary EmbolismPulmonary EmbolismPulmonary Embolism

� CORDCORDCORDCORD

� Lung ContusionLung ContusionLung ContusionLung Contusion

d)d)d)d) Pleural CavityPleural CavityPleural CavityPleural Cavity� PneumothoraxPneumothoraxPneumothoraxPneumothorax

� HaemothoraxHaemothoraxHaemothoraxHaemothorax

� Pleural effusionPleural effusionPleural effusionPleural effusion

e)e)e)e) Chest WallChest WallChest WallChest Wall� Rib FracturesRib FracturesRib FracturesRib Fractures

RCSPRCSPRCSPRCSP



Congestive Heart FailureCongestive Heart FailureCongestive Heart FailureCongestive Heart Failure with

Pulmonary edemaPulmonary edemaPulmonary edemaPulmonary edema3. What can cause CardiacCardiacCardiacCardiacShortness of Breath?

4. What can cause SepsisSepsisSepsisSepsisShortness of Breath?

Severe infectionSevere infectionSevere infectionSevere infection from any cause or

any site.

5. What can cause PsychogenicPsychogenicPsychogenicPsychogenicShortness of Breath?

HyperventilationHyperventilationHyperventilationHyperventilation of emotional of emotional of emotional of emotional

originoriginoriginorigin

6. What are the signs & Symptoms of a

patient suffering from HyperventilationHyperventilationHyperventilationHyperventilation?

� DizzinessDizzinessDizzinessDizziness

� Tingling of Fingers and LipsTingling of Fingers and LipsTingling of Fingers and LipsTingling of Fingers and Lips

� Spasm of hands and feetSpasm of hands and feetSpasm of hands and feetSpasm of hands and feet

7. How do you treat HyperventilationHyperventilationHyperventilationHyperventilation? � Lots of reassuranceLots of reassuranceLots of reassuranceLots of reassurance� Try and get patient to gain controlTry and get patient to gain controlTry and get patient to gain controlTry and get patient to gain control

8. What “caution” needs to be remembered

in treating a patient whom you believe is

suffering from HyperventilationHyperventilationHyperventilationHyperventilation?

� The diagnosis needs to be made The diagnosis needs to be made The diagnosis needs to be made The diagnosis needs to be made

after ALL other causes have been after ALL other causes have been after ALL other causes have been after ALL other causes have been

excludedexcludedexcludedexcluded



� Ensure Personal and Patient Ensure Personal and Patient Ensure Personal and Patient Ensure Personal and Patient SSSSafetyafetyafetyafety

� PPPPrimary Surveyrimary Surveyrimary Surveyrimary Survey

� OOOOxygen by nonxygen by nonxygen by nonxygen by non----rebreather mask rebreather mask rebreather mask rebreather mask or

� Bag Mask if UnconsciousBag Mask if UnconsciousBag Mask if UnconsciousBag Mask if Unconscious

� If wheeze present If wheeze present If wheeze present If wheeze present –––– AdministerAdministerAdministerAdminister

SSSSalbutamolalbutamolalbutamolalbutamol as per Asthma proceduresas per Asthma proceduresas per Asthma proceduresas per Asthma procedures

9. What is the treatment of a patient

who is suffering from Smoke InhalationSmoke InhalationSmoke InhalationSmoke Inhalation?


who is suffering from CORDCORDCORDCORD?


If hypoxia is immediately life threateningIf hypoxia is immediately life threateningIf hypoxia is immediately life threateningIf hypoxia is immediately life threatening

or Oxygen Saturation is < 88%:or Oxygen Saturation is < 88%:or Oxygen Saturation is < 88%:or Oxygen Saturation is < 88%:

� AAAAdjust Oxygen Flow to keep djust Oxygen Flow to keep djust Oxygen Flow to keep djust Oxygen Flow to keep

Saturation @ 88 to 92%Saturation @ 88 to 92%Saturation @ 88 to 92%Saturation @ 88 to 92%

� Give 5mg Give 5mg Give 5mg Give 5mg SSSSalbutamol and repeat albutamol and repeat albutamol and repeat albutamol and repeat

PRNPRNPRNPRN

SPOSSPOSSPOSSPOS

PASPASPASPAS




� OOOOxygen by nonxygen by nonxygen by nonxygen by non----rebreather maskrebreather maskrebreather maskrebreather mask

� CCCCall for an AP all for an AP all for an AP all for an AP (for Nebulised Adrenaline)(for Nebulised Adrenaline)(for Nebulised Adrenaline)(for Nebulised Adrenaline)


who is suffering from CroupCroupCroupCroup?

12. What causes

PULMONARY EDEMAPULMONARY EDEMAPULMONARY EDEMAPULMONARY EDEMA?

MMMMyocardial yocardial yocardial yocardial IIIIschemia or schemia or schemia or schemia or IIIInfarctionnfarctionnfarctionnfarction


RESPIRATORY PROBLEMS13. What is the Pathophysiological

components of


The The The The LEFTLEFTLEFTLEFT VentricleVentricleVentricleVentricle can not eject the bloodcan not eject the bloodcan not eject the bloodcan not eject the blood

returned to it from the right Ventricle.returned to it from the right Ventricle.returned to it from the right Ventricle.returned to it from the right Ventricle.

(Normal circumstances RV=LV output)

L) L) L) L) VentricleVentricleVentricleVentricle

R) R) R) R) VentricleVentricleVentricleVentricle

L) L) L) L)

AtriumAtriumAtriumAtrium

RV=LV RV=LV RV=LV RV=LV OUTPUTOUTPUTOUTPUTOUTPUT

BACKBACKBACKBACK

PRESSUREPRESSUREPRESSUREPRESSURE

BLOODBLOODBLOODBLOOD

SERUMSERUMSERUMSERUMPulmonary Pulmonary Pulmonary Pulmonary

CapillariesCapillariesCapillariesCapillaries

Aorta

L) Pulmonary Artery

R) Pulmonary Artery

Superior Vena Cava

R) Atrium

Inferior Vena Cava

Pulmonary Pulmonary Pulmonary Pulmonary

CapillariesCapillariesCapillariesCapillaries

R) Pulmonary

Veins

L) Pulmonary

Veins

� Therefore the Therefore the Therefore the Therefore the pressure in the pressure in the pressure in the pressure in the LEFTLEFTLEFTLEFT AtriumAtriumAtriumAtrium

risesrisesrisesrises and the and the and the and the back pressure builds up into back pressure builds up into back pressure builds up into back pressure builds up into

the Lungsthe Lungsthe Lungsthe Lungs

� Blood SerumBlood SerumBlood SerumBlood Serum is forced from the pulmonary is forced from the pulmonary is forced from the pulmonary is forced from the pulmonary

capillaries causing capillaries causing capillaries causing capillaries causing PULMONARY PULMONARY PULMONARY PULMONARY

EDEMAEDEMAEDEMAEDEMA

� As this fluid in the As this fluid in the As this fluid in the As this fluid in the AlveoliAlveoliAlveoliAlveoli increases, oxygen increases, oxygen increases, oxygen increases, oxygen

exchange is affected and hypoxia occursexchange is affected and hypoxia occursexchange is affected and hypoxia occursexchange is affected and hypoxia occurs

� May produce May produce May produce May produce RalesRalesRalesRales (Sound like rustling (Sound like rustling (Sound like rustling (Sound like rustling

hair)hair)hair)hair) in some patients in some patients in some patients in some patients (because of the fluid

build up)

