lec 1- communicating an emergency Flashcards
4 factors affecting respiration (10)
Phrenic nerve vagus nerve pulmonary sufficiency cardiac sufficiency diaphragmatic functionality pulmonary pathology psychological agitation O2 and CO2 balance atmospheric/internal pressure pH balance in blood
define:
- Tachypnea
- Bradypnea
- Hyperventilation
- Hypoventilation
- Chronic obstructive breathing
- Tachypnea: rapid, shallow breathing
- Bradypnea: slow breathing
- Hyperventilation: increase in rate and depth
- Hypoventilation: decrease in rate and depth
- Chronic obstructive breathing: normal inspiration and prolonged expiration (needs immediate assistance)
4 factors affecting Oxygen Sats (10)
Phrenic nerve vagus nerve pulmonary sufficiency cardiac sufficiency diaphragmatic functionality pulmonary pathology psychological agitation O2 and CO2 balance atmospheric/internal pressure pH balance in blood
4 factors affecting heart rate (9)
Cardiac vascular perfusion
carotid sinus reflex
SA and AV node arrhythmia
norepinephrine (Sympathetic nervous system)
diaphragmatic functionality, K+ (hyperpolarization)
vagus nerve sufficiency
parasympathetic vs sympathetic nerve systems
renal artery perfusion
peripheral vascular resistance
4 factors affecting blood pressure (oxygen sats) (10)
Health issues (smoking/diet/alcohol) vagus nerve venous sufficiency cardiac sufficiency excessive salt (causes heart to race and can cause heart attack) stress family history kidney sufficiency adrenal and thyroid pathologies O2 fluctuations
what is systolic and diastolic
- Systolic: heart pressure when contracting (higher number e.g. 108/68= 108)
- Diastolic: heart pressure when relaxing (lower number e.g. 108/68= 68)
4 factors affecting temperature (oxygen sats) (11)
Health issues (smoking/diet/alcohol) vagus nerve venous sufficiency cardiac sufficiency excessive salt stress family history kidney sufficiency liver (regulates temp.) adrenal and thyroid pathologies (thyroid regulates temp.) O2 fluctuations
the three levels of consciousness
- Delirium: confused thinking, reduced awareness of environment, can change rapidly
- Agitation: irrational irritability, fidgeting, excessive anger, incessant talking, restlessness
- Stupor: lack of reasoning, unresponsive, responds to extreme stimuli
what range is normal for oxygen sats?
97-100%
what is a normal resting heart rate for children, teenagers and adults
children: 90-120bpm
teens: 70-90bpm
adults: 70-80bpm
is an oxygen sat reading of 96% high or low?
low
in the blood pressure reading of 108/68, which number represents systolic and which represents diastolic?
108 = systolic 68 = diastolic
if you need to escalate care, who do you need to tell?
firstly your supervisor and then they will tell:
- radiologist
- referring doctor
- emergency team
- next of kin
what is an acute dislocation?
Sudden trauma impacting bones displacing them from the associated joint
3 signs of an acute dislocation
Visible deformity, swelling and/or bruising,
Intense pain;
without movement, very limited movement-no movement
Possible numbness and tingling beyond the joint
Symptoms are
dependent on location
what is an occult #
hidden fracture or suspected fracture
4 soft tissue signs of an occult # (7)
Swelling
Effusion in an area not normally associated with fluid collection
Fat pad or muscle innervation of fluid
Excessive pain in local area
Inability or unwillingness to move or weight bare
Decreased ROM
Negative X-ray: sometimes later the pain persists (symptoms persist
how to determine C spine alignment
The arcuate lines must be curved appropriately and in tact
Minimal soft tissue swelling: excessive swelling indicative of #
Width of lateral masses with odontoid should be equidistant. Unequal distances could be due to rotation of the head of a occult fracture
Lateral margins should be similar and intact
(not displaced)
what is a pneumothorax
the presence of air or gas in the pleural cavity causing collapse of the lung.
signs of a subdural haemorrhage
- Lethargy
- Seizure
- Nausea, headache
- Slurred speech
- Weakness
- Loss of consciousness after trauma
signs of a subarachnoid haemorrhage
- Sudden headache
- Meningeal irritation (neck stiffness, back pain, bilateral leg pain)
- Nausea/vomiting
- Photophobia with visual changes
- Global or focal neurological changes (depends on extend of bleed)
- Seizures
- Motor deficits
signs of an intracerebral haemorrhage
- Altered level of consciousness
- Nausea, vomiting
- Headache
- Seizures
- Focal neurological changes
- Nuchal rigidity (rigid neck muscles)
what is the subacute phase of a stroke
more than 24 hours post initial symptoms
what happens during the subacute phase of a stroke
A subacute stroke represents vasogenic oedema (collection of fluid from break down of blood brain barrier), with greater mass effect, hypo attenuation and well-defined margins. Mass effect and risk of herniation is greatest at this stage
what is a PE
material which is lodged in the pulmonary trunk
what information needs to be communicated when escalating an emergency?
Identify yourself
Situation: explain
Observations: vital signs
Background information
Agreed plan
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