Safety Considerations in Patient Care

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Questions and Answers

What is one of the safety considerations when approaching an ill or injured patient?

Ignoring the scene hazards to save time

Assuming the scene is safe without assessment

Checking for scene hazards (correct)

Focusing only on the patient's condition

What should be considered when approaching a road traffic crash scene?

Rushing to the patient without assessing the surroundings

Waiting for official clearance before approaching

Checking if the scene is closed to oncoming traffic (correct)

Assuming all traffic has been diverted

How should providers handle aggressive or agitated patients at a scene?

Request help as needed from security personnel or police (correct)

Administer sedatives without consent

Attempt to calm the patient without assistance

Ignore the patient's behavior and proceed with assessment

What risk should providers consider in terms of infectious diseases at a scene?

Possibility for disease exposure such as flu or haemorrhagic fever Signup and view all the answers

What personal protective equipment (PPE) is almost always required when approaching a patient to protect from exposure to bodily fluids?

Gloves and eye protection Signup and view all the answers

In what circumstances may specific protective practices be required when approaching a patient?

Suspected or confirmed haemorrhagic fever outbreaks Signup and view all the answers

What is emphasized to ensure when approaching a patient in terms of local recommendations?

Being up-to-date on current local recommendations Signup and view all the answers

What should be done before and after every patient contact to minimize infectious disease exposure?

Use PPE and wash hands Signup and view all the answers

What is recommended at the scene when hand washing is not immediately possible?

Carry an alcohol gel cleanser Signup and view all the answers

When may decontamination be required after exposure to chemicals?

After exposure to pesticides or other chemicals Signup and view all the answers

What should be done if multiple people are injured or ill?

Call for help or send someone to call Signup and view all the answers

When is it recommended to begin making arrangements for consultations or transfers?

As early as possible Signup and view all the answers

What should one know about relevant local agencies in case of suspected outbreaks or hazardous exposures?

Contact information for support and guidance Signup and view all the answers

What does the 'A' in the ABCDE approach stand for?

Airway Signup and view all the answers

What is the purpose of the ABCDE approach?

To rapidly identify and intervene for life-threatening conditions Signup and view all the answers

When should the ABCDE approach be performed?

In the first 5 minutes and repeated whenever a patient’s condition changes or worsens Signup and view all the answers

What does the 'D' in the ABCDE approach refer to?

Disability: assess and protect brain and spine functions Signup and view all the answers

What should be done if the patient is unconscious and not breathing normally with no trauma?

Open the airway using the head-tilt and chin-lift manoeuvre Signup and view all the answers

What should be done if a foreign body is suspected in a choking patient who is unable to cough or make noises?

Remove the object if visible, being careful not to push it deeper Signup and view all the answers

What should be done if the patient is choking and unable to cough or make sounds?

Use age-appropriate chest thrusts/abdominal thrusts/back blows Signup and view all the answers

What indicates a partially obstructed airway according to the text?

Abnormal sounds such as stridor, grunting, or snoring Signup and view all the answers

What should be done if there are no breath sounds on one side, hypotension, and a shifted trachea?

Check for distended neck veins or a shifted trachea (tension pneumothorax) Signup and view all the answers

What should be done if the patient is breathing inadequately (too slow for age or too shallow)?

Begin bag-valve-mask ventilation with oxygen Signup and view all the answers

What should be done if the patient is unconscious with abnormal breathing?

Start bag-valve-mask ventilation and follow relevant CPR protocols Signup and view all the answers

What should be done if breathing is very fast, very slow, or very shallow?

Assess if breathing is very fast, very slow, or very shallow and look for signs of increased work of breathing Signup and view all the answers

What should be done if there are no breath sounds on one side, hypotension, and a shifted trachea?

Check for distended neck veins or a shifted trachea (tension pneumothorax) Signup and view all the answers

When should bag-valve-mask ventilation with oxygen be initiated?

If the patient is not breathing adequately (too slow for age or too shallow) Signup and view all the answers

What should be done if the patient is unconscious with abnormal breathing?

Start bag-valve-mask ventilation with oxygen Signup and view all the answers

What should be done if breathing fast or hypoxic?

