WBCHSE HS Vocational Health Care cheat sheet

Anatomical position: standing erect, face forward, arms at sides with palms facing anteriorly; all directional terms assume this position.

Directional pairs: superior/inferior (above/below), anterior/posterior (front/back), medial/lateral (toward/away from midline), proximal/distal (nearer/farther from trunk attachment).

Body planes: sagittal divides left and right; coronal (frontal) divides anterior and posterior; transverse divides superior and inferior.

Vital sign reference ranges for adults: pulse 60-100 beats/min, respiratory rate 12-20 breaths/min, blood pressure about 120/80 mmHg, oral temperature 36.5-37.5 degrees C, SpO2 95-100 percent.

Four abdominal quadrants (RUQ, LUQ, RLQ, LLQ) are used for describing pain and organ location; the appendix lies in the RLQ and the liver mainly in the RUQ.

Eleven body systems: integumentary, skeletal, muscular, nervous, endocrine, cardiovascular, lymphatic/immune, respiratory, digestive, urinary, reproductive.

Blood components: plasma about 55 percent, formed elements about 45 percent; normal adult haemoglobin roughly 12-17 g/dL depending on sex.

Homeostasis is maintenance of a stable internal environment through negative feedback loops (a deviation triggers a response that reverses it) and positive feedback (amplifies the change).

Six rights of medication administration: right patient, right drug, right dose, right route, right time, right documentation.

Pulse sites in order of common use: radial, carotid, brachial, femoral, popliteal, posterior tibial, dorsalis pedis; count for a full 60 seconds when the rhythm is irregular.

Pressure injury (bed sore) staging runs from Stage 1 (non-blanchable erythema of intact skin) to Stage 4 (full-thickness tissue loss exposing bone, tendon or muscle); reposition immobile patients at least every 2 hours.

Intake-output charting: record all oral, tube and intravenous fluids as intake; urine, vomitus, drainage and stool as output; normal adult urine output is about 1-2 mL/kg/hour.

Fowler position raises the head of bed 45-60 degrees (semi-Fowler 30-45 degrees); it aids breathing and is used for nasogastric feeding to reduce aspiration risk.

Body temperature routes and typical values: oral 37 degrees C, axillary about 0.5 degrees C lower, rectal about 0.5 degrees C higher.

Before any procedure confirm patient identity with at least two identifiers (name plus registration or bed number) and explain the procedure to obtain consent.

Hand hygiene with soap and water lasts 40-60 seconds; alcohol-based hand rub 20-30 seconds, applied until dry.

Adult CPR sequence: check responsiveness and breathing, call for help, 30 chest compressions at 100-120 per minute, depth 5-6 cm, then 2 rescue breaths; repeat cycles.

Choking: for a conscious adult or child over 1 year give up to 5 back blows then up to 5 abdominal thrusts (Heimlich); for an infant use 5 back blows and 5 chest thrusts, never abdominal thrusts.

Recovery position (lateral) is used for an unconscious but breathing casualty to keep the airway open and prevent aspiration.

Severe bleeding: apply direct pressure with a clean dressing, elevate the limb if no fracture is suspected, and add dressings on top rather than removing soaked ones.

Burns: cool with running water for at least 20 minutes, remove jewellery before swelling, do not burst blisters, and never apply oil, toothpaste or ice.

Fracture immobilisation: splint the joint above and below the injury, check distal pulse and sensation before and after splinting.

Snake bite: keep the victim calm and the bitten limb still and below heart level, remove rings, and transport to hospital; do not incise, suck or apply a tight tourniquet.

Fainting and shock: lay the casualty flat, raise the legs about 30 cm, loosen tight clothing, keep warm, and never give food or drink to a semi-conscious person.

Chain of infection links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host; breaking any link prevents transmission.

Standard precautions apply to all patients regardless of diagnosis and include hand hygiene, gloves, gown, mask, eye protection and safe sharps handling.

Transmission-based precautions: contact (e.g. scabies, MRSA), droplet (e.g. influenza, pertussis), airborne (e.g. tuberculosis, measles, varicella).

Biomedical waste colour coding: yellow for human anatomical waste and soiled waste, red for contaminated recyclable plastics, white translucent for sharps, blue for glassware and metallic implants.

Sterilisation kills all microorganisms including spores; autoclave standard cycle is 121 degrees C at 15 psi for 15-20 minutes.

Disinfection reduces pathogens on inanimate objects; 70 percent alcohol or 1 percent sodium hypochlorite is used for surfaces, with higher concentrations for blood spills.

