CWIs

Question 1

Indications for SGA

Answer 1

N/A

Question 2

Contras for SGA

Answer 2

• gag reflex or resistance to insertion
• trismus or strong jaw tone
• epiglottitis or upper airway obstruction
• use of sedation to insert

Question 3

Precautions for SGA

Answer 3

• pt with high airway pressures, obese, pregnant, respiratory disease, asthma
• kids less than 14 yrs due to enlarged tonsils
• unable to prepare in sniffing position
• vomit in airway
• do not prevent passive regurgitation or gastric distension

Question 4

Indications for Quikclot

Answer 4

• uncontrolled haemorrhage from non-compressible wound site
• any traumatic haemorrhage that is not controlled by basic haemorrhage control measures such as direct pressure with pad and bandage
• severe limb wounds not controlled by 2 tourniquets
• multiple casualty scenes where patient numbers dictate that simple haemorrhage control cannot be individually applied

Question 5

Contras for Quikclot

Answer 5

• bleeding that can be controlled using basic first aid
• ocular trauma
• not to be used for haemorrhage where they are unlikely to contact the point of bleeding such as PV or PR haemorrhage, or posterior epistaxis

Question 6

Precautions for Quikclot

Answer 6

nil

Question 7

Things to listen for when auscultating

Answer 7

• air entry
• lung sounds normal
• do left and right sound the same
• wheeze
• crackles
• fine or course crackles

Question 8

Indications for back blows

Answer 8

conscious adult, child or infant with severe foreign body airway obstruction with ineffective cough and unable to speak

Question 9

Contras for back blows

Answer 9

• newborns, suction preferred

- unconscious pt

Question 10

Precautions for back blows

Answer 10

nil

Question 11

Indications for Laryncoscopy

Answer 11

pt in altered conscious state, without gag reflex, requiring inspection of the airway

Question 12

Contras for laryngoscopy

Answer 12

nil

Question 13

Precautions for laryngoscopy

Answer 13

• epiglottits

- croup

Question 14

Indications for magills

Answer 14

foreign body airway obstruction with altered conscious state

Question 15

contras for magills

Answer 15

nil

Question 16

precautions for magills

Answer 16

nil

Question 17

Indications for y suction catheter

Answer 17

suction may be required when a pt is in altered conscious state and unable to protect their own airway from secretions, vomit, bile

Question 18

Contras for y suction catheter

Answer 18

nil

Question 19

Precautions for y suction catheter

Answer 19

• croup
• epiglottis
• upper airway obstructions

Question 20

Indications for NPA

Answer 20

unconscious pt presenting with trismus, when an OPA cannot be inserted

Question 21

Contras for NPA

Answer 21

• middle third facial fracture - intrusion of brain tissue
• nasal trauma - induce gag increasing ICP
• TBI or neuro event when airway patent and TV adequate despite trismus

Question 22

Precautions for NPA

Answer 22

• basal skull fractures and CSF from nares or ears - possibility of intrusion into brain tissue
• may need to be removed for intubation attempts

Question 23

Indications for IPPV

Answer 23

• apnoea or hypoventilation

- ventilation of adult pts with CO use PEEP

Question 24

Contras of IPPV

Answer 24

-PEEP in paeds and cardiac arrest

Question 25

Precautions of IPPV

Answer 25

nil

Question 26

Indications for Triple airway

Answer 26

pt requiring airway management

Question 27

Contras for Triple airway

Answer 27

injury or anatomy prevents

Question 28

Precautions for triple airway

Answer 28

- spinal immobilised pts | - children and infants may require modified position

Question 29

Precautions for IN admin

Answer 29

-rhinitis, rhinorrhea, facial trauma

Question 30

Indications for IV insertion

Answer 30

IV medication admin is required in line with CPGs

Question 31

Contras for IV insertion

Answer 31

nil

Question 32

Precautions for IV insertion

Answer 32

- do not cannulate arms which show evidence of contamination, if so clean thoroughly - do not cannulate pts with renal failure in same arm as arteriovenous fistula

Question 33

Indications for IM injection

Answer 33

medications required to be administered via IM route as per CPGs

Question 34

Contras for IM injections

Answer 34

nil

Question 35

Precautions for IM injections

Answer 35

- safety, ensure correct technique, anatomical location and disposal of sharps - larger volumes may be painful, avoid dilution

Question 36

Indications for valsalva

Answer 36

- atrioventricular re-rentry tachycardia | - AV nodal re-entry tachycardia

Question 37

Contras for valsalva

Answer 37

- SBP under 90 - unstable or rapidly deteriorating pt - AF or atrial flutter

Question 38

Precautions for valsalva

Answer 38

nil

Question 39

Indications for TPT decompression

Answer 39

suspected TPT including in traumatic arrest

Question 40

Contras for TPT decompression

Answer 40

ARS may not be appropriate for paeds/small pts, use 14g or 16g

Question 41

Precautions for TPT decompression

Answer 41

- requires regular practice to maintain familiarity - right side decompressed first to minimise risk of puncturing heart - if air escapes, air and blood or no air/blood, leave in situ. If copious blood, remove cannula and cover - risk of body fluid being expelled under pressure - procedure monitored through limited occurrence screening process

Question 42

Indications for CPAP

Answer 42

pt presenting in cardiogenic pulmonary oedema and SOB that is severe or unresponsive to nitrates

Question 43

Contras for CPAP

Answer 43

``` Pneumothorax Active vomiting Hypoventilation Facial trauma Life threatening arrhythmias Airway secure GCS under 13 ```

Question 44

Precautions for CPAP

Answer 44

hT | COPD

Question 45

Indications for SAM splint

Answer 45

open book fracture of pelvis

Question 46

Precautions for SAM splint

Answer 46

- traction splint creating difficulty closing legs and hence pelvic injury - adult size splints should not be applied to children

Question 47

Indications for CT6

Answer 47

- middle third femur fractures | - upper 2 third tibia fractures

Question 48

Contras for CT6

Answer 48

- pelvic trauma | - knee or ankle/foot trauma

Question 49

Indications for Tourniquet

Answer 49

- uncontrolled haemorrhage from limb despite direct pressure - multiple casualty scene where pt numbers dictate that simple haemorrhage control cannot be applied

Question 50

Contras for tourniquet

Answer 50

Bleeding can be controlled using basic measures

Question 51

Precautions for tourniquet

Answer 51

- do not apply over a wound or joint | - once applied, must be kept visible