First Aid Facts..

First Aid Facts by medstudentz

Airway Management (Surgical)

Airway Managment Surgical by medstudentz

Airway Management (Non Surgical)

Airway Managment (NonSurgical) by medstudentz

Physical Examination Mnemonics

Heart ausculation sites: ribs Apt. M 225A: Aortic valve Pulmonary valve Tricuspid valve Mitral valve
· In order they correspond with the following landmarks: 2nd intercostal space (right) 2nd intercostal space (left) 5th intercostal space (left) Apex (still the 5th intercostal space)


Patient's model of illness (illness history) "DC REF
Fears Similar Decision At ER": Definition Cause Reasoning Effect Future Fears and concerns Similar experiences Decision-making Attempts at treatment Expectations of treatment Results


Pain history checklist DOCS ARE FIT: Duration Onset Character Site Associatied symptoms Radiation Exacerbating and relieving factors Frequency Intensity Timing


Breast history checklist LMNOP: Lump Mammary changes Nipple changes Other symptoms Patient risk factors


Pain history checklist COLDER BARS: Character Onset Location Duration Exacerbating factors Radiation Before (ever happened before) Associated symptoms Relieving factors Severity


Pain history checklist SO CRAP: Site Onset Character Radiates to Associated symptoms/ Alleviating and exacerbating factors Periodicity


History, HCFA components for E+M coding Q LSD MCAT: Quality Location Severity Duration Modifying factors Context Associated signs and symptoms Timing


Surgical sieve for diagnostic categories INVESTIGATIONS: Iatrogenic Neoplastic Vascular Endocrine Structural/ Mechanical Traumatic Inflammatory Genetic/ Congenital Autoimmune Toxic Infective Old age/ Degenerative Nutritional Spontaneous/ Idiopathic


Mental state examination: stages in order "Assessed Mental State To Be Positively Clinically Unremarkable": Appearance and behaviour [observe state, clothing...] Mood [recent spirit] Speech [rate, form, content] Thinking [thoughts, perceptions] Behavioural abnormalities Perception abnormalities Cognition [time, place, age...] Understanding of condition [ideas, expectations, concerns]


Branham sign: definition BRAnham sign: BRAdycardia after compression or excision of a large AV fistula.


Glasgow coma scale: components and numbers · Scale types is
3 V's: Visual response Verbal response Vibratory (motor) response
· Scale scores are 4,5,6:
Scale of 4: see so much more
Scale of 5: talking jive
Scale of 6: feels the pricks(if testing motor by pain withdrawl)


Physical examination - correct order "I Palpate People's Abdomens": Inspection Palpation Percussion Auscultation


Clinical examination: initial Inspection of patient from end of bed ABC: Appearance (SOB, pain, etc) Behaviour Connections (drips, inhalers, etc connected to patient)


Pain history checklist CLITORIS: Character Location Intensity Timing Onset Radiating Irritating and relieving factors Symptoms associated


Heart valve auscultation sites "All People
Try Marijuana": Aortic Pulmonic Tricuspid Mitral


Consolidations: sound Consolidations Conduct Consonants Clearly


Past medical history (PMH) VAMP THIS: Vices (tobacco, alcohol, other drugs, sexual risks) Allergies Medications Preexisting medical conditions Trauma Hospitalizations Immunizations Surgeries


Patient profile (PP) LADDERS: Living situation/ Lifestyle Anxiety Depression Daily activities (describe a typical day) Environmental risks/ Exposure Relationships Support system/ Stress


Family history (FH) BALD CHASM: Blood pressure (high) Arthritis Lung disease Diabetes Cancer Heart disease Alcoholism Stroke Mental health disorders (depression, etc.)


