Week 3 Flashcards
(74 cards)
1
Q
PERRLA
A
Pupils
Equal
Round
Reactive
Light
Accommodating
2
Q
Baseline Vital Signs
A
Pupils
Heart Rate
Respiratory Rate
Blood Pressure
Skin
3
Q
Cyanosis
A
Bluish skin
Moderate Sign of Hypoxia
(Starts at fingers and works up as it gets worse)
4
Q
Mottled
A
Red splotchy skin
Possible sign of shock
5
Q
Jaundice
A
Yellowing of skin / mucus membranes
Sign of liver failure
6
Q
Pallor
A
Paleness
vasoconstriction
bloodloss
shock
heart attack
anemia
7
Q
Flushed
A
Red Skin
Heat exposure
Carbon Monoxide Poisoning
8
Q
Fontenelle
A
Soft spots on infants head where the skull has not fused yet
9
Q
Hypotension
A
Lower than normal BP
10
Q
Hypoxia
A
Low oxygen
11
Q
Hypoxemia
A
low oxygen in the blood
12
Q
Hypertension
A
Higher than normal BP
13
Q
Breath Sounds
A
wheezing
Rhonchi
Rales
crowing/ stridor
Gurgling
snoring
14
Q
Wheezing
A
swelling constriction of lower airways
High pitched exhalation but can also be heard during inhalation
15
Q
Rhonchi
A
obstruction of the larger conducting airways of the respiratory tract by thick secretions of mucus
chronic bronchitis, emphysema, aspiration, and pneumonia
coarse crackles, are snoring or rattling noises heard on auscultation
sound changes if person coughs/changes position
16
Q
Rales
A
fluid that has surrounded or filled the alveoli or small bronchioles
pulmonary edema or pneumonia
bubbly or crackling sounds heard during inhalation
posterior base of lungs
17
Q
Crowing/stridor
A
swelling or muscle spasms that result from conditions
airway infections, allergic reactions, or burns to the upper airway
high-pitched sounds produced on inspiration
18
Q
Gurgling
A
liquid substance in airway
19
Q
Snoring
A
Tongue or Epiglottis bloacking airway
20
Q
Apnea
A
Not breathing
21
Q
Consensual reflex
A
Both pupils reacting equally
22
Q
Hypoxia
mild-moderate
A
Tachypnea
Dyspnea
Pale, cool, clammy skin (early)
Tachycardia
Elevation in blood pressure
Restlessness and agitation
Disorientation and confusion
Headache
23
Q
Tachypnea
A
increased respiratory rate
24
Q
Dyspnea
A
shortnes of breath
25
Hypoxia
| Severe
Tachypnea
Dyspnea
Cyanosis
Tachycardia dysrhythmias
bradycardia
Severe confusion
Loss of coordination
Sleepy appearance
Head bobbing with droopy eyelids
Slow reaction time
Altered mental status
Seizure
26
dysrhythmias
Irregular heart rythmes
27
Diaphoretic
excessive sweating and clamminess
28
hypercarbia
buildup of carbon dioxide in the blood
29
cricoid pressure
backward pressure to displace the larynx posteriorly
| BURP, ELM
## Footnote
can impede airflow
used to facilitate endotracheal tube
30
Respiratory distress
Compensatory (Adequate Tidal volume and Respiratory rate)
SOB
Resltessness/anxiety
Retractions
Abdominal breathing
coughing
tripod position
94% or greater.
| Provide supplemental oxygen to maintain SPO2
31
Respiratory Failure
Compensatory Mech. not working. insufficient rate/ tidal volume
| bag-valve-mask device with supplemental oxygen connected to the device.
32
Respiratory Failure
stopped breathing
(Agonal possible)
| BVM with supplemental oxygen
33
orthostatic vital signs
1. BP + HR in supine
2.stand pt up and after 2 mins BP + HR
3.while standing.
4. HR increases by greater than 10–20 bpm
systolic blood pressure decreases by 10–20 mmHg as compared to the readings taken while the patient was supine
= positive orthostatic test, which typically indicates a significant loss of blood or fluid
34
Alveolar ventilation
amount of air moved in and out of the alveoli in one minute.
35
Lordosis
stomach is too anterior and the buttocks are too posterior, causing excessive stress on the lumbar region of the back
36
kyphosis
shoulders are rolled forward, which results in fatigue of the lower back and increases pressure on every region of the spine
37
Emergency move
AMS
Inadequate respiratory rate
Indications of shock
Injuries to head, neck, chest, abdomen, pelvis Fracture of both femurs
Major bleeding
| immediate threat to life and the patient must be moved quickly
38
Cap refill
2 seconds for infants, children, and male adults;
3 seconds for females;
4 seconds in the elderly.
| compressed capillaries to fill up again with blood
39
Adjectives to describe pulse
1.Rapid, regular full
Exertion, fright, fever, high blood pressure, or very early stage of blood loss
2.Rapid, regular, and thready
Reliable sign of shock = early stage of blood loss
3.slow
Head injury, barbiturate or narcotic use, some poisons, possible cardiac problem or other medical conditions such as hypothyroidism
4.No pulse
Cardiac arrest, profound hypotension
5. Thready
Irregular
40
7 places to palpate pulses
Carotid
femorial
radial
brachial
popliteal (behind knee)
Posterior tibial
dorsalis pedis
41
Life span ages
Neonate - birth to one month
Infant - one month - 1 year
toddler - 1-2 years
Preschooler - 3-5 years
child - 6-11
adolescent - 12- 15/18
adult - 20-40
middle age - 41-60
late adult - 61 and up
42
Infant reflexes
blinking, startling, rooting, sucking, swallowing, stepping, gagging, and grasping reflexes.
