PHECC Advanced Paramedic flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Primary survey sequence

Catastrophic haemorrhage control, airway, breathing, circulation, disability and exposure, reassessing for life threats at each step before moving on.

GCS eye score range

Eye opening scores 1 to 4: none, to pain, to voice, spontaneous. Combined with verbal and motor to give a total of 3 to 15.

Shock index formula

Heart rate divided by systolic blood pressure. A value above 0.9 in an adult suggests occult hypoperfusion even when blood pressure appears normal.

OPQRST mnemonic

Onset, Provocation or palliation, Quality, Radiation, Severity and Time, used to characterise a patient's pain systematically during history taking.

Sample history components

Signs and symptoms, Allergies, Medications, Past medical history, Last oral intake and Events preceding the presentation.

Adult compression rate and depth

Compress at 100 to 120 per minute to a depth of 5 to 6 centimetres, allowing full chest recoil between compressions.

Adult CPR ratio no airway

Without an advanced airway, deliver 30 compressions to 2 ventilations. Once an advanced airway is placed, give continuous compressions with 10 to 12 breaths per minute.

Adrenaline dose adult arrest

1 mg of 1:10,000 adrenaline intravenously or intraosseously every 3 to 5 minutes during adult cardiac arrest.

Amiodarone in refractory VF

300 mg IV or IO bolus given after the third shock in cardiac arrest with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.

Reversible arrest causes 4Hs

Hypoxia, hypovolaemia, hypo or hyperkalaemia and metabolic disorders, and hypothermia. These are sought and corrected during resuscitation.

Reversible arrest causes 4Ts

Tension pneumothorax, cardiac tamponade, toxins, and thrombosis such as pulmonary or coronary embolism.

Capnography tube confirmation

A sustained waveform with each breath confirms tracheal tube placement. A flat trace suggests oesophageal intubation or absent pulmonary perfusion.

Paediatric two-rescuer CPR ratio

For children with two rescuers, use 15 compressions to 2 ventilations, compressing to at least one third of the chest depth.

Post-ROSC oxygen target

Titrate oxygen to an SpO2 of 94 to 98 percent after return of spontaneous circulation, avoiding both hypoxia and hyperoxia.

Adrenaline concentrations compared

1:10,000 contains 100 micrograms per mL and is used IV in arrest. 1:1,000 contains 1 mg per mL and is the intramuscular anaphylaxis preparation.

Adult anaphylaxis adrenaline dose

0.5 mg of 1:1,000 adrenaline intramuscularly into the anterolateral thigh, repeated every 5 minutes if the patient remains symptomatic.

GTN contraindications

Systolic blood pressure below 90 mmHg, suspected right ventricular infarction, and recent use of a PDE5 inhibitor such as sildenafil.

Aspirin in acute coronary syndrome

300 mg chewed, unless there is true allergy or active gastrointestinal bleeding. Chewing speeds absorption compared with swallowing whole tablets.

Naloxone re-dosing rationale

Naloxone's duration of action may be shorter than that of the opioid, so respiratory depression can recur and repeat doses or monitoring are needed.

Paediatric weight-based dosing

Paediatric drug doses are calculated in milligrams per kilogram using a measured, estimated or length-based weight, then independently checked before administration.

Seven rights of administration

Right patient, drug, dose, route, time, documentation and reason. Uncertainty in any element requires an independent check before giving.

Scope of practice definition

The range of interventions a practitioner is authorised to perform, set by PHECC registration level and the current Clinical Practice Guidelines.

Valid informed consent

Requires patient capacity, sufficient information about the proposed care, and voluntary agreement. A decision is not invalid merely because it seems unwise.

Capacity assessment elements

The patient can understand the information, retain it, weigh it in deciding, and communicate the decision. All four elements are needed.

Duty of care endpoint

The professional duty continues until care is formally handed over to a practitioner of equal or higher training who accepts responsibility.

Correcting a clinical record error

Draw a single line through the error, write the correction, then add signature, role and date. Never obliterate, overwrite or erase the original entry.

Advanced Paramedic additional skills

Beyond Paramedic level, authorised skills include advanced airway management, intravenous cannulation and fluid therapy, and additional listed medications.

CPG indication check

Before any CPG-directed intervention, confirm indication, contraindication, dose and route. Failure of any single criterion stops the intervention.

Refusal of care documentation

Record the capacity assessment, the risks explained, the alternatives offered, and a signed refusal where the patient is willing to sign.

Structured clinical handover

Handover covers presenting problem, key assessment findings, interventions and response, and outstanding needs or time-critical destination requirements.

Adverse incident reporting

Medication errors and adverse incidents are reported through the PHECC or employer incident process, separately from the patient care record.

Justifying prolonged scene time

Extended on-scene time must be justified by clinical need, such as extrication or resuscitation, and the reason documented in the record.