Needle-stick injury first aid: wash the site with soap and water, do not squeeze or scrub, report immediately and follow post-exposure prophylaxis protocol.

Fire safety uses the RACE rule (Rescue, Alarm, Contain, Extinguish/Evacuate) and PASS for extinguisher use (Pull, Aim, Squeeze, Sweep).

Levels of prevention: primary (immunisation, health education), secondary (screening, early diagnosis), tertiary (rehabilitation, disability limitation).

India's national immunisation schedule under UIP includes BCG and hepatitis B at birth, OPV and pentavalent at 6, 10 and 14 weeks, measles-rubella at 9-12 months and 16-24 months, and DPT and Td boosters later.

Indicators: infant mortality rate = infant deaths under 1 year per 1,000 live births in a year; maternal mortality ratio = maternal deaths per 100,000 live births.

Epidemiological triad: agent, host and environment; disease occurs when these factors interact to favour transmission.

Notifiable diseases in India include cholera, plague, dengue, malaria, polio, rabies and tuberculosis; these must be reported to the local health authority.

Vector control for malaria and dengue focuses on eliminating stagnant water, using larvicides, insecticide-treated nets and indoor residual spraying.

Cold chain: OPV is kept frozen at -20 degrees C or below, most other vaccines at 2-8 degrees C; vaccine vial monitors indicate heat exposure.

Pulse polio and routine immunisation rely on house-to-house surveys and defaulter tracking to reach every eligible child.

Macronutrient energy values: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g; alcohol provides 7 kcal/g.

Balanced diet concept groups foods into energy-giving (cereals, fats), body-building (pulses, milk, meat, eggs) and protective (fruits, vegetables) foods.

Deficiency diseases: vitamin A deficiency causes night blindness and xerophthalmia; vitamin D deficiency causes rickets in children and osteomalacia in adults; vitamin C deficiency causes scurvy; iron deficiency causes microcytic anaemia.

Iodine deficiency disorders are prevented by iodised salt; goitre and cretinism are classic outcomes.

Protein-energy malnutrition presents as marasmus (severe wasting, weight below 60 percent of expected) and kwashiorkor (oedema, distended abdomen, low protein).

Growth monitoring uses weight-for-age, height-for-age and mid-upper arm circumference; a MUAC below 11.5 cm in children aged 6-59 months indicates severe acute malnutrition.

Exclusive breastfeeding is recommended for the first 6 months, with complementary feeding starting at 6 months and continued breastfeeding to 2 years.

Developmental milestones: head control by about 3 months, sitting without support by 6-8 months, walking by 12-15 months, two-word phrases by about 2 years.

Four ethical principles: autonomy (respect patient choice), beneficence (act for the patient's good), non-maleficence (do no harm) and justice (fair treatment).

Informed consent requires capacity, adequate information, understanding and voluntariness; it can be withdrawn at any time.

Confidentiality: patient information is shared only with the care team on a need-to-know basis, or when legally required (e.g. notifiable disease reporting).

Records must be accurate, legible, dated, timed, signed and contemporaneous; corrections are made by a single strike-through with initials, never by overwriting.

Nursing documentation follows the SOAP format: Subjective, Objective, Assessment, Plan.

Effective communication uses active listening, open-ended questions, simple language and a trained interpreter; avoid medical jargon with patients and families.

Incident reporting is non-punitive and must be completed promptly for falls, medication errors, needle-stick injuries and equipment failure.

Privacy laws and institutional policy require secure storage of records; electronic records need unique login credentials that are never shared.

Measuring blood pressure: patient seated, arm supported at heart level, cuff 2-3 cm above the antecubital fossa; inflate to about 30 mmHg above the point where the radial pulse disappears and deflate at 2-3 mmHg per second.

Urine testing with reagent strips: dip and remove excess, read at the manufacturer's stated time; record colour, clarity, pH, protein, glucose, ketones and blood.

Blood glucose measurement: clean and dry the finger, prick the side of the fingertip (less painful), discard the first drop if the meter requires, and record in mg/dL.

Universal precautions in the laboratory include gloves, eye protection, a lab coat and a sharps container; never recap a needle by hand.

Weighing and height measurement: record to the nearest 0.1 kg and 0.1 cm; remove shoes and heavy clothing; use a stadiometer with the head in the Frankfort plane.

Vital sign charts must show the date, time, value, route and the recorder's signature; abnormal values are reported to the supervisor immediately.

A vocational project report includes aim, background, method, observations, discussion, conclusion and references; consent is obtained before involving patients or the public.

Basic life support skills are practised on manikins with a feedback device; compression quality is judged by rate, depth and full recoil.