43
OPA
Dis. cannot be used on pt with gag reflex
too long can push tongue or epiglottis and obstruct. does not protect from aspiration
Adv. keeps tongue from falling back
44
NPA
Adv. Used when pt has gag reflex/can't take OPA
Dis. does not protect for aspiration, can damage nose and cause bleeding, not used when there is facial trauma or skull fracture
45
O2 sat %, and meaning
person breathing room air is in the high 90s, typically 97–100% SpO2
Less than 94% - indicate hypoxia, needs to be investigated - Apply 02
90% or less is a definite indication of hypoxia.
| Low BP
Hypothermia
Excessive movement
nail polish
Anemia
Co2
46
When to take vitals stable/nonstable
Stable - every 15 mins
Unstable - every 5 mins
47
Assessing skin color
Look - Mottled, Cyanosis, red, pallor, Edema, bruising
Feel - Back of hand for temp, Clamminess
Cap refill (Perfusion)
48
correct BP cuff placement
Adult or Ped cuff
Pt sitting, palm up, legs not crossed, one inch above crease of elbow. Arrow pointing to brachial artery
level with the heart
49
CPAP indications
Awake, alert, and oriented enough to obey commands
Able to maintain own airway
Able to breathe on his own
respiratory rate >25 breaths/minute
moderate to severe respiratory distress or early respiratory failure (use of accessory muscles or SpO2 <94%)
Presenting with increased end tidal CO2 (ETCO2) values
Able to wear the face mask or interface chosen
50
CPAP contraindications
Apnea
respiratory arrest
agonal respirations
Inability to understand or obey commands (GCS <11)
Inability to maintain his own airway
Unresponsiveness
Shock associated with cardiac insufficiency (signs of poor perfusion and a SBP <90 mmHg)
Cardiac arrestActive vomiting
Upper gastrointestinal bleeding or history of recent gastric surgery
Pneumothorax or trauma to the chest
Tracheotomy
Facial trauma
Increased intrathoracic pressure causing hypotension
51
Types of respiratory drives
Hypercarbic - when the carbon dioxide level decreases in the blood, the chemoreceptors sense this and send signals
hypoxic drive - chemoreceptors relying on O2 levels
52
Supplies needed to start an IV
IV Catheter
Tubing
Bag of fluid
tape
Tegaderm
Alcohol prep
4x4
tourniquet
flush
53
NRB
Nonrebreather mask
15 LPM
90% O2
still able to breath on own
ppv
54
FROPVD
Flow-Restricted, Oxygen-Powered Ventilation Device
PPV
100%
adult pt only
breathing on own
| dis. emt not aware of lung compliance
55
BVM
Bag valve mask
deliver 600ml of O2
15 lpm
21% O2
Add O2 = 100% O2
PPV
56
Humidified O2
recommended for asthma pt
for long transport
makes dryness more comfy
57
nasal canula
24 – 44% oxygen 1-6 lpm
58
upper airway structures
nasalpharynx
oropharynx
vellecula
eppiglottis
larynx
(trachea, esophagus - lower)
59
Indications of giving adequate ventilation
Rate
chest rise and fall
heart rate returns to normal
color improves
60
what decreases minute volume
Tidal volumexfrequency (MV)
decreases: tidal volume
61
Hazards of O2 therapy
increase coronary artery in pt with cardiac disease
tissue damage in stroke and acute coronary syndrome
O2 toxicity
damage to retina through scare tissue
Respiratory depression or respiratory arrest in patients with COPD
62
When to suction
Always before ventilation
63
Types of suctioning
rigid/hard/yankaur
soft/French
64
Causes of hypoxia
occluded airway
inadequate breathing,
hypoperfusion or shock
toxic gases
lung and airway diseases (e.g., asthma and emphysema),
drug overdose that suppresses the respiratory center in the brain
stroke,
injury to the chest or respiratory structures
head injury.
65
signs of inadequate airway
Abnormal upper airway sound
An awake patient who is unable to speak
foreign body airway obstruction
Swelling to the mouth, tongue, or oropharynx
66
drug effect on pupils
Amphetamines - constricts
Opioids - Dilates
67
O2 tank pressure
2,000 PSI
68
4 lead placement
The arm leads should be placed on the right and left arm right above the wrist.The leg leads should be placed on the right and left leg above the ankles
69
12 lead placement
V1 lead immediately right of the sternum at the fourth intercostal space V2 immediate left of the sternum at the fourth intercostal space V4 to the left midclavicular line at the fifth intercostal space V3 place midway between V2 and V4 leads on the left anterior chest V5 to the left anterior axillary line at the same level as V4 V6 to the left midaxillary line at the same level as V4 and V5
70
Steps for Kingtube and combitube placement
Check for obstructions
Correct sizing
Lubricate device
Insert until blocked
Inflate
71
Factors to consider before moving patient
PT Spinal injuries
Body mechanics
Planning a move (gear and people needed)
Packing a patient
72
Adult
Rr : 12-20
Hr: 60-100
Bp: 120/80
73
Adolecent
12-18
Rr: 12-20
Hr: 60-100
Bp: 110/65 - 130/80
74
Child
6-11
Rr: 18-25
Hr: 75-118
Bp: 90/45 - 112/72