Differential diagnosis checklist DIRECTION: Drugs Infection Rheumatologic Endocrine Cardiovascular Trauma Inflammatory Other Neoplasm


Pathologic classification NIT DIT FIT: Neoplastic Infectious Traumatic Degenerative/ Drugs Immune Toxic Vascular Inflammatory Totally obscure


Pyrexia of Unknown Origin: history taking SIT ON FRAD: Sexual history Immunisation status Travel history Occupational history Nutrition (consumption of dairy products, etc.) Family history Recreational habits Animal contacts (including ticks and other vectors) Drug history


Health related behavior (HRB) topics: history taking
"Healthy SEEDS": Substances (alcohol, tobacco, IV drugs?) Environment (hazards at home or work? feel safe?) Exercise (what do you do? how often do you do it?) Diet (any special diet?) Sex (active with m/f/both? >1 partner? safe sex? STD history? difficulty
with arousal or orgasm? history of abuse?)
· I find this order works well: patients most expect to be asked about alcohol
and they least want to talk about their STD history, but taking a solid HRB
history first reassures them that it's all part of good medical care.


Pain history checklist LOST WAR: Location Onset Severity Time Worsening factors Alleviating factors Radiation


Short statue causes RETARD HEIGHT: Rickets Endocrine (cretinism, hypopituitarism, Cushing's) Turner syndrome Achondroplasia Respiratory(suppurative lung disease) Down syndrome Hereditary Environmental (postirradiation, postinfectious) IUGR GI (malabsorption) Heart (congenital heart disease) Tilted backbone (scoliosis)


Ascultation: crackles (rales) "PEBbles": Pneumonia Edema of lung Bronchitis


Pain history checklist CHLORIDE: CHaracter (stabbing, throbbing, etc.) Location Onset Radiation Intensity Duration Exacerbating and alleviating factors


Differential diagnosis CIMETIDINE: Congenital Infection/ Inflammatory Metabolic Endocrine Trauma Iatrogenic Degenerative Idiopathic Neoplastic Everything else


Sign vs. symptom Remember Ace of Base's song that goes like
this:
"I Saw the Sign, and it opened up my eyes".
The physician sees the signs.


Systems review: systems checklist I PUNCH EAR: Integumental Pulmonary Urogenital Nervous Cardiovascular Hematolymphoid Endocrine Alimentary Reproductive


History taking -past medical history ABCDEFGHI: Asthma Blood pressure (say: 'blood pressure problems') CVA (say: 'stroke') Diabetes mellitus (say: 'diabetes') Epilepsy Fever, rheumatic Gastrointestinal (jaundice) Heart attack Infection (TB)


Pain history checklist MR. C T FARADS: Main site Radiation Character Timing Frequency Associated factors Relieving factors Aggravating factors Duration Severity


Abdomen assessment To assess abdomen, palpate all 4
quadrants for DR. GERM: Distension: liver problems, bowel obstruction Rigidity (board like): bleeding Guarding: muscular tension when touched Eviseration/ Ecchymosis Rebound tenderness: infection Masses


Pain history checklist "On Days Feeling Low Character, Run A Seven Pace Race": Onset Duration Frequency Location Character Radiation Severity Precipitating factors Relieving factors


Pain history checklist ASK LAST: Aggravating/ Alleviating Severity Karacter Location Associated symptoms Setting Timing


Pain history checklist SOCRATES: Site Onset Character Radiation Alleviating factors/ Associated symptoms Timing (duration, frequency) Exacerbating factors Severity
· Alternatively, Signs and Symptoms with the 'S'.


Symptom attributes "FAST LQQ'S": Factors that make it better/worse Associated manifestations Setting Timing Location Quality Quantity Severity


Heart valve auscultation sites "All Patients Take Meds":
· Reading from top left: Aortic Pulmonary Tricuspid Mitral
· See diagram.
· Alternatively: All Prostitutes Take Money.
· Alternatively: APe To Man.
· Alternatively: Always Pumps Too Much.


Four point physical assessment of a disease "I'm A People Person": Inspection Auscultation Percussion Palpation
· Alternatively: "I'm A Perfect Person".


