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Emergency care 13th edition > Chap 13 > Flashcards

Chap 13 Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Vital signs

A

Outward signs of what is going on inside the body, including respiration; pulse; skin color, temperature, and condition (plus capillary refill in infants and children); pupils; and blood pressure

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2
Q

First vital signs you take are called

A

Baseline vital signs

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3
Q

Two factors of taking a pulse

A

Rate and quality

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4
Q

Normal pulse rate of adult at rest

A

60-100

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5
Q

Rapid heart rate minimum (tachycardia)

A

Anything greater than 100

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6
Q

Slow heart rate minimum (Bradycardia)

A

Anything below 60

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7
Q

Normal heart rate range

A 
Adult normal heart rate 60-100
Adolescent normal heart rate 60-105
School age normal heart rate 70-110
Preschool age normal heart rate 80-120
Toddler age normal heart rate 80-130
Infant age 6-12 month normal heart rate 80-140
Infant age 0-5 months normal heart rate 90-140
Newborn normal heart rate 120-140
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8
Q

Possible causes of rapid, regular and full pulse

A

Exertion, fright, fever, high blood pressure, first stage of blood loss

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9
Q

Possible causes of rapid, regular and thread pulse

A

Shock, later stages of blood loss

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10
Q

Possible causes of slow pulse

A

Head injury, drugs, some poisons, some heart problems, lack of oxygen in children

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11
Q

Possible causes of no pulse

A

Cardiac arrest

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12
Q

Two factors of pulse quality

A

Rhythm
-Regular or irregular
Force
-Strong or thready

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13
Q

Radial pulse

A

greater than 1 years old

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14
Q

Brachial pulse

A

less than a year old

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15
Q

Carotid pulse

A
  • Don’t assess on both sides at same time

- Excessive pressure can slow heart rate

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16
Q

How to take a pulse

A

Count pulsations for 30 secs and times by 2

-If the pulse rate, rhythm and force is not normal, continue with your count and observations for a full 60 secs

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17
Q

Ventricular assist device

A

A pump implanted in the chest that helps the heart move blood through the circulatory system. Because the device propels blood continuously and not in waves the way the heart does, there is no pulse

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18
Q

Normal respiration rates

A 
Adult 12-20, Serious if Above 24 or  Below 10 
Adolescent 12-20
School age 15-30
Preschooler 20-30
Toddler 20-30
Infant 6-12 months 20-30
Infant 1-6 months 25-40
Newborn 30-50
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19
Q

Snoring causes and interventions

A

Airway blocked/ open patients airway

20
Q

Wheezing causes and interventions

A

Medical problem such as asthma/ assist patient in taking prescribed medications

21
Q

Gurgling causes and interventions

A

Fluids in airway/ suction airway

22
Q

Crowing (harsh sound when inhaling

A

Medical problem that cannot be treated on the scene

23
Q

4 categories of respiratory quality

A

Normal
-Normal rise and fall of chest with no accessory muscles being used
Shallow
- Slight movement of the chest and abdomen
Labored
-Increased work of breathing
-Nasal flaring, retractions, use of accessory muscles
-Stridor, gasping, or grunting of exhale
Noisy
-Snoring, wheezing, gurgling, crowing

24
Q

Respiratory categories

A

Rate, rhythm and quality

25
Q

Best places for checking skin for blood flow

A

Nail beds, lower eye lids (conjunctiva), and inside of cheeks

  • Infants and children
    • Best place to look are the palms of the hands and the soles of the feet
26
Q

Skin colors

A

Pink
-Normal in light-skinned patients; normal at inner eyelids, lips, and nail beds of dark-skinned patients
Pale
-Constricted blood vessels possibly resulting from blood loss, shock, hypotension, emotional distress
Cyanotic (blue-gray)
-Lack of oxygen in blood cells and tissues resulting from inadequate breathing or heart function
Flushed (red)
Jaundiced (yellow)
-Abnormalities of the liver
Mottled (blotchy)
-Occasionally in patients with shock

27
Q

Skin temperature and condition

A 
Cool, clammy
   -Signs of shock, anxiety
Cold, moist
   -Body is losing heat
Cold, dry
   -Exposure to cold
Hot, dry
   -High fever, heat exposure
Hot, moist
   -High fever, heat exposure
Goose pimples
   -Chills, communicable disease, exposure to cold, pain, or fear
28
Q

Capillary refill

A
  • Should take no more than 2 secs
  • Children 6 years and younger
    • Check refill
    • Unreliable in cold temperatures
29
Q

PEARL

3 things to look for

A

Pupils Equal And Reactive to Light

Size, Quality and Reactivity

30
Q

Pupils

A

Dilated
-Fright, blood loss, drugs, prescription eye drops
Constricted
-Drugs (narcotics), prescription eye drops
Unequal
-Stroke, head injury, eye injury, artificial eye, prescription eye drops
Lack of reactivity
-Drugs, lack of oxygen to brain

31
Q

Blood pressure SYS DIA

A 
Adults Less   Less or equal 120 less than or equal 80
Infants and children   80   2/3 systolic
Adolescent 114/ 76
School age 105/69
Preschooler 99/65
32
Q

Different blood pressure causes

A

High blood pressure
-Medical condition, exertion, fright, emotional distress, or excitement
Low blood pressure
-Athlete or other person with normally low blood pressure; blood loss; late sign of shock
No blood pressure
-If patient is awake and talking, he may have a ventricular assist device in his chest

33
Q

Blood pressure is usually not taken on anyone under what age?

A

3 years old

34
Q

Sphygmomanometer

A

The cuff and gauge used to measure blood pressure

35
Q

Taking blood pressure notes

A
  • Inflate cuff 30mm higher than cut off of pulse
  • allow pressure fall smoothly are 5-10mm per sec
  • If pulse falls between 2 lines, round up
  • Blood pressure from auscultation is the standard
36
Q

MAP

A

Mean arterial pressure

37
Q

Cases where temperature is important

A
  • Hypothermic
  • Hyperthermic
  • Febrile (feverish)
  • Suffering from a generalized infection (septic)
38
Q

Core temperature

A

Reflects level of heat inside the trunk, where the heart, lungs and digestive organs function
Ave- 98.6
Normal 96-100
-Rectal is usually 1 degree higher
-Axillary is usually 1 degree lower
-Elderly usually lower than younger people

39
Q

Different thermometers

A
  • Glass
  • Electronic
  • Rectal
  • Tympanic- Ear
  • Fore head
40
Q

Pulse oximeter

A

an electronic device for determining the amount of oxygen carried in the blood, known as the oxygen saturation or SpO2

41
Q

Oxygen saturation

A

the ratio of the amount of oxygen present in the blood to the amount that could ne carried, expressed as a percentage
-Can be used to assess effectiveness of artificial respirations, oxygen therapy, and bronchodilators (inhaler) therapy

42
Q

CO-oximeter

A

A different light wavelength oximeter that measure carbon monoxide as well as oxygen

43
Q

Normal SpO2 % range

A 
Normal 96-100
Mild hypoxia 91-95
Moderate hypoxia 86-90
Severe hypoxia <85
AHA doesn't recommend O2 on patients equal or greater than 95%O2
44
Q

Cautions of oximeters

A

-inaccurate with patients with shock and hypothermic
-False readings on patients with carbon monoxide and other types of poisoning
-Smokers might have 10-15% carbon monoxide
Inaccurate reading from movement

45
Q

Normal blood glucose level

A

At least 60-80 mg/dL

No more than 120-140

Emergency care 13th edition (32 decks)

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