Vital Signs (In depth)

Question 1

Vital signs emt measures

Answer 1

Respiration
Pulse
Skin
Pupils
Blood pressure
Pulse oximetry

Question 2

What are you looking for when taking respiratory vital sign

Answer 2

Rate
Quality
rhythm

Question 3

what should you base a patients normal Respiratory on?

Answer 3

How the patient presents

Question 4

What respiratory rate should you begin to provide ventilation
(adult, Infant)

Answer 4

Adult - over 30
Infant - Over 60

not sustainable
To fast for good Tidal volume

Question 5

Normal respiration signs

Answer 5

at least 1 inch of chest rise
no accessory muscles
normal rate
Exhale 2x as long as inhale

Question 6

Shallow resporation signs

and treatment

Answer 6

slight chest rise
abnormal chest expansion

PPV by bvm or just PPV

Question 7

Labored resporation signs

Answer 7

Grunting or stridor
accessory muscles
nasal flaring

Question 8

Signs of struggle to inhale vs. exhale

Answer 8

Inhale = Accessory muscles
Exhale = abdominal

Question 9

Noisy resperation signs

on auscultation

Answer 9

wheezing, rhonchi, and crackles (rales).

Question 10

Trauma patient resperation assessment

looking for

Answer 10

sounds or not

Question 11

medical patient resperation assessment

looking for

Answer 11

abnormal sounds

Question 12

what age do you check brachial pulse

Answer 12

1 year or younger

Question 13

Pulse to assess when pt is unresponsive

Answer 13

carotid and radial at same time

Question 14

How to take accurate pulse

Answer 14

pt sitting/laying down
irregular for full minute

Question 15

Pulse description meaning

Rapid, regular, full

Answer 15

Exertion, fright, fever, high blood pressure, or very early stage of blood loss

Question 16

Pulse description meaning

Rapid, regular, and thready

Answer 16

Reliable sign of shock, often evident in early stage of blood loss

Question 17

Pulse description meaning

Slow

Answer 17

Head injury
barbiturate/narcotic use
some poisons
possible cardiac problem
hypothyroidism

Question 18

Pulse description meaning

No pulse

Answer 18

Cardiac arrest
Profund hypotension

Question 19

What to record for pulse quality

Answer 19

strong
weak
reggular
irregular

Question 20

pulses paradoxis

Answer 20

decrease in pulse strength during inhalation

Report this to hospital

Question 21

Pallor signs

Answer 21

vasoconstriction
bloodloss
shock
heart attack
anemia

Question 22

Diaphorosis

Answer 22

excessive sweating

Question 23

Pupil Factor cause

Dialated

Answer 23

Cardiac arrest (pupils will also be fixed), drug use such as LSD, amphetamines, or cocaine

Question 24

Pupil Factor cause

Constricted

Answer 24

Central nervous system disorder or narcotics use

Question 25

# Pupil Factor cause Unequal

Answer 25

Stroke head injury artificial eye eye drops eye trauma

Question 26

# Pupil Factor cause nonreactive

Answer 26

Stroke, head injury, artificial eye (occasionally a normal finding), eye drops, or eye trauma

Question 27

# Pupil Factor cause Sluggish reaction

Answer 27

hypoxia drug overdose inadequate perfusion

Question 28

# Pupil Factor cause fixed

Answer 28

Cardiac arrest severe head injury severe hypoxia, extremely poor perfusion to the brain | not reactive to light

Question 29

Good systolic and diastolic ration

Answer 29

distolic is 2/3 of systolic

Question 30

systolic hypotension indicator | Adult/children

Answer 30

less than 90

Question 31

systolic hypotension indicator | 1-10 yo / infants

Answer 31

toddler = less than 70 + (2 x age) Infant = Less than 60

Question 32

Early sign of shock

Answer 32

Tachycardia weak pulses cool and clammy skin

Question 33

Late sign of shock

Answer 33

Hypotension

Question 34

Pulse pressure equation

Answer 34

systolic - dystolic * Narrow = less than 25% of systolic * wide = 50% of systolic

Question 35

Wide pulse pressure causes

Answer 35

Head injury

Question 36

narrow pulse pressure causes

Answer 36

less blood being ejected from the left ventricle because of either volume loss or left ventricular failure | shock, cardiac temponade, tension pnuemothorax

Question 37

Properly placed BP cuff

Answer 37

one inch above antecubital space level with heart cover 2/3 of arm bladder above brachial artery fit one finger under bottom edge arm relaxed

Question 38

BP by palpation

Answer 38

Innacurate systolic = 7 mmHg lower

Question 39

age to measure BP

Answer 39

3 YO and above

Question 40

Chest pain BP steps

Answer 40

Take in both arms report difference of 20 in systolic

Question 41

Orthostatic Vital Signs | when to take

Answer 41

Suspected volume loss

Question 42

Orthostatic Vital Signs | how to take

Answer 42

BP in supine assisted stand up pt wait 2 mins BP standing | Measure HR and BP

Question 43

Orthostatic Vital Signs | Positive test result

Answer 43

while standing: * HR increases 10-20 * Systolic decreases 10-20

Question 44

Orthostatic Vital Signs | Downsides

Answer 44

pt over 60 = not accurate beta blockers affect results not for spinal injuries

Question 45

Pulse oximeter | where on body to place ## Footnote When to place

Answer 45

finger toe earlobe across the bridge of the nose | in primary assesment

Question 46

Pulse oximeter | Limitations

Answer 46

Blood loss poor perfusion excessive movement Nail polish Carbon monoxide cigarette smokers Anemia

Question 47

First BP taken by what device? | when to use the other?

Answer 47

BP cuff and Stethiscope | non invasive blood pressure monitor: After initial reading

Question 48

Capnometry (EtCO2 Monitor) | and advantages

Answer 48

* EtCO2 = Co2 at end of exhale * PaCO2 = arterial blood Co2 Pressure * | good look at alveolar ventilation

Question 49

Smooth transition of care

Answer 49

* info from on scene personelle = 1 min or less *

Question 50

ways to reduce pt anxiety

Answer 50

Bring order to the environment. Introduce yourself. Gain patient consent. Position yourself. Use communication skills. Be courteous. Use touch when appropriate.

Question 51

Chief complaint

Answer 51

where history begins why EMS was called not always primary problem

Question 52

Active listening techniques

Answer 52

* facilitation = Body language, eye contact * Reflection = repeating what patient says * Clarification * empathetic response * confrontation = determine accurate information * Interpretation