Give oxygen Signup and view all the answers

What are signs of poor perfusion to look for?

Cool, moist extremities and delayed capillary refill Signup and view all the answers

What is the recommended action for suspected internal bleeding or pericardial tamponade?

Refer rapidly to a center with surgical capabilities Signup and view all the answers

What should be done if signs of poor perfusion are observed?

Give IV fluids and oxygen Signup and view all the answers

In case of trauma, what should be done for fractures with compromised blood flow?

Bind pelvic fractures and splint femur fractures Signup and view all the answers

What are signs of poor perfusion to look for?

Cool, moist extremities Signup and view all the answers

What should be done in case of suspected internal bleeding or pericardial tamponade?

Refer rapidly to a centre with surgical capabilities Signup and view all the answers

What is the recommended action for external bleeding?

Apply direct pressure or use other technique to control Signup and view all the answers

What should be done for fractures with compromised blood flow?

Bind pelvic fractures and splint femur fractures Signup and view all the answers

What does the AVPU scale assess in a patient?

Level of consciousness Signup and view all the answers

In trauma cases, what scale is recommended to assess level of consciousness?

Glasgow Coma Scale (GCS) Signup and view all the answers

What should be checked in a confused or unconscious patient?

Glucose level Signup and view all the answers

What does the AVPU scale assess in a patient?

Level of consciousness Signup and view all the answers

When should glucose level be checked in a confused or unconscious patient?

Always Signup and view all the answers

What is the purpose of the Glasgow Coma Scale (GCS) in trauma cases?

To assess level of consciousness Signup and view all the answers

What should be done if snake bite is suspected?

Immobilize the limb Signup and view all the answers

What action should be taken to prevent hypothermia in acutely ill patients?

Cover the patient as soon as possible Signup and view all the answers

What should be done if cause of exposure is unknown?

Consider the possibility of trauma and log roll if suspected spinal injury Signup and view all the answers

What should be done if snake bite is suspected?

Immobilize the limb Signup and view all the answers

What should be done to prevent hypothermia in acutely ill patients?

Cover the patient as soon as possible Signup and view all the answers

What should be done if cause of exposure is unknown?

Consider the possibility of trauma Signup and view all the answers

What are the visible signs and symptoms of airway obstruction due to a foreign body?

Visible secretions, vomit, or foreign bodies in the airway Signup and view all the answers

Which abnormal sounds may indicate airway obstruction due to a foreign body?

Stridor, snoring, gurgling Signup and view all the answers

What is a potential consequence of airway obstruction from the tongue?

Poor chest rise Signup and view all the answers

What should be done if the airway is completely obstructed by a foreign body?

Perform age-appropriate chest thrusts/abdominal thrusts/back blows Signup and view all the answers

How should the airway be opened in patients with a decreased level of consciousness?

Perform a head-tilt and chinlift manoeuvre Signup and view all the answers

When should a foreign body be removed from the airway?

Only if it is clearly visible Signup and view all the answers

What should be done if the airway is completely obstructed by a foreign body?

Perform age-appropriate chest thrusts/abdominal thrusts/back blows Signup and view all the answers

What should be used to open the airway in patients with a decreased level of consciousness?

Jaw thrust if there is concern for trauma Signup and view all the answers

When should a foreign body be removed from the airway?

Only if clearly visible Signup and view all the answers

What should be done if the airway is completely obstructed by a foreign body?

Perform age-appropriate chest thrusts/abdominal thrusts/back blows Signup and view all the answers

How should the airway be opened in patients with a decreased level of consciousness?

Perform a head-tilt and chinlift manoeuvre Signup and view all the answers

When should a foreign body be removed from the airway?

Only if clearly visible Signup and view all the answers

What may indicate airway obstruction due to burns?

Burned nasal hairs or soot around the nose or mouth Signup and view all the answers

Which abnormal sound may indicate airway obstruction due to burns?

Stridor Signup and view all the answers

What is a visible sign of airway obstruction due to burns?

Poor chest rise Signup and view all the answers

What should be done for patients with suspected airway burns, even if they do not show signs of hypoxia?

Administer oxygen Signup and view all the answers

Why is it important to maintain cervical spine immobilization in burn patients?

