Crashing Medical PT

Question 1

General Impression (S/S)

Answer 1

• New Onset ALOC (Motor GCS <6)
• Airway Issues/Resp. Distress
• Shock

Question 2

Initial Actions

Answer 2

• Don’t move PT
• Call additional resources
• Secure Airway (NPA,OPA)
• Apply monitors (Pads, 3 lead, ETCO2)

Question 3

Overall Goals

Answer 3

Manage ABCS:

A/B: >94% O2

C: SBP >90

Stabilize Pt before Transporting

Question 4

Respiratory Distress S/S & TX

Answer 4

• Increased work of breathing
• Inability to speak full sentences
• Accessory muscle use
• SpO2 <90 on room air

TX:
- High Flow O2 via NRB or CPAP
- Respiratory/Asthma/COPD AG
- CHF/Pulmonary Edema AG

Question 5

Respiratory Failure S/S & TX

Answer 5

• Poor respiratory effort
• Unable to speak
• Loss of muscle tone
• Unable to sit up
• SpO2 < 90 despite O2
• ALOC
• Increasing EtCO2

TX:
Immediate PPV with BVM:
- 2-person
- Elevate the head of bed
- 100% O2
- 2 NPA +/- OPA

Question 6

No Improvement or persistent hypoxia w/ PPV BVM?

Answer 6

• I-Gel
• ETI
• Surgical airway (if unable to oxygenate / ventilate)

Question 7

BP <90 with signs of shock OR hypoxia unresponsive to above airway interventions

Answer 7

Unstable Bradycardia:
- Pace
- Push Dose Epi

General Medical/Cardiogenic:
- Fluids
- Push Dose Epi

Unstable Tachycardia:
- Cardiovert

*After Epi/Cardioversion, Pt can THEN be transported