Management of the Medical Patient in Remote & Rural Location
What Investigations are we Able to do for Mr Mackay in a Rural GP Practice?
Primary Survey - DR ABCDE - Performed by First Responder, Paramedic or GP depending on who is first to get to the patient. In a rural environment, this is much more likely to be a First Responder or GP, compared to in a city where paramedics will nearly always be the first in contact with the patient.
ECG - Done pre-hospitally either in the ambulance, the GP practice or by a portable ECG carried by rural GPs if an ambulance response is likely to take a long time. The ECG is then sent to the PPCI (Primary Percutaneous Coronary Intervention) Centre or CCU (Coronary Care Unit) for interpretation and advice.
AVPU is a quick and easy way to clerk the response and consciousness level of your patient. A = Alert, V = responds to Voice, P = responds to Pain, U = Unconscious.
RIPPA is a useful acronym to remember the different components of a breathing assessment: R = Respiratory Rate, I = Inspection, P = Palpation, P = Percussion, A = Auscultation.
Can you list which questions we are looking to answer as part of a primary survey?
You correctly matched the following 21 options
Is there anything obstructing the airway?
Is the patient responsive?
Are you able to gain IV or IO access?
Are they making any abnormal breathing sounds?
What is the patient's score on the AVPU scale?
What is the patient's respiratory rate?
What is the patient's capillary blood glucose?
Investigate alternative causes of symptoms
Is the patient's airway patent?
Are the patient's pupillary responses normal?
Does the chest sound normal on percussion and auscultation?
