QAS_ACP2_skills
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| show | The administration of a drug or fluid
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| show | Whenever possible avoid sites of burn,
infection or localised cellulitis
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| show | Air embolus
Arterial puncture
• Cannula shear or breakage
• Drug/fluid extravasion
• Haematoma or haemorrhage from the site
• Infection or phlebitis
Irritation to the vein wall
• Nerve damage
• Vasovagal syncope
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| Intravenous access Additional info | show 🗑
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| Intravenous access Additional info.2 | show 🗑
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| Airway suctioning Indications | show 🗑
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| show | • Nil in this setting
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| show | Airway trauma
•Stimulate coughing or gagging
•Hypoxia from delays in ventilation with tracheal
tube suctioning
• Vagal stimulation can result in bradycardia
and hypotension
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| show | When performing tracheal suctioning, ensure the disruption
to ventilation is less than 30 seconds.
•Consider managing patient in lateral position if secretions
are overwhelming
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| Laryngeal mask airway Indications | show 🗑
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| show | • Nil in this setting
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| show | • Failure to provide adequate airway or ventilation
• Can precipitate vomiting and aspiration
in a patient with intact airway reflexes
• Airway trauma
• Patient intolerance
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| Laryngeal mask airway Additional info | show 🗑
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| show | Clearing the airway
• Insertion of an endotracheal tube
• Insertion of a gastric tube
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| show | Epiglottitis
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| show | • Laryngospasm
• Hypoxia due to delays in oxygenation while
performing procedure
• Trauma to mouth or upper airway, particularly
teeth/dentures
• Exacerbation of underlying C-spine injuries
• Failure to visualise glottis
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| Laryngoscopy Additional info | show 🗑
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| Nasopharyngeal airway Indications | show 🗑
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| Nasopharyngeal airway Contraindications | show 🗑
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| Nasopharyngeal airway Complications | show 🗑
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| show | An NPA does not protect the patient’s airway from aspiration.
• The right nostril is often preferred for NPA insertion given
that it is typically larger and straighter than the left.
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| show | Maintain airway patency
• Bite block in advanced airways
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| Oropharyngeal airway Contraindications | show 🗑
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| show | • Airway trauma from OPA placement
• Intolerance of OPA requiring removal
• Can precipitate vomiting/aspiration in patient with intact gag reflex
• Incorrect size or placement can potentially
exacerbate airway obstruction
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| Oropharyngeal airway Additional info | show 🗑
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| APGAR Stands for: | show 🗑
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| APGAR Appearance | show 🗑
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| show | Count heart rate:
0. Absent.
1. < 100 .
2. > 100
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| show | Monitor response
0. No response.
1. Grimace.
2. Vigorous cough
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| APGAR Activity | show 🗑
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| APGAR Respiration | show 🗑
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| APGAR Indications | show 🗑
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| APGAR Contraindications & Complications | show 🗑
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| show | Seizures
• Sick paediatric patients
• Impaired consciousness
• Post collapse
• Abnormal behaviour
• Any patient who is suspected of being
hypoglycaemic
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| Glucometry Contraindications | show 🗑
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Alwaysconsider other clinical signs
and available history.
Numerous variables may distort test results such as:
• blood volume on the sensor
• oxygen level of the blood
• glucose contaminants on the skin.
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| Glucometry Additional info | show 🗑
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| Glucometry Additional info.2 | show 🗑
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| show | Appearance
Behaviour
Speech
Mood
Affect
Thought form
Thought content
Perception
Insight & judgement
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| 12-Lead ECG acquisition Indications | show 🗑
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| show | Nil in this setting
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| show | •Should be acquired as part of an early
secondary assessment of the patient, especially in the setting of suspected cardiac ischaemia or infarct.
• Electrodes should remain in their original placement for comparison of serial 12-Lead ECGs
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| show | ECG frequency is set at 0.05–40 Hz, and
• paper speed is set at 25 mm/sec
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| Cardiac monitoring Indications | show 🗑
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| Cardiac monitoring Contraindications | show 🗑
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| Cardiac monitoring Precautions | show 🗑
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| Cardiac monitoring Additional info | show 🗑
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| Valsalva manoeuvre Indications | show 🗑
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| Valsalva manoeuvre Contraindications | show 🗑
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| show | Syncope
Prolonged hypotensive state
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| Valsalva manoeuvre Additional information | show 🗑
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| show | - minimum pressure of 40 mmHg
- optimal duration of 15 seconds
- supine position as an ideal posture
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| Bimanual compression Indications | show 🗑
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| Bimanual compression Contraindications | show 🗑
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| show | • Trauma
• Pain
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| Bimanual compression procedure: | show 🗑
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| show | Frank breech, Complete breech, Footling breech, Kneeling breech
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| Breech birth Breech birth Indications | show 🗑
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| show | • Nil in this setting
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| Breech birth Complications | show 🗑
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| Breech birth Additional information | show 🗑
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| show | When buttocks have entered the vagina, woman can push, let lower back and shoulder blades deliver, If not spontaneous deliver 1 leg at a time, Hold the baby by the hips 2 avoid internal damage
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| show | Allow arms to disengage spontaneously assist if necessary. After first arm, lift buttocks to mums abdomen to enable the second arm to deliver. If an arm does not spontaneously deliver, place 1 or 2
fingers in elbow, bend arm, hand down over baby’s face.
