lec 1- communicating an emergency

Question 1

4 factors affecting respiration (10)

Answer 1

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

Question 2

define:

• Tachypnea
• Bradypnea
• Hyperventilation
• Hypoventilation
• Chronic obstructive breathing

Answer 2

• 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)

Question 3

4 factors affecting Oxygen Sats (10)

Answer 3

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

Question 4

4 factors affecting heart rate (9)

Answer 4

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

Question 5

4 factors affecting blood pressure (oxygen sats) (10)

Answer 5

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

Question 6

what is systolic and diastolic

Answer 6

• Systolic: heart pressure when contracting (higher number e.g. 108/68= 108)
• Diastolic: heart pressure when relaxing (lower number e.g. 108/68= 68)

Question 7

4 factors affecting temperature (oxygen sats) (11)

Answer 7

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

Question 8

the three levels of consciousness

Answer 8

• 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

Question 9

what range is normal for oxygen sats?

Answer 9

97-100%

Question 10

what is a normal resting heart rate for children, teenagers and adults

Answer 10

children: 90-120bpm
teens: 70-90bpm
adults: 70-80bpm

Question 11

is an oxygen sat reading of 96% high or low?

Answer 11

low

Question 12

in the blood pressure reading of 108/68, which number represents systolic and which represents diastolic?

Answer 12

108 = systolic
68 = diastolic

Question 13

if you need to escalate care, who do you need to tell?

Answer 13

firstly your supervisor and then they will tell:

• radiologist
• referring doctor
• emergency team
• next of kin

Question 14

what is an acute dislocation?

Answer 14

Sudden trauma impacting bones displacing them from the associated joint

Question 15

3 signs of an acute dislocation

Answer 15

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

Question 16

what is an occult #

Answer 16

hidden fracture or suspected fracture

Question 17

4 soft tissue signs of an occult # (7)

Answer 17

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

Question 18

how to determine C spine alignment

Answer 18

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)

Question 19

what is a pneumothorax

Answer 19

the presence of air or gas in the pleural cavity causing collapse of the lung.

Question 20

signs of a subdural haemorrhage

Answer 20

• Lethargy
• Seizure
• Nausea, headache
• Slurred speech
• Weakness
• Loss of consciousness after trauma

Question 21

signs of a subarachnoid haemorrhage

Answer 21

• 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

Question 22

signs of an intracerebral haemorrhage

Answer 22

• Altered level of consciousness
• Nausea, vomiting
• Headache
• Seizures
• Focal neurological changes
• Nuchal rigidity (rigid neck muscles)

Question 23

what is the subacute phase of a stroke

Answer 23

more than 24 hours post initial symptoms

Question 24

what happens during the subacute phase of a stroke

Answer 24

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

Question 25

what is a PE

Answer 25

material which is lodged in the pulmonary trunk

Question 26

what information needs to be communicated when escalating an emergency?

Answer 26

Identify yourself

Situation: explain

Observations: vital signs

Background information

Agreed plan

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