WBBSE Madhyamik Vocational Health Care cheat sheet

Vital signs normal adult ranges: temperature 36.5–37.5 °C (oral), pulse 60–100 beats/min, respiration 12–20 breaths/min, blood pressure 120/80 mmHg (normal), systolic 90–120 mmHg, diastolic 60–80 mmHg.

Infection control chain: infectious agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host. Hand hygiene interrupts the transmission link, the single most effective break point.

Standard precautions apply to all patients regardless of diagnosis: hand hygiene, gloves for body-fluid contact, gown/mask/eye protection when splash risk exists, safe sharps handling, no recapping of needles.

Pulse sites in order of common use: radial (routine), brachial (BP, infants), carotid (cardiac arrest adult), femoral (arrest/child), apical (via stethoscope, count 1 full minute, used in infants and irregular rhythm).

Respiration counting rule: count for 30 seconds and multiply by 2 if regular; count a full minute if irregular. Do not tell the patient you are counting respiration, to avoid altering the rate.

Blood pressure measurement: cuff width should cover about 40% of arm circumference and bladder length about 80%; inflate to 30 mmHg above the point where the radial pulse disappears, then deflate at 2–3 mmHg per second.

First aid priority sequence: scene safety → check responsiveness → call for help → airway → breathing → circulation (CPR) → control severe bleeding → treat shock → secondary survey.

Adult CPR: compression rate 100–120/min, depth 5–6 cm, ratio 30 compressions to 2 breaths, full recoil, minimize interruptions to under 10 seconds.

Sterilisation versus disinfection: sterilisation destroys all microorganisms including spores (autoclave 121 °C at 15 psi for 15–20 minutes); disinfection reduces pathogens on inanimate objects but may not kill spores.

Positioning rules: Fowler/semi-Fowler (head elevated 45–60°) for breathlessness and feeding; lateral (Sims) for unconscious or vomiting patients to protect the airway; supine for abdominal examination; Trendelenburg is avoided in head injury and raised intracranial pressure.

Pressure ulcer (bed sore) prevention: reposition a bedridden patient at least every 2 hours, keep skin clean and dry, use a pressure-relieving mattress, inspect bony prominences (sacrum, heels, elbows, occiput) each shift.

Body temperature routes and relative readings: rectal is about 0.5 °C higher than oral; axillary about 0.5 °C lower than oral. Oral route is avoided in unconscious patients, infants, and after oral surgery.

Intake-output recording: normal adult urine output is roughly 1–2 litres per day; output below 400 mL/day (oliguria) or below 100 mL/day (anuria) must be reported immediately.

Fall prevention rules: bed in lowest position, wheels locked, side rails up for at-risk patients, call bell within reach, non-slip footwear, adequate lighting, and hourly rounding for high-risk patients.

Communication principles: use simple language, face the patient, maintain eye contact, allow silence, use open questions, avoid medical jargon, and confirm understanding by asking the patient to repeat instructions.

Confidentiality: patient information is shared only with the care team on a need-to-know basis; disclosure without consent is limited to legal requirements, statutory notification, and immediate danger to life.

Biomedical waste segregation (colour coding): yellow - human anatomical waste, soiled waste, expired medicines; red - contaminated recyclable plastic (tubing, bottles); white - sharps in puncture-proof container; blue - glassware and metallic implants.

Emergency drug and equipment readiness: oxygen, suction, ambu bag, and emergency drugs must be checked each shift; an expired or empty cylinder is recorded and replaced immediately, not at the end of the shift.