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Pulmonary artery pressure (PAP) - Systolic 15-30 mmHg Diastolic 5-15 mmHg Stroke volume (SV) - 50-100 ml/beat Symptoms of Systolic heart failure - Decreased stroke volume, decreased ejection fraction, S3 and enlarged heart Physical signs of DIC - Hypotension, Petechia, Purpura, Bruising, Bleeding in oral, GI/GU, or pulmonary Symptoms of Left heart failure - Orthopnea, dyspnea, crackles, Low PaO2, SaO2 & SpO2, S3 & S4, Increased PAOP & PA pressures Mean arterial pressure (MAP) - 70-105 mmHg Cardiac output (CO) - 4-5 L/min Cardiac index (CI) - 2.5-4.5 L/min/m2 Stroke index (SI) - 35-60 ml/m2/beat Right arterial pressure (RAP) - 4-8 mmHg Pulmonary artery occlusive pressure (PAOP) - 8-12 mmHg Systemic vascular resistance (SVR) - 800-1200 dynes/sec/cm-5 Systemic vascular resistance index (SVRI) - dynes/se/com-5/m2Pulmonary vascular resistance (PVR) - 100-250 dynes/sec/cm-5 Pulmonary vascular resistance index (PVRI) - 255-285 dyens/sec/cim-5/m2 Arterial oxygen saturation (SaO2) - 95-100% Venous oxygen saturation (SvO2) - 60-80% Delivery of oxygen (DO2) - 550-650 ml/min/m2 Oxygen consumption (VO2) - 200-250 ml/min Inferior leads and artery - cardiac - Lead II, III, aVF - RCA Heart rate (HR) - 60-100 beats/min Anterior septal leads and artery - cardiac - Lead V1, V2 - LM Anterior leads and artery - cardiac - Lead V3, V4 - LAD Low lateral lead and artery - cardiac - Lead V5, V6 - LCX High lateral lead - cardiac - Lead I, aVL Symptoms of Right heart failure - JVD, Peripheral edema, Hepatomegaly, Increased CVP/RAP, S3 & S4Symptoms of Diastolic heart failure - Decreased stroke volume, normal ejection fraction, S4, normal heart size Laboratory signs of DIC - Decreased platelets Increased PT/INR Increased aPTT Decreased fibrinogen Increased FSP Increased D-Dimer Chvostek's Sign - Facial muscle twitching when cheek is tapped - Hypocalcemia Trousseau's Sign - Spasming of the hand when the bp cuff is inflated beyong systolic pressure for >3 min - Hypocalcemia Grey Turner's Sign - Bruising of the flanks, appearing as a blue discoloration - retroperitoneal bleed Cullen's Sign - Superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus - Intraperitoneal bleed Calculation of anion gap - (Na + K) - (CL + HCO3) *Cations - Anions Normal is < 15 PaO2/FiO2 Ratio (P/F ratio) - Measures the difference between oxygen content in PaO2 divided by the FiO2. Used to predict shunting and hypoxemia <300 = ALI <200 = ARDS Acute Respiratory Failure - PaO2 <60 mmHgPaCO2 >50 mmHg pH <7.30 Acute Lung Injury & ARDS - Cxr - bilateral diffuse infiltrates with no cardiac enlargement (whiteout or ground-glass appearance) P/F ratio: (<200 ARDS; <300 for ALI) PAOP <18mmHg Status Asthmaticus - ABG revealing normalizing or increasing CO2 with no signs of improvement Little to no breath sounds auscultated Disappearance of wheezing Flail Chest - Paradoxical wall movement: - On inspiration when chest wall should move outward, the fractured area will move inward - On expiration when chest wall should move imward, the fractured area will move outward Tension Pneumothorax - Tracheal deviation and PMI move away from affected side High peak inspiratory pressure (if vented) Hypotension Cranial Nerve I - Olfactory - sense of smell Cranial Nerve II - Optic - Central and peripheral vision Cranial Nerve III - Oculomotor - Eye and upper eyelid movement, pupil constriction Cranial Nerve IV - Trochlear - Down and inward eye movementCranial Nerve V - Trigeminal - Touch, pain, temperature, jaw and eye muscle proprioception (sense of position), chewing Cranial Nerve VI - Abduncens - Lateral eye movement Cranial Nerve VII - Facial - Close eyelid, taste (anterior 2/3 of tongue), saliva and tears