How to read blood pressure - Answers Top number: systolic pressure (heart's ventricles contract)
Bottom number: diastolic pressure (heart's ventricles are relaxed)
carotid pulse - Answers the pulse felt along the large carotid artery on either side of the neck. Blood
pressure is at least 60 systolic
femoral pulse - Answers Pulse felt on either side of the groin; Femoral artery. blood pressure is at
least 70 systolic.
brachial pulse - Answers the pulse felt in the upper arm. (often used for infants.)
radial pulse - Answers the pulse felt at the wrist. blood pressure is at least 80 systolic.
pedal pulse - Answers The pulse rate obtained on the top of the foot. blood pressure is at least 90-100
systolic
types of shock - Answers cardiogenic, neurogenic, septic, anaphylactic, hypovelimic,
obstructive(mechanical), insulin (pseudo)
shock - Answers lack of perfusion at the cellular level
general signs and symptoms of shock - Answers -skin:pale, cool, diaphoretic
-anxiety
-impending doom
-altered LOC
-dilated pupils
-sustained tachycardia
-tachypnea
-decreased urine output
-thirst
-delayed capillary refill
general treatment in shock - Answers -high flow oxygen
-trendelenberg position
-keep warm
-load and go transport
cardiogenic shock - Answers -most commingly caused by AMI
-other causes: Myocarditis, myocardial contusion
-"pump problem"
-decreased CO leads to hyperfusion
-heart begins to fail
cardiogenic shock treatment - Answers -standard shock treatment applies
-patient may not tolerate supine or trendelenberg position
-transport to cardiac facility critical
neurogenic shock - Answers Circulatory failure caused by paralysis of the nerves that control the size
of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.
-caused by-
-spinal cord injury above T6
-spinal anesthesia
-vasomotor center depression
-may take hours to appear
*symptoms*
-skin warm and dry
-bradycardia
-poikilothermia
septic shock - Answers Shock caused by severe infection, usually a bacterial infection.
-distributive type of shock
-due to infection that becomes systemic
-very common in icu setting
-patients often febrile
-antibiotics are needed to treat infection
-more gradual onset starting with SIRS
hypovolemic shock - Answers shock resulting from blood or fluid loss
, obstructive shock - Answers Shock that occurs when there is a block to blood flow in the heart or
great vessels, causing an insufficient blood supply to the body's tissues.
-tension pneumothorax
-pericardial tamponade
anaphylactic shock - Answers -distributive shock
-severe allergic reaction
-onset is quick
-most deaths from people with NKA and no epi pen
-uticaria, wheezes, pruritus
-use epi pen
insulin shock - Answers the result of too much insulin which causes a dangerous drop in blood
glucose.
-looks similar to shock
-skin cool pale and diaphoretic
-altered mentation
-seizures can occur
-administer oral glucose
-patient must eat afterwards
Beck's Triad - Answers -hypotension (narrow pulse pressure)
-neck veins distended
-heart sounds muffled
-paradoxical pulse
-breath sounds equal
basilar skull fracture - Answers fracture at the base of the skull
-raccoon eyes
-battle signs
-takes a while to show up
OPA (oropharyngeal airway) - Answers Oral airway
Used to maintain or open a patient's airway. It does this by preventing the tongue from covering the
epiglottis.
*used in patients with no gag reflex
*measure from the edge of the mouth to the angle of the jaw to determine the correct size .
*insert with the tip pointing to the top of the head then rotate 180 degrees until position
NPA (nasal trumpet) - Answers -can use on patients with a gag reflex
-patients who are snoring or have ETOH are common
-measure from the nare to the tip of the earlobe
-use surgical lube to help with insertion
- right nare is usually largest
how to open airway - Answers head tilt chin lift
-*do not perform on suspected c-spine injury
jaw thrust maneuver
- *use if you suspect a neck injury and tilt head to slight sniffing position or neutral position. use
thumbs to pull down lower jaw.
KED - Answers Kendrick Extrication Device
-used to extricate patients in a sitting position when spinal injury is suspected
-do NOT use when patient is unstable-straps need to be applied in specific order: Middle (yellow),
Bottom (red), leg straps, headstraps, top (green)
-"My Baby Looks Hot Tonight
AVPU - Answers Alert, Verbally responsive, Pain responsive, Unresponsive
Golden Hour - Answers the 60-minute period after a severe injury; it is the maximum acceptable time
between the injury and initiation of surgery for the seriously injured trauma patient.
common illnesses in geriatrics - Answers -cardiovascular diseases
-CVA and AAA
-chronic respiratory disease
-acute respiratory disease
-cancer