� Patients with CORD may have heart failure Patients with CORD may have heart failure Patients with CORD may have heart failure Patients with CORD may have heart failure

as wellas wellas wellas well



14. What is the signs & symptoms of a patient

suffering from PULMONARY EDEMAPULMONARY EDEMAPULMONARY EDEMAPULMONARY EDEMA?� AAAApprehensionpprehensionpprehensionpprehension

� AAAAgitationgitationgitationgitation

� CCCCyanosisyanosisyanosisyanosis

� CCCConfusion (Hypoxia)onfusion (Hypoxia)onfusion (Hypoxia)onfusion (Hypoxia)

� Feeling of Feeling of Feeling of Feeling of DDDDrowningrowningrowningrowning

� Distended Distended Distended Distended JJJJugular Veins ugular Veins ugular Veins ugular Veins when lying when lying when lying when lying

downdowndowndown

� PPPPinkinkinkink sputum sputum sputum sputum ---- Advanced stage

� Cold, very Cold, very Cold, very Cold, very SSSSweaty Skinweaty Skinweaty Skinweaty Skin

� Severe Severe Severe Severe SSSSOBOBOBOB

AACCDJPSSAACCDJPSSAACCDJPSSAACCDJPSS




who is suffering from



� OOOOxygen to Maintain Sats @ >95%xygen to Maintain Sats @ >95%xygen to Maintain Sats @ >95%xygen to Maintain Sats @ >95%

� Determine Cardiac Determine Cardiac Determine Cardiac Determine Cardiac RRRRhythmhythmhythmhythm

� Allow to Allow to Allow to Allow to SSSSit it it it (Helps to pull excess fluid in feet not lungs)

Give:Give:Give:Give:

� 0.8mg 0.8mg 0.8mg 0.8mg GGGGTN provided the systolic TN provided the systolic TN provided the systolic TN provided the systolic

B/P >80mmHgB/P >80mmHgB/P >80mmHgB/P >80mmHgNoteNoteNoteNote::::

� CautionCautionCautionCaution & consider reducing dose if patient is elderly, small or hypotensive.

� Extreme CautionExtreme CautionExtreme CautionExtreme Caution if patient has taken Viagra in

last 24hrs (Prolonged Hypotension can occur)

� Gain Gain Gain Gain IIIIV accessV accessV accessV access

� IIIIPPV if necessary PPV if necessary PPV if necessary PPV if necessary (Increases Intrathorasic (Increases Intrathorasic (Increases Intrathorasic (Increases Intrathorasic

Pressure, thereby decreasing Venus return and Pressure, thereby decreasing Venus return and Pressure, thereby decreasing Venus return and Pressure, thereby decreasing Venus return and

therefore, Preload)therefore, Preload)therefore, Preload)therefore, Preload)

� Repeat 0.4 to 0.8mg of Repeat 0.4 to 0.8mg of Repeat 0.4 to 0.8mg of Repeat 0.4 to 0.8mg of GGGGTN every 2 TN every 2 TN every 2 TN every 2

to 5 minutes if B/P >80mmHgto 5 minutes if B/P >80mmHgto 5 minutes if B/P >80mmHgto 5 minutes if B/P >80mmHg

� LLLLOAD & GOOAD & GOOAD & GOOAD & GO

� UUUUrgent AP Backup rgent AP Backup rgent AP Backup rgent AP Backup (for Frusemide and/or

Morphine)

PORSGIIGLUPORSGIIGLUPORSGIIGLUPORSGIIGLU



16. Why do we use IPPVIPPVIPPVIPPV in the treatment of

a patient suffering from


� Increases IIIIntrantrantrantratttthorasic horasic horasic horasic PPPPressure,ressure,ressure,ressure,

� thereby decreasing VVVVenus enus enus enus RRRReturneturneturneturn

� and therefore, PPPPreloadreloadreloadreloadItP, VR, PItP, VR, PItP, VR, PItP, VR, P

17. What does the letters IPPVIPPVIPPVIPPV stand for?� IIIIntermittentntermittentntermittentntermittent

� PPPPositiveositiveositiveositive

� PPPPressureressureressureressure

� VVVVentilationentilationentilationentilation

18. What is PreloadPreloadPreloadPreload? BBBB � The amount of The amount of The amount of The amount of BBBBlood that returns back lood that returns back lood that returns back lood that returns back to the heartto the heartto the heartto the heart

V, I, RV, I, RV, I, RV, I, RWidespread Widespread Widespread Widespread VVVVasodilatationasodilatationasodilatationasodilatation therefore therefore therefore therefore

�IIIIncreasing venous poolingncreasing venous poolingncreasing venous poolingncreasing venous pooling andandandand� RRRReducing the amount of blood that educing the amount of blood that educing the amount of blood that educing the amount of blood that returns back to the heartreturns back to the heartreturns back to the heartreturns back to the heart

GTN affects preload by:GTN affects preload by:GTN affects preload by:GTN affects preload by:



19. What is AfterloadAfterloadAfterloadAfterload?


� The amount of PPPPeripheral eripheral eripheral eripheral RRRResistanceesistanceesistanceesistance

� created by the SSSSystemic ystemic ystemic ystemic SSSSystem ystem ystem ystem

� that the VVVVentricles entricles entricles entricles has to eject against.


1. What is the generic name of GTNgeneric name of GTNgeneric name of GTNgeneric name of GTN?

REVIEW OF GTN

2. What does GTNGTNGTNGTN do?

GGGGlyceryl Trinitrate.lyceryl Trinitrate.lyceryl Trinitrate.lyceryl Trinitrate.

3. What is PreloadPreloadPreloadPreload?

� Widespread universal Widespread universal Widespread universal Widespread universal vasodilatorvasodilatorvasodilatorvasodilator

� used to used to used to used to decreasedecreasedecreasedecrease PreloadPreloadPreloadPreload and and and and

AfterloadAfterloadAfterloadAfterload on the heart and on the heart and on the heart and on the heart and

� therefore therefore therefore therefore decreasingdecreasingdecreasingdecreasing Cardiac Output Cardiac Output Cardiac Output Cardiac Output because of a decrease of Venous returnbecause of a decrease of Venous returnbecause of a decrease of Venous returnbecause of a decrease of Venous return

V, P, A, C/OV, P, A, C/OV, P, A, C/OV, P, A, C/O

� The amount of The amount of The amount of The amount of BBBBlood that returns back lood that returns back lood that returns back lood that returns back to the heartto the heartto the heartto the heart

BBBB � The amount of The amount of The amount of The amount of BBBBlood that returns back lood that returns back lood that returns back lood that returns back to the heartto the heartto the heartto the heart

GTN affects preload by:GTN affects preload by:GTN affects preload by:GTN affects preload by:

Widespread Widespread Widespread Widespread VVVVasodilatationasodilatationasodilatationasodilatation therefore therefore therefore therefore

�IIIIncreasing venous poolingncreasing venous poolingncreasing venous poolingncreasing venous pooling andandandand� RRRReducing the amount of blood that educing the amount of blood that educing the amount of blood that educing the amount of blood that returns back to the heartreturns back to the heartreturns back to the heartreturns back to the heart

V, I, RV, I, RV, I, RV, I, R


REVIEW OF GTN


for CARDIAC CHEST PAINCARDIAC CHEST PAINCARDIAC CHEST PAINCARDIAC CHEST PAIN?