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| show | Loveset’s manoeuvre: Hold baby by hips, turn half circle,keep back uppermost, applying downward traction at the same time. Sweep hand over the face. 2nd arm:turn back 1/2 circle, keeping the back uppermost, repeat.
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| Breech birth Procedure: Baby's body cannot be turned | show 🗑
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| Breech birth Procedure: Delivery of the head, Mauriceau-Smellie-Veit: | show 🗑
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| Breech birth Procedure:Post-delivery care | show 🗑
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| show | To assist a labouring woman in the delivery
of her child
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| Cephalic delivery Contraindications | show 🗑
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| Cephalic delivery Complications | show 🗑
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| show | process by which fetus, placenta and membranes are expelled via the birth canal. In normal labour:
• The fetus presents by the vertex
• The occiput rotates anteriorly
• The result is the birth of a living, mature fetus (28–42 weeks)with no complication
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| show | cervix fully dilated,push.
pant as head delivers.
to control birth,fingers
against head to keep it flexed.
support the perineum
Once head delivers,no pushing
if meconium present,suction mouth then nose.
If cord around neck loosely, slip it
over th
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| show | cord tight around neck, two
clamps, cut between them, before
unwinding cord from around neck.
Allow the fetus’s head to turn spontaneously
place hand on each side of fetus’s head. mother to push gently with next contraction.
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| Cephalic delivery Procedure.3 | show 🗑
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| Cephalic delivery Care of the newborn | show 🗑
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| Cephalic delivery Care of the newborn.2 | show 🗑
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| show | The anterior shoulder does not deliver
spontaneously with good contractions.
The head does not restitute and externally rotate.
The chin burrows into the perineum as the anterior shoulder is caught on the symphysis pubis.
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| show | • Nil
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| Shoulder dystocia Complications | show 🗑
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| show | McRoberts
Rubin I (suprapubic pressure):
All-fours (Gaskin)
Rubin II(1 hand, push shoulder towards fetal chest.
Woods screw (2 hands, fingers both shoulders n screw)
Reverse Woods screw
Delivery of the posterior arm (sweep posterior arm across che
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| Defibrillation Indications | show 🗑
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| Defibrillation Contraindications | show 🗑
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| Defibrillation Complications | show 🗑
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| Defibrillation Joules: | show 🗑
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| Defibrillation Additional information (ICD) | show 🗑
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| show | Mid shaft femoral fractures
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| Donway traction splinting Contraindications | show 🗑
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| Donway traction splinting Precautions | show 🗑
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| show | To facilitate safe extrication from a confined space
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| NEANN immobilisation & extrication jacket Contraindications | show 🗑
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| show | •Chest straps 2 tight interfere with resp.
•Groin straps secured 2 minimise jacket and neck movement
•Incorrect head padding lead to C-spine
hyperextension or hyperflexion.
•Immobilising head without properly securing
torso may cause C-spine move
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| show | Suspected pelvic fracture with evidence of
haemodynamic comprimise
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| show | • Suspected isolated neck of femur fracture
• Suspected traumatic hip dislocation
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| show | Once applied, a binder should not be removed
due to the risk of haemodynamic instability.
• Other methods (e.g. a vacuum splint)
may be used in small children.
•Apply carefully in gross compound fractures
to minimise pain and further complications
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| show | “My name is X I’m an ACP with
QAS. I’m phoning with a notification.
I have a X year old male / female patient with X.
Treatment to this point has involved X and current vital signs are X.
I have administered / performed X
Our ETA is X minutes.”
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| show | My name is X,I’m an ACP with QAS. I’m phoning with a clinical consult.
I have a Xyo m/f pt with X.
Treatment has been X VSS are X.
I would like to administer / perform / seek advice regarding X.
this is appropriate? anything u suggest?
Confirm X
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| Tension pneumothorax decompression Indications | show 🗑
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| Tension pneumothorax decompression Contraindictions | show 🗑
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| show | •Improper diagnosis and insertion of pleural
catheter may creat simple or tension pneumo
• Incorrect placement may injure heart, great vessels, or damage lung
*Bilateral pleural decompression in
spontaneously breathing pt may cause resp compromise.
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| Tension pneumothorax decompression Procedure | show 🗑
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| show | •CPR or IPPV (BVM/LMA/ETT)
•Sedation and procedural sedation
• Endotracheal intubation (placement confirmation)
• Ongoing monitoring of ventilation
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| Waveform capnography Contraindications | show 🗑
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| Waveform capnography Precautions | show 🗑
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