emerg foundations-ppt and notesfrom wk 1 Flashcards
what is the difference between beta 1 and 2 receptors
Beta receptors-beta 1 inc the heart rate, inc contractility. Beta 1-you have 1 heart
Beta 2-you have two lungs. Causes bronchodilation
what function do bound alpha receptors have
Alpha your bodys organ triage system. It decides which organs are most imp or least imp. They will draw blood away to most imp organs. Alpha receptors withdraw in order from extrem, GI, kidneys,
how long can the cells in extremities metb anaerobically
- GI
- kidneys
The cells in extremities can metb anaerobically for 1.5hrs.
Gi tract can last an hr before cell death
Kidneys can last approx 45min without oxygenated blood.
pt has compartment syndrome and pulseless limb what CTAS triage level might they be
how soon should they be seen
Level II- see in 15min
which triage levels are focused upon in a disaster
focus on levels II and III as the interventions will make the biggest difference for them. Level Is will die and IVs can wait..
greatest good for most # of people
inflm peaks at __hrs and genrally subsides by ___
12
36 or 48?
pt has inspiratory stridor what might be the problem in adult
foreign body is stuck in a/w
why does inspiratory stridor often happen in kids? what is occuring physiologically
Classically peds sound. Gen from croup. From pulling diaphragm down their trachea is soft and closes off
Pay most attention to tongue and inflm.
pt has C spine injury and is unconscious and making snoring noise what can you not do
what should you do instead
head tilt chin lift. DONT
jaw thrust
your pts a/w is in trouble but you put in oropharyngeal a/w are they safe now?
no, all this does is keep the tongue from back of throat
they need intubation for definitive a/w mgmt
your pt is breathing very quickly and struggling to get air but their lungs sound fine and Sp02 is 98% what could be the problem
low Hgb
what 3 parts of breathing are there
Ventilation
Diffusion
Perfusion
pt doesnt have reg pulse and pulse is thready what intervention (not assessment) do you do
Generally first approach is to give them volume.
if your pt needs _liters fast then gen you should use blood products instead as they need Hgb to transport 02
3l
what does AVPU stand for
alert
A=awake and alert
V=respond only to verbal stimulus
P=responds to pain
U=unresponsive
what is CTAS
canadian triage acuity scale
what order of things do you treat and assess eg starting with airway
airway; then ventilation but c spine must be protected and chest injuries ruled out first, immed after a/w; eval and restore CO by control of hemorrhage, prevent or treat shock, manage hypothermia, examine periph pulses and any immed closed reductions of fractures are performed if extremity is pulseless, GCS, motor and sensory eval of spine.)
how many mins before you have permanent brain injury or death from cerebral hypoxia
3-5mins
you find a pt unconscious other than listening for breathing what do you assess
assess oropharynx in case they have something in mouth
your pt comes into ER bleeding what test do you want what do you want put in
blood typing will be done
put in two large gauge Ivs one for replacement and the other for blood
would it be better to use O negative or O positive blood for woman age 27
O neg as she is childbearing age and she might be Rh negative and positive blood could sensitize her to a future Rh pos baby–>hemolytic disease of the newborn
is a tourniquet applied early to bleeding wounds
no it is last resort
why are ABGs taken during internal hemmorhage
• ABG’s are obtained to evaluate pulmonary function and tissue perfusion and to establish hemodynamic parameters and then used as an index for determining the amount of fluid replacement the patient can tolerate and the response to therapy.
why does a grand mal seizure stop
there is no longer enough oxygen
You are walking down the hallway of your unit when a visitor comes out of a room calling for help. You go into the room and find another visitor on the floor seizuring.
what will you do first?
check room is safe
turn on 02 and suction
what kind of a/w doesnt stim the gag reflex
nasopharyngeal
why get 02 ready for seizure pt
their seizure will use a lot of oxygen and they may come out of it breathing irregularly
how does vagal stimulation affect the heart
it slows it. this is part of parasympathetic system
wat kind of things can cause vagal stimulation
eating too much, things that inc intrathoracic pressure
many things can cause vasovagal syncope like seeing blood
how is someones BP after seizure
very high
