List six (6) specific medical problems that you would anticipate during the transport of this patient. For each problem state one (1) measure that you would take to minimise the likelihood of each problem. (12 marks) Specific medical problems Measure you would take to minimise Airway compromise- secondary to ETT reduced GCS, potential aspiration Fill cuff with saline Ventilation compromise- Hypoxia ICC- with Heimlick valve due to evolving pulm contusion/ PTX Secure ICC carefully Lung protective ventilation strategy May need sea level pressurisation if profound hypoxia Paralyse PTX increasing/ Tension ICC to right side/ secure well Confirm position of tube Prophylactic ICC to Left Suction Heimlich valve (if not haemothorax) Haemodynamic instability Chest blood loss Take Packed cells Ensure 2 large bore, well secured IVC Optimise vol status prior to departure Increased intracranial pressure if HI avoid tube ties constricting IJV PEEP as low as tolerated Manitoba and seizure prophylaxis Nurse at 30° (probably not possible in spinal immobilisation) Keep warm- avoid hypothermia, covered with blankets and forced air warmer, heat on place, regular monitoring temp Monitor glucose Monitor ETC02 etc Gas in stomach NGT ETT dislodgement Secure ETT carefully Question 2 (12 marks) 6 minutes A mother presents with her very distressed 18 month old child. The mother is concerned that the child may have eaten powder detergent from the dishwasher, 30 minutes ago. List three (3) features of toxicity of this ingestion. (3 marks)
List six (6) specific medical problems that you would anticipate during the transport of this patient. For each problem state one (1) measure that you would take to minimise the likelihood of each problem. (12 marks) Specific medical problems Measure you would take to minimise Airway compromise- secondary to reduced GCS, potential aspiration ETT Fill cuff with saline Ventilation compromise- Hypoxia due to evolving pulm contusion/ PTX ICC- with Heimlick valve Secure ICC carefully Lung protective ventilation strategy May need sea level pressurisation if profound hypoxia Paralyse PTX increasing/ Tension ICC to right side/ secure well Confirm position of tube Prophylactic ICC to Left Suction Heimlich valve (if not haemothorax) Haemodynamic instability Chest blood loss Take Packed cells Ensure 2 large bore, well secured IVC Optimise vol status prior to departure Increased intracranial pressure if HI avoid tube ties constricting IJV PEEP as low as tolerated Manitoba and seizure prophylaxis Nurse at 30° (probably not possible in spinal immobilisation) Keep warm- avoid hypothermia, covered with blankets and forced air warmer, heat on place, regular monitoring temp Monitor glucose Monitor ETC02 etc Gas in stomach NGT ETT dislodgement Secure ETT carefully Question 2 (12 marks) 6 minutes A mother presents with her very distressed 18 month old child. The mother is concerned that the child may have eaten powder detergent from the dishwasher, 30 minutes ago. List three (3) features of toxicity of this ingestion. (3 marks)
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