To prevent spinal injury Signup and view all the answers

What should be planned for burn patients due to the potential rapid swelling and closure of the airway?

Rapid handover/transfer to advanced airway management provider Signup and view all the answers

What should be done for burn patients with suspected airway burns, even if they do not show signs of hypoxia?

Administer oxygen Signup and view all the answers

What should be done to open the airway in burn patients with evidence of trauma?

Maintain cervical spine immobilization Signup and view all the answers

What should be planned for burn patients due to the potential rapid swelling and closure of the airway?

Rapid handover/transfer to a provider capable of advanced airway management Signup and view all the answers

Study Notes

Safety Considerations

Approach ill or injured patients with caution, considering potential risks and taking necessary precautions.
When approaching a road traffic crash scene, prioritize scene safety and wear personal protective equipment (PPE).
Handle aggressive or agitated patients calmly and safely, avoiding physical confrontation.
Be aware of infectious disease risks and take precautions, such as wearing PPE, especially when dealing with bodily fluids.

Personal Protective Equipment (PPE)

Wear gloves, masks, and eye protection to prevent exposure to bodily fluids.
Consider specific protective practices when approaching patients, such as using respirators or full-face shields.

Infectious Diseases

Consider the risk of infectious diseases, such as HIV, Hepatitis, and tuberculosis, and take necessary precautions.
Perform hand hygiene before and after every patient contact to minimize infectious disease exposure.
Use hand sanitizer when hand washing is not immediately possible.

Patient Assessment

Use the ABCDE approach to assess patients: Airway, Breathing, Circulation, Disability, and Exposure.
Perform the ABCDE approach on all patients, considering potential life threats.
The 'A' in the ABCDE approach stands for Airway.
Assess airway obstacles, breathing, and circulation during the primary survey.

Airway Management

If the patient is unconscious and not breathing normally with no trauma, begin ventilation with a bag-valve-mask device.
If a foreign body is suspected in a choking patient, encourage the patient to cough.
If the patient is choking and unable to cough or make sounds, perform back blows or abdominal thrusts.
A partially obstructed airway is indicated by labored breathing, stridor, or wheezing.
If there are no breath sounds on one side, hypotension, and a shifted trachea, consider a tension pneumothorax.

Breathing and Circulation

If the patient is breathing inadequately, provide oxygen and consider ventilation.
If the patient is unconscious with abnormal breathing, consider ventilation and oxygen therapy.
If breathing is very fast, very slow, or very shallow, consider respiratory failure.
Signs of poor perfusion include pale or cool skin, decreased capillary refill, and weak or absent pulses.

Trauma and Bleeding

In trauma cases, use the Glasgow Coma Scale (GCS) to assess level of consciousness.
Assess for signs of internal bleeding or pericardial tamponade and consider cardiothoracic surgery.
Control external bleeding with direct pressure and consider tourniquets.
Immobilize fractures with compromised blood flow.

Glucose and Confusion

Check glucose levels in confused or unconscious patients.
Use the AVPU scale to assess level of consciousness: Alert, Voice, Pain, Unresponsive.

Snake Bites and Hypothermia

Suspect snake bites and treat accordingly.
Prevent hypothermia in acutely ill patients by maintaining a warm environment and using blankets.

Airway Obstruction

Visible signs and symptoms of airway obstruction due to a foreign body include choking, gagging, and difficulty breathing.
Abnormal sounds indicating airway obstruction include stridor, wheezing, and coughing.
Completely obstructed airways require immediate removal of the foreign body.
Open the airway in patients with a decreased level of consciousness using the head-tilt, chin-lift, or jaw-thrust maneuver.

Burns and Airway Management

Suspect airway burns if the patient has facial burns, singed nasal hairs, or hoarseness.
Indicators of airway obstruction due to burns include inspiratory stridor, wheezing, and hoarseness.
Maintain cervical spine immobilization in burn patients.
Plan for rapid intubation and potential surgical airway management in burn patients.

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Description

Learn about the critical importance of safety considerations when treating ill or injured patients. This includes identifying and addressing scene hazards to keep providers and bystanders safe.