1. Venous – dark red, continuous flow 2. Capillary – red, slow bleed from tissue 3. Arterial – bright red, “spurts”

Stroke & Shock Flashcards by Brooke Routhier

Stroke (CVA)

Sudden interruption of blood flow to the brain

Time-sensitive emergency!

Use BE FAST

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BE FAST

Balance - loss of balance, headache, dizziness

Eyes - blurred vision

Face - one side of face drooping

Arms - arm or leg weakness

Speech - speech difficulty

Time - time to call 911

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Shock

Circulatory system fails → inadequate blood/O₂ to vital organs

Life threatening !!

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Types of Shock

Hypovolemic (blood/fluid loss)

Anaphylactic (allergic reaction) = inadequate distribution of blood

Cardiogenic (heart can’t pump)

Obstructive (embolism, pneumothorax) = blood flow obstruction

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Shock Vital Signs

Pulse: Weak, rapid

RR: Shallow, rapid

BP: Low

Skin: Cool, clammy, pale

Pupils: Dilated

O₂ Sat: <95% or <90%

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Shock Care

Treat the cause

Call 911

Manage airway, give emergency oxygen

Maintain body heat

Elevate legs (unless contraindicated)

Reassure, keep calm

No food or drink

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Hemorrhage

Abnormal discharge of blood
– may be internal or external

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Hemorrhage Types:

Venous – dark red, continuous flow
Capillary – red, slow bleed from tissue
Arterial – bright red, “spurts”

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External Hemorrhage Steps:

PPE

Direct pressure

Elevate limb

Pressure points (brachial/femoral)

Tourniquet/wound packing if needed

Check distal circulation

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Internal Hemorrhage

“Invisible”

Thorax, Abdomen, Skull

Sx vary → may go into Shock

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Abdomen

Area between diaphragm and pelvis

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Internal Organs

spleen
kidneys
liver
bladder
intestines
ovaries
pancreas
stomach

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RUQ

liver
R kidney

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LUQ

spleen
L kidney

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RLQ

appendix
intenstines
ovary

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LLQ

inestines
ovary

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Abdomen - Critical Points: History

Blood in urine, difficulty/pain urinating?

Type and location of pain

Referred pain patterns

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Abdomen - Critical Points: Palpation/Special Tests

Monitor vital signs

Auscultation

Percussion test

Palpation/Rebound tenderness

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Abdominal Injury Signs

increase HR (rapid, weak)

increase RR (rapid, shallow)

decrease BP

Pale or cyanotic

Many serious abdominal injuries progress to shock!

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Spleen function:

Stores blood and filters bacteria

Reservoir of RBC

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Spleen Injury Sx:

Kehr’s sign (shoulder pain = spleen injury)

Nausea, dizzy, shock

Rigid Abdomen

May have delayed hemorrhage (hours/weeks)

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Kidneys function:

Fxn:
Regulates and filters water, electrolytes

Well protected ½ under ribs

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Kidney Contusion/Rupture:

Study These Flashcards

Mx:
Blow to midback flank

Sx:
Shock, nausea, vomit
* Hematuria
Referred pain

Injury to: Appendix

Study These Flashcards

Acute or Chronic
Appendicitis

Localized pain at McBurney’s Point

Appendicitis Sx:

Nausea, vomiting, fever, cramping General pain -> sharp pain Usually initially mistaken for GI complaint

Appendicitis Rx:

Surgery often is required Want to avoid bacterial infection!

Abdomen Injury Management:

EMS/911 Administer Emergency O2 Hook-lying position No direct pressure Minimize risk of shock Monitor ABCs, vital signs

Pneumothorax/Hemothorax =

(“Collapsed Lung”) Traumatic blow/compression

Pneumothorax/Hemothorax Sx:

Pain in chest Dyspnea Anoxia (lack O2) May cough up blood Tracheal deviation Protruding neck veins

Pneumothorax/Hemothorax Rx:

Medical Emergency! O2 , Treat for shock

Pneumothorax:

air in pleural cavity

Hemothorax:

blood in pleural cavity → Chest pain, dyspnea, cyanosis, tracheal deviation

Blow to the Solar Plexus

“Spasm” or transient paralysis of: Diaphragm “Wind knocked out” *Transient Relax, hook-lying, short inspirations

Flail Chest:

Multiple rib fractures → paradoxical breathing Life Threatening! May need to give rescue breaths. Possible bulky dressing/direct pressure over the flail? May transport injured side down

Sucking Chest Wound:

Bubbles and makes noises when the person breathes. Occlusive dressing required = does not allow air or water pass through

Airway Management & Emergency O₂

Bag-Valve-Mask (BVM) Jaw thrust OPA = Oropharyngeal airway NPA = Nasopharyngeal airway King LTS-D, i-Gel, Combitube Manual suction

Two-person BVM rescue breathing

Rescuer 1: seals mask and opens airway Rescuer 2: squeeze bag slowly Adult: 1 breath every 5 seconds (1:5) Child/Infant: 1 breath every 3 seconds (1:3) Each breath ~ 1 second, allow full exhalation Rescuer 2: recheck breathing/pulse every 2 minutes

Emergency Oxygen

Hypoxia Respiratory arrest or distress Pulse Oximetry – check protocols < 95%; < 92%; < 90%

Emergency Oxygen Appropriate Use: ADULT:

< 12 bpm; or > 20 bpm

Emergency Oxygen Appropriate Use: CHILD:

< 15 bpm; or > 30 bpm

Emergency Oxygen Appropriate Use: INFANT:

< 25 bpm; or > 50 bpm

Oxygen Delivery Systems Delivery device:

Oxygen cylinder Pressure regulator w/ flowmeter Nasal Cannula Resuscitation Mask w. O2 inlet Non-Rebreather Mask BVM

Variable-Flow-Rate

1-25 LPM

Fixed-Flow-Rate

15 LPM 6LPM Other

Internal pressure of O2 tank:

~ 2,000 psi

Pressure Regulator and Flowmeter

Reduces flow to safe 30-70 psi Full: 2,000 psi Nearly empty: 200 psi Pin index safety system O-ring gasket = tight seal

Normal breathing:

21% O2

Exhaled air:

16% O2

Nasal Cannula

For patients who are breathing Flow rate: 1-6 LPM Peak O2 Concentration: 44%

Resuscitation Mask w/ O2 Inlet

Can be used on non-breathing patient Flow rate: 6-15 LPM Peak O2 Concentration: 55% When used with rescue ventilations: 35%

Non-Rebreather Mask

For patients who are breathing Flow rate: 10-15 LPM Peak O2 Concentration: up to 90% Reservoir bag should be 2/3 full

BVM (Bag-Valve-Mask)

Can be used on non-breathing patient Flow rate: > 15 LPM Peak O2 Concentration: 90%

O2 Delivery

Listen and feel for O2 flowing through device “Breathe normally” “Blow-by” technique for children

Devices for NON-BREATHING Patients

(Used when patient has no spontaneous breaths) Bag-Valve-Mask (BVM) Resuscitation Mask with O₂ Inlet

Devices for BREATHING Patients

(Used when patient is breathing on their own) Nasal Cannula Non-Rebreather Mask Resuscitation Mask with O₂ Inlet (can also be used if breathing)

Stroke & Shock Flashcards

(55 cards)