0.8mg0.8mg0.8mg0.8mg sublingually every sublingually every sublingually every sublingually every 5555 minutes minutes minutes minutes

provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure is >is >is >is >80808080mmHgmmHgmmHgmmHg


for CHFCHFCHFCHF?0.40.40.40.4----8mg8mg8mg8mg sublingually every sublingually every sublingually every sublingually every 2222----5555 minutes minutes minutes minutes

provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure provided the systolic blood pressure

is >is >is >is >80808080mmHgmmHgmmHgmmHg

4. What is AfterloadAfterloadAfterloadAfterload?


� The amount of PPPPeripheral eripheral eripheral eripheral RRRResistanceesistanceesistanceesistance

� created by the SSSSystemic ystemic ystemic ystemic SSSSystem ystem ystem ystem � that the VVVVentricles entricles entricles entricles has to eject against.


7. What are 2 CONTRACONTRACONTRACONTRA----INDICATIONSINDICATIONSINDICATIONSINDICATIONSfor GTN?

REVIEW OF GTN

8. What are some of the

SIDE EFFECTSSIDE EFFECTSSIDE EFFECTSSIDE EFFECTS of GTN?

a.a.a.a. Patients who used Patients who used Patients who used Patients who used VVVViagra within the iagra within the iagra within the iagra within the

last 24 hourslast 24 hourslast 24 hourslast 24 hoursb.b.b.b. Systolic Systolic Systolic Systolic BBBBlood Pressure under lood Pressure under lood Pressure under lood Pressure under


DDDDizzinessizzinessizzinessizziness

HHHHeadacheseadacheseadacheseadaches

SlightSlightSlightSlight Increase in Increase in Increase in Increase in HHHHeart Rateeart Rateeart Rateeart RateHHHHypotensionypotensionypotensionypotension

PPPPalpitationsalpitationsalpitationsalpitations

DHHHPDHHHPDHHHPDHHHP

And the 2

““““USE WITH CAUTIONSUSE WITH CAUTIONSUSE WITH CAUTIONSUSE WITH CAUTIONS””””?a. If patient nearing a. If patient nearing a. If patient nearing a. If patient nearing 80808080mmHgmmHgmmHgmmHg

b. Known Hypersensitivity (b. Known Hypersensitivity (b. Known Hypersensitivity (b. Known Hypersensitivity (AAAAllergy)llergy)llergy)llergy)

V B/PV B/PV B/PV B/P

B/P AB/P AB/P AB/P A


1. What is the treatment for a

Conscious Adult or Child Patient with an

airway obstruction?

FOREIGN BODY AIRWAY OBSTRUCTION

�Give 5 Give 5 Give 5 Give 5 BBBBack Blowsack Blowsack Blowsack BlowsFollow by:Follow by:Follow by:Follow by:

� 5 5 5 5 AAAAbdominal Thrusts if blows failbdominal Thrusts if blows failbdominal Thrusts if blows failbdominal Thrusts if blows fail�In very obese or pregnant patients use In very obese or pregnant patients use In very obese or pregnant patients use In very obese or pregnant patients use

CCCChest Trusts instead of abdominal thrustshest Trusts instead of abdominal thrustshest Trusts instead of abdominal thrustshest Trusts instead of abdominal thrusts

�CCCContinue cycle until either obstruction is ontinue cycle until either obstruction is ontinue cycle until either obstruction is ontinue cycle until either obstruction is

relieved or the patient becomes relieved or the patient becomes relieved or the patient becomes relieved or the patient becomes

unconsciousunconsciousunconsciousunconscious

� Under direct vision try to find andUnder direct vision try to find andUnder direct vision try to find andUnder direct vision try to find and

remove the foreign body with yourremove the foreign body with yourremove the foreign body with yourremove the foreign body with your

FFFFingersingersingersingers

� Give Give Give Give CCCChest Trusts if the above failshest Trusts if the above failshest Trusts if the above failshest Trusts if the above fails

� Open the airway and try andOpen the airway and try andOpen the airway and try andOpen the airway and try and

ventilate using a manual ventilationventilate using a manual ventilationventilate using a manual ventilationventilate using a manual ventilation

BBBBagagagag

� Call for an Call for an Call for an Call for an AAAAP URGENTLY!!!!P URGENTLY!!!!P URGENTLY!!!!P URGENTLY!!!!

2. What is the treatment for a

Unconscious Patient with an airway obstruction?

BACCBACCBACCBACC

FCBAFCBAFCBAFCBA


3. Conscious Infant Patient with an

airway obstruction?

FOREIGN BODY AIRWAY OBSTRUCTION

�Give 5 Give 5 Give 5 Give 5 BBBBack Blowsack Blowsack Blowsack BlowsFollow by:Follow by:Follow by:Follow by:

� 5 5 5 5 CCCChest Thrusts if blows failhest Thrusts if blows failhest Thrusts if blows failhest Thrusts if blows fail�CCCContinue cycle until either obstruction is ontinue cycle until either obstruction is ontinue cycle until either obstruction is ontinue cycle until either obstruction is

relieved or the patient becomes relieved or the patient becomes relieved or the patient becomes relieved or the patient becomes

unconsciousunconsciousunconsciousunconscious

BCCBCCBCCBCC


NASOPHARYNGEAL AIRWAY

1. What are the indications for the insertion

of a Nasopharyngeal Airway?

�To provide an alternative airway for To provide an alternative airway for To provide an alternative airway for To provide an alternative airway for patients with patients with patients with patients with TTTTrismus, in which an rismus, in which an rismus, in which an rismus, in which an oropharyngeal airway placement is not oropharyngeal airway placement is not oropharyngeal airway placement is not oropharyngeal airway placement is not possiblepossiblepossiblepossible�To provide airway assistant where an To provide airway assistant where an To provide airway assistant where an To provide airway assistant where an OOOOrorororoppppharyngeal airway will not be toleratedharyngeal airway will not be toleratedharyngeal airway will not be toleratedharyngeal airway will not be tolerated�To provide a portal for airway suction To provide a portal for airway suction To provide a portal for airway suction To provide a portal for airway suction and and and and RRRRemoval of debrisemoval of debrisemoval of debrisemoval of debris

2. What are the pre-cautions for

the use of a Nasopharyngeal Airway?

�Vascular Vascular Vascular Vascular AAAAbnormalities of the nosebnormalities of the nosebnormalities of the nosebnormalities of the nose�BBBBleeding disordersleeding disordersleeding disordersleeding disorders�IIIInfection in the nosenfection in the nosenfection in the nosenfection in the nose�TTTTrauma to the noserauma to the noserauma to the noserauma to the nose�Patient on antiPatient on antiPatient on antiPatient on anti----coagulant coagulant coagulant coagulant ((((warfrinwarfrinwarfrinwarfrin/aspirin)/aspirin)/aspirin)/aspirin)

3. What are the complications in the

use of a Nasopharyngeal Airway?

