Cardiovascular Flashcards
Relative to what you have learned about tissue requirements for oxygen, what is the condition of the right lower limb?
The tissues in Mr. Hutchinson’s right leg were deprived of oxygen and nutrients for at least half hour. When tissues are deprived of oxygen, tissue metabolism decreases and eventually cease, so these tissues may have died due to anoxia.
Will the fracture be attended to, or will Mr. Hutchinson’s other homeostatic needs take precedence? Explain your answer choice and predict his surgical treatment.
Mr. Hutchinson’s vital signs ( low BP; rapid,thready pulse) indicate that he is facing a life threatening problem that must be stabilised before other, less vital problems can be addressed. As for surgery, he may be scheduled for open reduction of his crushed bone, depending upon the condition of the tissues in his crushed right leg. If tissue death has occurred in his leg, he may undergo amputation of that limb.
Mr. Hutchinson, another middle aged victim of the collision on Route 91, has a tourniquet around his thigh when admitted in an unconscious state to Noble Hospital. The emergency technician who bring him in states that his lower limb was pinned beneath the bus for at least 30 mins. He is immediately scheduled for surgery. Admission notes include the following:
Multiple contusions of lower limbs
Compound fracture of the right tibia; bone ends covered with sterile gauze
Right leg blanched and cold, no pulse
Blood pressure 90/48; pulse 140 min and thready; patient diaphoretic ( sweaty)
.
What do you conclude regarding Mr. Hutchinson’s cardiovascular measurements ( pulse and BP), and what measures do you expect will be taken to remedy the situation before commencing surgery?
Mr. Hutchinson’s rapid, thready pulse and falling blood pressure are indications of hypovolaemic shock, a type of shock resulting from decreased blood volume. Because his blood volume is low, his heart rate is elevated to increase cardiac output in an effort to maintain the blood supply to his vital organs. Mr. Hutchinson’s blood volume must be increased as quickly as possible with blood transfusions or intravenous saline. This will stabilise his condition and allow his physicians to continue with surgery.