Physical exam for 'lumps and bumps' "6 Students and 3 Teachers go for CAMPFIRE": Site, Size, Shape, Surface, Skin, Scar Tenderness, Temperature, Transillumination Consistency Attachment Mobility Pulsation Fluctuation Irreducibility Regional lymph nodes Edge


Surgical sieve VANISHED: Vascular Accident & trauma Neoplastic Inflammatory Septic Haematologic/ Hereditary Endocrinological Degenerative


Differential diagnosis checklist "I VINDICATE AIDS": Idiopathic Vascular Infectious Neoplastic Degenerative Inflammatory Congenital Autoimmune Traumatic Endocrinal and metabolic Allergic Iatrogenic Drugs Social


Symptom sieve "TIN CAN BED DIP POG": Trauma Infection Neoplasm Cardiac Autoimmune Neurological Blood/ Bone Endocrine Disintegration/ Degeneration Drugs Iatrogenic/ Idiopathic Psychological Paediatric Obstetric Gynaecological


Alcohol abuse screening questions CAGE:
1. Ever felt it necessary to Cut down on drinking?
2. Has anyone ever said they felt Annoyed by your drinking?
3. Ever felt Guilty about drinking?
4. Ever felt a need to have a morning drink as an Eye opener?


Abdominal swelling causes 9 F's: Fat Feces Fluid Flatus Fetus Full-sized tumors Full bladder Fibroids False pregnancy


Patient examination organization SOAP: Subjective: what the patient says. Objective: what the examiner observes. Assessment: what the examiner thinks is going on. Plan: what they intend to do about it.


Vomiting: non-GIT differential ABCDEFGHI: Acute renal failure Brain [increased ICP] Cardiac [inferior MI] DKA Ears [labyrinthitis] Foreign substances [Tylenol, theo, etc.] Glaucoma Hyperemesis gravidarum Infection [pyelonephritis, meningitis]


History: quick EMS medical history checklist SAMPLE: Signs/ Symptoms Allergies Medications Pertinent history Last oral intake Events preceding this incident


Pain history checklist OPQRSTU: Onset of pain (time, duration) Palliative factors for pain Quality of pain (throbbing, stabbing, dull, etc.) Region of body affected Severity of pain (usually scale of 1-10) Timing of pain (after exercise, in evening, etc.) U: How does it affect 'U' in your daily life?
· May wish to expand to OPPQRRSTTUVW, with the extra letters
representing: Provocative factors Radiation (how does pain spread) Treatments tried
Deja Vu: Has this happened before? Worry: What do you think or fear that it is?


Differential diagnosis checklist "A VITAMIN C" A and C stand for Acquired and Congenital
· VITAMIN stands for: Vascular Inflammatory (Infectious and non-Infectious) Trauma/ Toxins Autoimmune Metabolic Idiopathic Neoplastic
· Example usage: List causes of decreased vision: Central retinal artery
occlusion, Retinitis pigmentosa, Perforation to gobe, Chronic Gentamycin use,
Ruematoid arthritis, Diabetes, Idiopathic, Any eye tumor, Myopia.


Sign vs. symptom sIgn: something I can detect
even if patient is unconscious.
sYMptom is something only hYMknows about.


Eyes: abbreviations for the eyes You look OUt with
Both eyes.
Take the Right dose so you won't OD [overdose].
The only one that is Left is OS.
· Both eyes=OU, Right eye=OD, Left eye=OS.


Medical history: disease checklist MJ THREADS: Myocardial infarction Jaundice Tuberculosis Hypertension Rheumatic fever/ Rheumatoid arthritis Epilepsy Asthma Diabetes Strokes
· Aside: "History" album was by Michael Jackson (MJ).

Bear pain with patience, your rainbow will come, remain the beautiful person you are!

Bear pain with patience, your rainbow will come, remain the beautiful person you are!

Sinus Arrest