�AAAAirway Obstruction, may kink or clogirway Obstruction, may kink or clogirway Obstruction, may kink or clogirway Obstruction, may kink or clog

�EEEEpistaxispistaxispistaxispistaxis

�Coughing Coughing Coughing Coughing LLLLaryngospasmaryngospasmaryngospasmaryngospasm

�VVVVagal stimulation if the tube is too longagal stimulation if the tube is too longagal stimulation if the tube is too longagal stimulation if the tube is too long

�GGGGaggingaggingaggingagging�VVVVomiting, difficult to suction throughomiting, difficult to suction throughomiting, difficult to suction throughomiting, difficult to suction through

ABITABITABITABIT

TOpRTOpRTOpRTOpR

AELVGVAELVGVAELVGVAELVGV



4. What is the better airway Oropharyngeal

Or Nasopharyngeal?

�Neither. Neither. Neither. Neither.

�An OP is preferableAn OP is preferableAn OP is preferableAn OP is preferable

�The placement of an The placement of an The placement of an The placement of an EndotrachelEndotrachelEndotrachelEndotrachel TTTTubeubeubeubeis the only method of providing a secure is the only method of providing a secure is the only method of providing a secure is the only method of providing a secure

airwayairwayairwayairway5. What sizes of Nasopharyngeal

Airway that are used by this service?

�8.58.58.58.5 Large AdultLarge AdultLarge AdultLarge Adult�7.57.57.57.5 Medium AdultMedium AdultMedium AdultMedium Adult�6.56.56.56.5 Small AdultSmall AdultSmall AdultSmall Adult

6. How do you choose the correct size

of Nasopharyngeal Airway?�Measure the airway by placing the Measure the airway by placing the Measure the airway by placing the Measure the airway by placing the

airway next to the patients face.airway next to the patients face.airway next to the patients face.airway next to the patients face.

�The airway should extend from the tip of The airway should extend from the tip of The airway should extend from the tip of The airway should extend from the tip of

the patients nose to the tip of the patients the patients nose to the tip of the patients the patients nose to the tip of the patients the patients nose to the tip of the patients

earlobeearlobeearlobeearlobe

�The diameter should be so the airway The diameter should be so the airway The diameter should be so the airway The diameter should be so the airway

can fit inside the patient nostril without can fit inside the patient nostril without can fit inside the patient nostril without can fit inside the patient nostril without

blanching the skin at the side of the nostrilblanching the skin at the side of the nostrilblanching the skin at the side of the nostrilblanching the skin at the side of the nostril



7. How do you insert the Airway?�Measure the airwayMeasure the airwayMeasure the airwayMeasure the airway

�Select the biggest nostrilSelect the biggest nostrilSelect the biggest nostrilSelect the biggest nostril

�Lubricate the airway, using KY JellyLubricate the airway, using KY JellyLubricate the airway, using KY JellyLubricate the airway, using KY Jelly

�Insert the airway into the nostril and aim Insert the airway into the nostril and aim Insert the airway into the nostril and aim Insert the airway into the nostril and aim

directly to the floor of the nose directly to the floor of the nose directly to the floor of the nose directly to the floor of the nose (aim towards (aim towards (aim towards (aim towards

the ear, not the top of the head)the ear, not the top of the head)the ear, not the top of the head)the ear, not the top of the head) straight back straight back straight back straight back

into the nasopharynxinto the nasopharynxinto the nasopharynxinto the nasopharynx

�If resistance is met rotate the airway gently If resistance is met rotate the airway gently If resistance is met rotate the airway gently If resistance is met rotate the airway gently

as you continue to insert it. as you continue to insert it. as you continue to insert it. as you continue to insert it.

�If you still can’t insert the airway, remove it If you still can’t insert the airway, remove it If you still can’t insert the airway, remove it If you still can’t insert the airway, remove it

and try the other nostril.and try the other nostril.and try the other nostril.and try the other nostril.

�You may feel it “give” as it turns the corner You may feel it “give” as it turns the corner You may feel it “give” as it turns the corner You may feel it “give” as it turns the corner

into the pharynxinto the pharynxinto the pharynxinto the pharynx

�When correctly inserted the flange of the When correctly inserted the flange of the When correctly inserted the flange of the When correctly inserted the flange of the

airway will lie against the flare of the nostrilairway will lie against the flare of the nostrilairway will lie against the flare of the nostrilairway will lie against the flare of the nostril

�Check that air is flowing through the airway, Check that air is flowing through the airway, Check that air is flowing through the airway, Check that air is flowing through the airway,

inhalation and exhalationinhalation and exhalationinhalation and exhalationinhalation and exhalation

�Check that insertion has not caused bleeding Check that insertion has not caused bleeding Check that insertion has not caused bleeding Check that insertion has not caused bleeding

–––– Suction if requiredSuction if requiredSuction if requiredSuction if required

�Maintain a Head TiltMaintain a Head TiltMaintain a Head TiltMaintain a Head Tilt

�If gagging or choking withdraw the airway If gagging or choking withdraw the airway If gagging or choking withdraw the airway If gagging or choking withdraw the airway

slightly and reassess for patencyslightly and reassess for patencyslightly and reassess for patencyslightly and reassess for patency



8. What position should you have your

patient in after insertion?�Recover Position if ableRecover Position if ableRecover Position if ableRecover Position if able


LARYNGEAL MASK AIRWAY

1. What are the indications for the insertion

of a LMA?�The airway is still poor despite other The airway is still poor despite other The airway is still poor despite other The airway is still poor despite other

airways being used (OP or NPA) and jaw airways being used (OP or NPA) and jaw airways being used (OP or NPA) and jaw airways being used (OP or NPA) and jaw

thrust thrust thrust thrust

orororor

�When bag/Mask ventilation is difficultWhen bag/Mask ventilation is difficultWhen bag/Mask ventilation is difficultWhen bag/Mask ventilation is difficult

orororor

�When the patient needs to be When the patient needs to be When the patient needs to be When the patient needs to be intubatedintubatedintubatedintubated

and no one is available to do soand no one is available to do soand no one is available to do soand no one is available to do so

orororor

�Intubation attempts have failedIntubation attempts have failedIntubation attempts have failedIntubation attempts have failed

2. What are the relative contraindications forthe use of a LMA?

�VomitingVomitingVomitingVomiting

�TrismusTrismusTrismusTrismus

3. What size mask do we use in this

service?

�Size 4Size 4Size 4Size 4


LMA MASK AIRWAY

4. How do you insert the Airway?

�Remove the airway from it’s packageRemove the airway from it’s packageRemove the airway from it’s packageRemove the airway from it’s package

�Fully deflate the cuff with the bowl of the cuff Fully deflate the cuff with the bowl of the cuff Fully deflate the cuff with the bowl of the cuff Fully deflate the cuff with the bowl of the cuff

pressed down on a flat surfacepressed down on a flat surfacepressed down on a flat surfacepressed down on a flat surface

�Lubricate the airway, using KY JellyLubricate the airway, using KY JellyLubricate the airway, using KY JellyLubricate the airway, using KY Jelly

�Hold the LMA using fingers and thumb (like holding Hold the LMA using fingers and thumb (like holding Hold the LMA using fingers and thumb (like holding Hold the LMA using fingers and thumb (like holding

a pen) at the cuff end of the LMAa pen) at the cuff end of the LMAa pen) at the cuff end of the LMAa pen) at the cuff end of the LMA

�Extend the neck gently and open the mouth Extend the neck gently and open the mouth Extend the neck gently and open the mouth Extend the neck gently and open the mouth

�Hold the LMA with the hole in the cuff facing the Hold the LMA with the hole in the cuff facing the Hold the LMA with the hole in the cuff facing the Hold the LMA with the hole in the cuff facing the

patient’s feet.patient’s feet.patient’s feet.patient’s feet.

