Luke

Question 1

Open # Zygoma

Answer 1

• What does ‘open’or compound fracture mean?–Bones protrude through the skin
• Flatness of the cheek
• Altered sensation underneath the eye on the affected side
• Blurred or double vision
• Pain with jaw movement

Question 2

Management of Head injury

Answer 2

• neuro assessment
• signs of a deterioration
• GCS: Standardised approach to assessing LOC
• Defines severity of brain injury

Provides a rule of thumb management

• Cerebral CT (CTB) if drops by 2 points
• GCS <8 requires airway management
• Spinal Precautions – needs radiological and clinical clearance

Question 3

Types of Consent

Answer 3

Verbal
Written
Implied or inferred

Question 4

Consent - voluntary

Answer 4

Not coerced into giving consent

Question 5

Informed consent

Answer 5

Understands the procedure

Question 6

Legal capacity

Answer 6

Competent to give consent

Question 7

Elements of a valid consent

Answer 7

voluntary
covers the procedure
informed
legal capacity

Question 8

Cannula changing

Answer 8

72hrs generally but not if:

• No inflammation or phlebitis
• Difficult to re-cannulate e.g.child/veins
• Only required for another 24hrs
• Aseptic insertion

Question 9

Cannula Assessment

Answer 9

Site inspection for signs of inflammation
Check patency
Check dressing integrity

Question 10

Cannula - signs of inflammation

Answer 10

redness
Swelling/oedema
heat
pain

Question 11

Cephazolin - action

Answer 11

• Selectively interferes with cell wall synthesis
• Bacteriacidal
• Broad spectrum often 2nd line

Question 12

Cephazolin - use

Answer 12

• Resp, Skin, Bone and joint, urinary tract, Intra abdominal, Gynaecological infections, ENT,
• Meningitis, Surgical prophylaxis

Question 13

Cephazolin - adverse effect

Answer 13

N + V,   
abdo pain
Rash, urticaria, fever , pruritus
Dizziness, headache, insomnia, malaise
Super infection
MRSA is resistant to cefalosporins)
Anaphylaxis

Question 14

Woundcleansing

Answer 14

Use of fluid e.g. normal saline to clean the wound and optimise healing.

Goal is to:

• Remove visible debris and devitalised tissue
• Remove dressing residue
• Remove excessive or dry crusting exudates