7 - Shock / BLS Resuscitation / Medical Overview Flashcards
Adequate perfusion performs two vital tasks, what are these tasks?
Maintain normal organ function through pushing fluids through the body
Transport CO2 out of the body
List two devices that can be used to improve CPR.
(ITD) - Impedence Threshold Device
(LBD) - Load Distributing Band
While assessing an unconscious patient, list two ways to determine the patient’s medical history?
Checking for medical alert bracelets or identification with relevant information
Interview family or bystanders present at the scene
What three conditions may result in obstructive shock?
Cardiac Tamponade - leak in pericardial sack that compresses heart
Tension pneumothorax - air enters pleural space and cannot escape, collapses lung
Pulmonary embolism - blockage in pulmonary artery, obstructs blood flow to lungs or to the heart
What is afterload?
High afterload is often that heart failure develops in patients with what medical condition?
Amount of blood left in the arteries that the heart works against during systolic phase.
Hypertension
Aortic Stenosis
You are treating a 4-year-old patient who is unresponsive and breathing at a rate of 8 breaths/minute. There is cyanosis present in the face, with the heart rate of 46. What is the MOST effective treatment for this patient?
Alert ALS, maintain clear open airway, provide O2 with BVM, monitor vitals, rapid transport to pediatric hospital
The most common endocrine emergencies are from complications of what chronic disease?
Diabetes
How does septic shock occur? Briefly explain how sepsis causes shock.
Toxins damage the vessel walls and begin to leak. Plasma loss through injured vessel walls, results in shock
(Pneumonia , UTI )
List two types of medical, neurological emergencies
Stroke
Seizure
Cerebral aneurysm
Which bacterium is believed to be transmitted from patient to patient via unwashed hands of health care providers?
MRSA
While reassessing a 53-year-old, you notice the patient has deteriorated into cardiogenic shock and during your assessment, you auscultate crackles bilaterally. What is this finding called? Explain what is causing this finding.
Rales aka crackles, caused by pulmonary edema
Pulmonary edema , caused by CHF progressing which leads to cardiogenic shock also pulmonary edema (crackles bilaterally).
What two organs typically become hypoperfused first when a patient goes into shock?
Skin
Kidneys
Gastrointestinal tract
When would it be appropriate to perform a focused exam, instead of a head-to-toe exam, on a patient suffering from a traumatic injury?
During the secondary assessment
What two complications of anaphylaxis are life-threatening for patients?
Respiratory Arrest
Cardiac Arrest
A 45-year old patient presents with agitation, a HR of 110, BP of 114/80 and cool, pale skin signs. What stage of shock is this patient exhibiting?
Compensated Shock
A 13-year old is complaining of a fever, headache and a stiff neck. Your secondary assessment reveals red blotches in the skin. You should suspect this patient is suffering from what condition? You should take what immediate action?
Meningitis
Put on N95 respirator
Place surgical mask on patient
Rapid transport to hospital with an infectious disease department
What is usually the first measurable sign that a patient has progressed into decompensated shock?
Falling blood pressure (systolic of 90 mmHg or lower with adults)
All strains of influenza are transmitted by:
Direct contact with nasal secretions and aerosolized droplets
List two characteristic signs of neurogenic shock that are not found in other forms of shock.
Normal to low HR despite hypotension
No sweating below injury
(538)
What is the action of epinephrine as it relates to anaphylactic shock?
Bronchodilation - relaxes muscles for better airflow
Vasoconstriction - vessels constrict, increased blood flow
Explain why a patient suffering from neurogenic shock does not present with the characteristic pale, cool skin.
The brain and spine are not able to send signals to the body below the level of trauma.
This is the only type of shock that presents without characteristic pale, cool skin, because the peripheral vasoconstriction cannot be triggered through the autonomic nervous system.
While treating a patient for neurogenic shock, your primary assessment should be focused on:
Circulation
What are the three basic causes of shock?
Pump failure (heart)
Poor vessel function (pipes)
Low blood volume (fluid)
- Perfusion Triangle
(533)
A 32-year-old patient presents with an altered mental status. His RR is 28, HR is 114, BP is 108/82 and SPO2 is 93% and pale, cool, clammy skin. What stage of shock is this patient exhibiting?
Compensated shock
S/S: AMS, pale, cool, clammy skin, change in BP
List all of the types of shock that would result from the pump failing.
Cardiogenic shock
Obstructive shock ,
Cardiac tamponade,
Tension pneumothorax,
Pulmonary embolism
(534-7)
List two kinds of urologic emergencies.
Kidney stones, UTI
You are assessing an altered patient with pale skin. This skin is most commonly an indication of:
Poor circulation or loss of fluid
What two factors have a direct impact on cardiac output?
Heart rate: Number of times your heart beats in one minute
Stroke volume: volume of blood pumped out of the heart’s left ventricle during each systolic cardiac contraction
Equation: SV * HR = Cardiac Output
Which of the four types of shock are classified as distributive shock?
Septic shock
Neurogenic shock
Anaphylactic shock Psychogenic shock
(537)
List two situations where CPR should not be initiated.
(Do not write patient with pulse)
If the scene is not safe
If the patient has obvious signs of death. (i.e Rigor mortis , dependent lividity)
DNR order or no-CPR order
(584)
List two situations that would require an EMT to perform a detailed exam, instead of a focused exam, on a patient who has a medical emergency?
If there is suspected trauma. Based off of their chief complaint.
You are treating a patient who was struck in the chest with a metal pipe. His RR is 28, HR 94, BP 104/82, and SpO2 is 90%. Upon reassessment you notice JVD and the patient now has a RR 32, HR 98, BP 92/86 and SpO2 is 90%. What is your working diagnosis for this patient?
Cardiac tamponade
How is pertussis transmitted? What age group is mostly affected by pertussis?
Pertussis is airborne mostly affecting children age 6 and younger
You are treating a patient who you suspect may have an infectious disease. How should the assessment of this patient be approached?
Assess them as any other patient
Briefly explain how septic shock results in hypoperfusion.
Plasma leaks from vessels, a buildup of fluid in the alveoli resulting in hypo-perfusion
MRSA is believed to be transferred by what means?
Through direct contact with healthcare providers
Regardless of the type of shock, what treatments should be initiated in patients suffering from hypoperfusion?
SOBER- (supine, oxygen, blanket, external bleeding, rapid transport)
After delivering a shock to a pulseless patient you notice that the patient now has agonal breathing at 4 breaths/minute. The patient now has a weak radial pulse, which translates to a systolic BP of what reading? Outline your treatment for this patient?
Systolic BP 40
Continue CPR & assisted ventilations
List three diseases an EMT may be at risk of contracting while on duty.
Influenza, hepatitis, HIV, meningitis