�Press the cuff into the mouth and manoeuvre it past Press the cuff into the mouth and manoeuvre it past Press the cuff into the mouth and manoeuvre it past Press the cuff into the mouth and manoeuvre it past

the teeth keeping the tip firmly pressed against the the teeth keeping the tip firmly pressed against the the teeth keeping the tip firmly pressed against the the teeth keeping the tip firmly pressed against the

hard palatehard palatehard palatehard palate

�Once the cuff is past the teeth, grasp the LMA at the Once the cuff is past the teeth, grasp the LMA at the Once the cuff is past the teeth, grasp the LMA at the Once the cuff is past the teeth, grasp the LMA at the

proximal end between the thumb and fingersproximal end between the thumb and fingersproximal end between the thumb and fingersproximal end between the thumb and fingers

�Push the LMA into the pharynx in one smooth Push the LMA into the pharynx in one smooth Push the LMA into the pharynx in one smooth Push the LMA into the pharynx in one smooth

movement. Push directly downwards (backwards) so movement. Push directly downwards (backwards) so movement. Push directly downwards (backwards) so movement. Push directly downwards (backwards) so

that the LMA follows the curve of the posterior that the LMA follows the curve of the posterior that the LMA follows the curve of the posterior that the LMA follows the curve of the posterior

pharyngeal wall. Stop pushing when you begin to feel pharyngeal wall. Stop pushing when you begin to feel pharyngeal wall. Stop pushing when you begin to feel pharyngeal wall. Stop pushing when you begin to feel

some resistance.some resistance.some resistance.some resistance.

�Inflate the LMA with 30mls of airInflate the LMA with 30mls of airInflate the LMA with 30mls of airInflate the LMA with 30mls of air

�Connect the bag ventilator to the LMAConnect the bag ventilator to the LMAConnect the bag ventilator to the LMAConnect the bag ventilator to the LMA

�Check it’s patencyCheck it’s patencyCheck it’s patencyCheck it’s patency

�Insert a OP airway between the teethInsert a OP airway between the teethInsert a OP airway between the teethInsert a OP airway between the teeth

�Secure the LMA, using tapeSecure the LMA, using tapeSecure the LMA, using tapeSecure the LMA, using tape


LMA MASK AIRWAY

5. What is now required? �Backup is required by an APBackup is required by an APBackup is required by an APBackup is required by an AP


CPR

DEFIBRILLATION

ECG


1. What is the compression/inflation ratio for

Child CPR?

CPR

2. What is the neonatal compression/inflation

ratio for CPR <44 weeks gestation?

Ages 1 to 8Ages 1 to 8Ages 1 to 8Ages 1 to 8

5:15:15:15:1 with depth of 3cm, using heal of one handwith depth of 3cm, using heal of one handwith depth of 3cm, using heal of one handwith depth of 3cm, using heal of one hand

< 1 year< 1 year< 1 year< 1 year

5:15:15:15:1 using 2 fingers between the nipple lineusing 2 fingers between the nipple lineusing 2 fingers between the nipple lineusing 2 fingers between the nipple line

All at a rate of 100/minAll at a rate of 100/minAll at a rate of 100/minAll at a rate of 100/min

3. At what heart rate would you initiate CPR

for a newborn?

<60beats/min commence CPR @ 3:1<60beats/min commence CPR @ 3:1<60beats/min commence CPR @ 3:1<60beats/min commence CPR @ 3:1

3:13:13:13:1 with depth of 2cm, with depth of 2cm, with depth of 2cm, with depth of 2cm, using 2 thumbsusing 2 thumbsusing 2 thumbsusing 2 thumbs

between the nipple line,between the nipple line,between the nipple line,between the nipple line, at a rate of at a rate of at a rate of at a rate of

100/min100/min100/min100/min

4. What is the ventilation rate used if an

asthmatic patient arrests?

6/min 6/min 6/min 6/min

5. What is the compression/inflation ratio for

an adult CPR two person and one person?

15:215:215:215:2 with a depth of 4cmwith a depth of 4cmwith a depth of 4cmwith a depth of 4cmFor Intubated Patients changes to For Intubated Patients changes to For Intubated Patients changes to For Intubated Patients changes to 5:15:15:15:1

Both at a rate of 100/minBoth at a rate of 100/minBoth at a rate of 100/minBoth at a rate of 100/min


DEFIBRILLATION

1. What joules would we administer the first 3

shocks in a VT/Vf cardiac arrest?

� 1111stststst Two Shocks @ 200 JoulesTwo Shocks @ 200 JoulesTwo Shocks @ 200 JoulesTwo Shocks @ 200 Joules

� 3333rdrdrdrd Shocks @ 360 JoulesShocks @ 360 JoulesShocks @ 360 JoulesShocks @ 360 JoulesThen:Then:Then:Then:

� Repeat @ 360 Joules in lots of 3 Repeat @ 360 Joules in lots of 3 Repeat @ 360 Joules in lots of 3 Repeat @ 360 Joules in lots of 3

shocks every two to three minutesshocks every two to three minutesshocks every two to three minutesshocks every two to three minutesIf the patient reverts and then reIf the patient reverts and then reIf the patient reverts and then reIf the patient reverts and then re----arrests:arrests:arrests:arrests:

� use the last successful settinguse the last successful settinguse the last successful settinguse the last successful setting

2. What joules would we set the first shock

for a 14 year old cardiac arrest?

2 x weight 2 x weight 2 x weight 2 x weight therefore:therefore:therefore:therefore:

14 x 3 = 42kgs x 2 = 84 rounded off to 14 x 3 = 42kgs x 2 = 84 rounded off to 14 x 3 = 42kgs x 2 = 84 rounded off to 14 x 3 = 42kgs x 2 = 84 rounded off to 80808080

Joules, for 1Joules, for 1Joules, for 1Joules, for 1stststst Two shocks, Two shocks, Two shocks, Two shocks, followed by:followed by:followed by:followed by:

160160160160 for 3for 3for 3for 3rdrdrdrd and subsequent Shocksand subsequent Shocksand subsequent Shocksand subsequent Shocks

3. If a patient presents in VT and has a GCSless than or equal to 10 and your Advanced

Paramedic backup is 40 minutes away,

what could you do?

CardiovertCardiovertCardiovertCardiovert at 2 shocks of 100 Joules at 2 shocks of 100 Joules at 2 shocks of 100 Joules at 2 shocks of 100 Joules followed by: 200 Joulesfollowed by: 200 Joulesfollowed by: 200 Joulesfollowed by: 200 Joules

4. How would you know that a patient

needed to be Cardioverted?

The patient is:The patient is:The patient is:The patient is:

�In VTIn VTIn VTIn VT�GCS less than or equal to 10 GCS less than or equal to 10 GCS less than or equal to 10 GCS less than or equal to 10

�and your AP is more than 40 and your AP is more than 40 and your AP is more than 40 and your AP is more than 40 minsminsminsmins awayawayawayaway


ECG

1. What does the “P” wave represent

in an ECG?

DepolarizationDepolarizationDepolarizationDepolarization of the Atrium. (AV Node of the Atrium. (AV Node of the Atrium. (AV Node of the Atrium. (AV Node

shortly after) shortly after) shortly after) shortly after)

2. What does the “R” wave represent

in an ECG?DepolarizationDepolarizationDepolarizationDepolarization of the Ventriclesof the Ventriclesof the Ventriclesof the Ventricles

4. What does the “T” wave represent in an ECG?

RepolerisationRepolerisationRepolerisationRepolerisation of the Ventriclesof the Ventriclesof the Ventriclesof the Ventricles

5. What is the Isoelectric Line in an ECG The line shown on the ECG showing no The line shown on the ECG showing no The line shown on the ECG showing no The line shown on the ECG showing no

electrical activityelectrical activityelectrical activityelectrical activity

6. How fast does the ECG paper move at? 25mm/Sec25mm/Sec25mm/Sec25mm/Sec

7. What does one small square on the

ECG paper represent?1mm and 0.04 seconds1mm and 0.04 seconds1mm and 0.04 seconds1mm and 0.04 seconds

8. What does one large square on the ECG

paper represent?

5mm and 0.20 seconds5mm and 0.20 seconds5mm and 0.20 seconds5mm and 0.20 seconds


ECG

9. What 5 things do we look for to interpret

an ECG?

RRRRegularegularegularegular

RRRRateateateate

PPPP WavesWavesWavesWaves

PRPRPRPR Interval Interval Interval Interval (should be .12 to .2 seconds (should be .12 to .2 seconds (should be .12 to .2 seconds (should be .12 to .2 seconds

–––– 3 to 5 squares)3 to 5 squares)3 to 5 squares)3 to 5 squares)

QRSQRSQRSQRS Complex Complex Complex Complex

RRPPrQRSRRPPrQRSRRPPrQRSRRPPrQRS


ECG

10. What do we look for on an ECG whenwe are looking at the “QRS COMPLEX”?

PPPPresent or resent or resent or resent or AAAAbsentbsentbsentbsent

RRRRelationship to P waveelationship to P waveelationship to P waveelationship to P wave

RRRRelationship to other QRS Complexeselationship to other QRS Complexeselationship to other QRS Complexeselationship to other QRS Complexes

WWWWidth: .1 to .12 Seconds (3 squares)idth: .1 to .12 Seconds (3 squares)idth: .1 to .12 Seconds (3 squares)idth: .1 to .12 Seconds (3 squares)

PRRWPRRWPRRWPRRW


ECG

11. What is + deflection on an ECG? Upward movement above (^) the Base Upward movement above (^) the Base Upward movement above (^) the Base Upward movement above (^) the Base

line (Isoelectric Line)line (Isoelectric Line)line (Isoelectric Line)line (Isoelectric Line)

12. What is - deflection on an ECG? Downward movement (v) below the Downward movement (v) below the Downward movement (v) below the Downward movement (v) below the

Base line (Isoelectric Line)Base line (Isoelectric Line)Base line (Isoelectric Line)Base line (Isoelectric Line)


ECG

13. What 6 things have to be present in13. What 6 things have to be present in13. What 6 things have to be present in13. What 6 things have to be present in

a PVC?a PVC?a PVC?a PVC?

1.1.1.1. WWWWide and bizarreide and bizarreide and bizarreide and bizarre

2.2.2.2. PPPPrematurerematurerematureremature

3.3.3.3. NNNNo P Waveo P Waveo P Waveo P Wave

4.4.4.4. CCCConstant Couplingonstant Couplingonstant Couplingonstant Coupling

5.5.5.5. CCCCompensatory Pauseompensatory Pauseompensatory Pauseompensatory Pause

6.6.6.6. DDDDeflection opposite to last beateflection opposite to last beateflection opposite to last beateflection opposite to last beat

14. Where should the electrodes be 14. Where should the electrodes be 14. Where should the electrodes be 14. Where should the electrodes be

positioned on the patients chest?positioned on the patients chest?positioned on the patients chest?positioned on the patients chest?

White:White:White:White: (Is right)Right Right Right Right ---- 2222ndndndnd intercostalintercostalintercostalintercostal, mid , mid , mid , mid clavicularclavicularclavicularclavicular

Red:Red:Red:Red:Left Left Left Left ---- 6666thththth––––7777thththth IntercostalIntercostalIntercostalIntercostal, mid , mid , mid , mid clavicularclavicularclavicularclavicular

Black:Black:Black:Black:Left Left Left Left ---- 2222ndndndnd intercoastalintercoastalintercoastalintercoastal, mid , mid , mid , mid clavicularclavicularclavicularclavicular

15. Name 5 common artifacts causes seen 15. Name 5 common artifacts causes seen 15. Name 5 common artifacts causes seen 15. Name 5 common artifacts causes seen

on an ECG?on an ECG?on an ECG?on an ECG?

1.1.1.1. 50505050 cycle Interferencecycle Interferencecycle Interferencecycle Interference

2.2.2.2. MMMMuscle uscle uscle uscle tremourtremourtremourtremour

3.3.3.3. WWWWandering base line (movement)andering base line (movement)andering base line (movement)andering base line (movement)4.4.4.4. LLLLoose Electrodesoose Electrodesoose Electrodesoose Electrodes

5.5.5.5. TTTThick Base line (oil, hair, etc)hick Base line (oil, hair, etc)hick Base line (oil, hair, etc)hick Base line (oil, hair, etc)

50MWLT50MWLT50MWLT50MWLT

WPNCCDWPNCCDWPNCCDWPNCCD


ECG

16. Name the Electrical Conduction 16. Name the Electrical Conduction 16. Name the Electrical Conduction 16. Name the Electrical Conduction

System of the Heart?System of the Heart?System of the Heart?System of the Heart?

SA NodeSA NodeSA NodeSA Node

Internodal Atrial Internodal Atrial Internodal Atrial Internodal Atrial PathwaysPathwaysPathwaysPathways

AV JunctionAV JunctionAV JunctionAV Junction

AV NodeAV NodeAV NodeAV Node

Bundle of HisBundle of HisBundle of HisBundle of His

Left Bundle BranchLeft Bundle BranchLeft Bundle BranchLeft Bundle Branch

Right Bundle BranchRight Bundle BranchRight Bundle BranchRight Bundle Branch

Purkinje FibersPurkinje FibersPurkinje FibersPurkinje Fibers

Purkinje NetworkPurkinje NetworkPurkinje NetworkPurkinje Network


IV CANNULATION


IV CANNULATION

1. What is the procedure the insertion

of a IV Cannula?

•Inform PatientInform PatientInform PatientInform Patient

•Where possible gain there permissionWhere possible gain there permissionWhere possible gain there permissionWhere possible gain there permission

•Prepare the equipmentPrepare the equipmentPrepare the equipmentPrepare the equipment•Select and check the correct fluidSelect and check the correct fluidSelect and check the correct fluidSelect and check the correct fluid

•Prime the IV SetPrime the IV SetPrime the IV SetPrime the IV Set

•Put on glovesPut on glovesPut on glovesPut on gloves

•Apply venous tourniquetApply venous tourniquetApply venous tourniquetApply venous tourniquet

•Select veinSelect veinSelect veinSelect vein

•Swab siteSwab siteSwab siteSwab site•Stabile the veinStabile the veinStabile the veinStabile the vein

•Puncture skin with bevel upPuncture skin with bevel upPuncture skin with bevel upPuncture skin with bevel up

•Decrease cannula angle and enter vein Decrease cannula angle and enter vein Decrease cannula angle and enter vein Decrease cannula angle and enter vein

lumenlumenlumenlumen

•Advance cannula down needleAdvance cannula down needleAdvance cannula down needleAdvance cannula down needle

•Tamponade vein and remove needleTamponade vein and remove needleTamponade vein and remove needleTamponade vein and remove needle•Remove tourniquetRemove tourniquetRemove tourniquetRemove tourniquet

•Connect IV and set drip rate or connect Connect IV and set drip rate or connect Connect IV and set drip rate or connect Connect IV and set drip rate or connect

luerluerluerluer

•Flush the luer with salineFlush the luer with salineFlush the luer with salineFlush the luer with saline

•Secure Set/LuerSecure Set/LuerSecure Set/LuerSecure Set/Luer


IV CANNULATION

2. What do you need to check at regular

Intervals?

•InfiltrationInfiltrationInfiltrationInfiltration

•Other ComplicationsOther ComplicationsOther ComplicationsOther Complications

•Flow RateFlow RateFlow RateFlow Rate

3. What do you need to do when you haveHave finished the procedure?

•Dispose of all equipment correctlyDispose of all equipment correctlyDispose of all equipment correctlyDispose of all equipment correctly•Document the procedure on the Patient Document the procedure on the Patient Document the procedure on the Patient Document the procedure on the Patient

ReportReportReportReport


IV FLUIDS


2. What is the fluid rate for children suffering hypervolemia?

IV FLUIDS

3. What is the targeted systolic blood

Pressure for an adult patient suffering Penetrating trauma?

20mls/Kg20mls/Kg20mls/Kg20mls/Kg20 x age x 2 + 8 or 20 x age x 2 + 8 or 20 x age x 2 + 8 or 20 x age x 2 + 8 or 20 x age x 320 x age x 320 x age x 320 x age x 3E.g.: 9 year old = 20 x (9 x 3 = 27) = 540mlsE.g.: 9 year old = 20 x (9 x 3 = 27) = 540mlsE.g.: 9 year old = 20 x (9 x 3 = 27) = 540mlsE.g.: 9 year old = 20 x (9 x 3 = 27) = 540mlsDextrose 2ml/KgDextrose 2ml/KgDextrose 2ml/KgDextrose 2ml/Kg

4. What is the targeted systolic for an adult head injury patient who is unable to

obey commands?

Anyone patient that:Anyone patient that:Anyone patient that:Anyone patient that:• Is unable to Is unable to Is unable to Is unable to obey commandsobey commandsobey commandsobey commands

• Has a Has a Has a Has a Systolic B/P <= 120mmHgSystolic B/P <= 120mmHgSystolic B/P <= 120mmHgSystolic B/P <= 120mmHg


5. What criteria must the patient meet to run

0.9% Nacl for a head injury patient?


No Fluids, No Fluids, No Fluids, No Fluids, but an AP might if giving AP might if giving AP might if giving AP might if giving

adrenaline diluted in 1000mls of NaCladrenaline diluted in 1000mls of NaCladrenaline diluted in 1000mls of NaCladrenaline diluted in 1000mls of NaCl

1. How much fluids would you run for an adult

patient suffering severe asthma?


6. What is the targeted systolic blood

pressure for an adult patient sufferingblunt trauma?

IV FLUIDS

7. When would we administer fluids to a

burns patient?

8. At what stage can we run fluids for a

hypotensive patient in cardiogenic shock?

� If Systolic If Systolic If Systolic If Systolic B/PB/PB/PB/P < 80mmHg< 80mmHg< 80mmHg< 80mmHg

� Has Has Has Has NNNNOOOO SOB SOB SOB SOB � Has Has Has Has NNNNO Significant crackles in chestO Significant crackles in chestO Significant crackles in chestO Significant crackles in chest

� Rate:Rate:Rate:Rate:� 500ml of NaCl as a fluid challenge500ml of NaCl as a fluid challenge500ml of NaCl as a fluid challenge500ml of NaCl as a fluid challenge

STOP FLUID IF patient becomes SOBSTOP FLUID IF patient becomes SOBSTOP FLUID IF patient becomes SOBSTOP FLUID IF patient becomes SOB

� If improvement with 1If improvement with 1If improvement with 1If improvement with 1stststst Bolus Repeat Bolus Repeat Bolus Repeat Bolus Repeat

500mls500mls500mls500mlswith the same precautions (SOB)with the same precautions (SOB)with the same precautions (SOB)with the same precautions (SOB)

Burn is >= 15%Burn is >= 15%Burn is >= 15%Burn is >= 15%

Rate:Rate:Rate:Rate:Adults:Adults:Adults:Adults: 1000mls NaCl as a Bolus1000mls NaCl as a Bolus1000mls NaCl as a Bolus1000mls NaCl as a Bolus

Repeated enrouteRepeated enrouteRepeated enrouteRepeated enroute

Child:Child:Child:Child: 20ml/Kg as a Bolus20ml/Kg as a Bolus20ml/Kg as a Bolus20ml/Kg as a Bolus

Repeated enrouteRepeated enrouteRepeated enrouteRepeated enroute


9. When should you NOT give fluids to a

patient in cardiogenic shock?

If the patient has pulmonary edemaIf the patient has pulmonary edemaIf the patient has pulmonary edemaIf the patient has pulmonary edema

Use GTN but with extreme cautionUse GTN but with extreme cautionUse GTN but with extreme cautionUse GTN but with extreme caution

B/PNNB/PNNB/PNNB/PNN


IV FLUIDS

10. A patient has a Cardiac Arrest after

overdosing on antidepressants.

What fluid should you administer?

1000mls NaCl as a Bolus, repeated.1000mls NaCl as a Bolus, repeated.1000mls NaCl as a Bolus, repeated.1000mls NaCl as a Bolus, repeated.

11. What fluid should be given to a person

who is suffering from Hyperthermia?



who is suffering from the “Bends”?



who is suffering from Hypovolaemic Shock”?1000mls NaCl as a Bolus, repeated 1000mls NaCl as a Bolus, repeated 1000mls NaCl as a Bolus, repeated 1000mls NaCl as a Bolus, repeated

PRN is B/P under 100mmHgPRN is B/P under 100mmHgPRN is B/P under 100mmHgPRN is B/P under 100mmHg

NoteNoteNoteNote::::

Remember your B/P Targets forshock associated with PenetratingPenetratingPenetratingPenetratingTraumaTraumaTraumaTrauma and shock associated withBrain InjuryBrain InjuryBrain InjuryBrain Injury


SHOCK


SHOCK

3. At what stage can we run fluids for a

hypertensive patient in cardiogenic shock?

4. When should you NOT give fluids to a

patient in cardiogenic shock?

If the patient has pulmonary edemaIf the patient has pulmonary edemaIf the patient has pulmonary edemaIf the patient has pulmonary edema

Use GTN but with extreme cautionUse GTN but with extreme cautionUse GTN but with extreme cautionUse GTN but with extreme caution

� If Systolic If Systolic If Systolic If Systolic B/PB/PB/PB/P < 80mmHg< 80mmHg< 80mmHg< 80mmHg� Has Has Has Has NNNNOOOO SOB SOB SOB SOB � Has Has Has Has NNNNO Significant crackles in chestO Significant crackles in chestO Significant crackles in chestO Significant crackles in chest� Rate:Rate:Rate:Rate:� 500ml of NaCl as a fluid challenge500ml of NaCl as a fluid challenge500ml of NaCl as a fluid challenge500ml of NaCl as a fluid challengeSTOP FLUID IF patient becomes SOBSTOP FLUID IF patient becomes SOBSTOP FLUID IF patient becomes SOBSTOP FLUID IF patient becomes SOB� If improvement with 1If improvement with 1If improvement with 1If improvement with 1stststst Bolus RepeatBolus RepeatBolus RepeatBolus Repeatwith the same precautions (SOB)with the same precautions (SOB)with the same precautions (SOB)with the same precautions (SOB)

1. What are the types of Shock? Hypovolaemic shock Hypovolaemic shock Hypovolaemic shock Hypovolaemic shock – Fluid lossCardiogenic Shock Cardiogenic Shock Cardiogenic Shock Cardiogenic Shock - Pump failureNeurogenicNeurogenicNeurogenicNeurogenic ShockShockShockShock - Fluid

2. What are the Signs and Symptoms of

Hypovolaemic Shock? Patient “Shut down”Patient “Shut down”Patient “Shut down”Patient “Shut down”TachycardicTachycardicTachycardicTachycardic

Remember: some exceptionsRemember: some exceptionsRemember: some exceptionsRemember: some exceptionsBeta-blocker = No Tachycardia

Shocked + Bradycardic = ? Ruptured Ectopic Pregnancy

B/PNNB/PNNB/PNNB/PNN


SHOCK

5. What is the treatment for a patient withcardiogenic shock?

� PPPPrimary surveyrimary surveyrimary surveyrimary survey

� OOOOxygen via nonxygen via nonxygen via nonxygen via non----rebreather Maskrebreather Maskrebreather Maskrebreather Mask

� Determine Determine Determine Determine RRRRhythmhythmhythmhythm

� Gain Gain Gain Gain IIIIV accessV accessV accessV access

� If patient has pulmonary edema, If patient has pulmonary edema, If patient has pulmonary edema, If patient has pulmonary edema,

treat as pulmonary edema proceduretreat as pulmonary edema proceduretreat as pulmonary edema proceduretreat as pulmonary edema procedure

� using GTN with extreme cautionusing GTN with extreme cautionusing GTN with extreme cautionusing GTN with extreme caution


IM INJECTIONS


1. What are the sites for an IM Injection?

IM INJECTIONS

2. What is the procedure for giving an

IM Injection?

•Inform PatientInform PatientInform PatientInform Patient

•Where possible gain there permissionWhere possible gain there permissionWhere possible gain there permissionWhere possible gain there permission

•Draw drug into syringeDraw drug into syringeDraw drug into syringeDraw drug into syringe•Select site for injectionSelect site for injectionSelect site for injectionSelect site for injection

•Cleanse surface with alcohol swabCleanse surface with alcohol swabCleanse surface with alcohol swabCleanse surface with alcohol swab

•Expel residue air from syringeExpel residue air from syringeExpel residue air from syringeExpel residue air from syringe

•Flatten skin with 2 fingersFlatten skin with 2 fingersFlatten skin with 2 fingersFlatten skin with 2 fingers

•Penetrate the skin in on movement @ a Penetrate the skin in on movement @ a Penetrate the skin in on movement @ a Penetrate the skin in on movement @ a

90 degree angle90 degree angle90 degree angle90 degree angle•Pull back syringe, checking for bloodPull back syringe, checking for bloodPull back syringe, checking for bloodPull back syringe, checking for blood

•If blood, withdraw slightlyIf blood, withdraw slightlyIf blood, withdraw slightlyIf blood, withdraw slightly

•Inject the drug slowlyInject the drug slowlyInject the drug slowlyInject the drug slowly

•Remove needle at same angleRemove needle at same angleRemove needle at same angleRemove needle at same angle

•Apply firm pressure to injection siteApply firm pressure to injection siteApply firm pressure to injection siteApply firm pressure to injection site

•Rub siteRub siteRub siteRub site•Dispose of equipmentDispose of equipmentDispose of equipmentDispose of equipment

•Record drug on patient reportRecord drug on patient reportRecord drug on patient reportRecord drug on patient report

•Buttock Buttock Buttock Buttock (Upper outer quadrant of Gluteus Muscle)(Upper outer quadrant of Gluteus Muscle)(Upper outer quadrant of Gluteus Muscle)(Upper outer quadrant of Gluteus Muscle)

•Mid Lateral ThighMid Lateral ThighMid Lateral ThighMid Lateral Thigh

•Deltoid MusclesDeltoid MusclesDeltoid MusclesDeltoid Muscles


GENERAL


1. What is the expected weight of a 6 year

old from our procedures?

GENERAL

2. What is the weight calculation for a 14 yearold from our procedures?

Age x 2 +8Age x 2 +8Age x 2 +8Age x 2 +8 (for 1(for 1(for 1(for 1----8 yr olds) 8 yr olds) 8 yr olds) 8 yr olds) Therefore:Therefore:Therefore:Therefore:

6x2 = 12 + 8 = 6x2 = 12 + 8 = 6x2 = 12 + 8 = 6x2 = 12 + 8 = 20Kgs20Kgs20Kgs20Kgs

3. What would be the suspected normalsystolic for a 10 year old?

Calculation:Calculation:Calculation:Calculation: 80mmHg + 2 x age 80mmHg + 2 x age 80mmHg + 2 x age 80mmHg + 2 x age Therefore:Therefore:Therefore:Therefore:

80 + 2 x 10 = 80 + 2 x 10 = 80 + 2 x 10 = 80 + 2 x 10 = 100mmHg100mmHg100mmHg100mmHg

Age x 3Age x 3Age x 3Age x 3 (for 9(for 9(for 9(for 9----15 yr olds) 15 yr olds) 15 yr olds) 15 yr olds) Therefore:Therefore:Therefore:Therefore:

14x3 = 14x3 = 14x3 = 14x3 = 42Kgs42Kgs42Kgs42Kgs

4. What criteria would you look at when not

fitting a C-Collar to a patient?a.a.a.a. If the patient is If the patient is If the patient is If the patient is AAAAlert andlert andlert andlert andb.b.b.b. CCCCooperative ooperative ooperative ooperative andandandand

c.c.c.c. No No No No NNNNeck or eck or eck or eck or

d.d.d.d. UUUUpper back Tenderness on palpation pper back Tenderness on palpation pper back Tenderness on palpation pper back Tenderness on palpation

or movement or movement or movement or movement andandandand

e.e.e.e. No significant No significant No significant No significant DDDDistracting injury or istracting injury or istracting injury or istracting injury or

condition condition condition condition andandandand

f.f.f.f. Normal Normal Normal Normal PPPPeripheral sensation anderipheral sensation anderipheral sensation anderipheral sensation and

g.g.g.g. MMMMotor power.otor power.otor power.otor power.

ACNUDPMACNUDPMACNUDPMACNUDPM


5. What is the Systolic Blood Pressure?

GENERAL

6. What is the Diastolic Blood Pressure?

Ventricles ContractingVentricles ContractingVentricles ContractingVentricles Contracting

Ventricles at RestVentricles at RestVentricles at RestVentricles at Rest

PRACTICE QUIZ for CSR - paradisehomepages.paradise.net.nz/gettingustarted/Downloads/CSR Practice... · CSR PRACTICE QUIZ 1. What is meant by the term “Indications”? ... hypoglycemia

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