lindsey jones Flashcards
stage 1 assessment
visual
- general appearance
- color
- medical history
- heart rate
stage 2 assessment
patient contact
- breath sounds
- palpation of chest/trachea
- examination of upper airway
- blood pressure
- vital capacity measurement
stage 3 assessment
labs
- abg
- chest xray
- cbc
- urinalysis
- pft
- electrolytes
- ecg
- bilirubin level
stage 4 assessment
special test to specific problem
- ct scan of head
- complete pft
- tensilon test
- bronchogram
- sweat chloride test
- montoux test
- pulmonary angiogram
- lung perfusion scan
- neck xray
- amniocentesis
- acidfast sputum stain
if current stage reveals an emergency
do not advance to next stage!
if youre clear and advance to the next stage
pick everything in that stage
starting FiO2
if EMERGENCY, 100%
no record of previous FiO2, 50-60%
weaning from vent
- no need to decrease FiO2 below 40%
2. no need to decrease PEEP below +5
high PIP alarm
- patient (cough. secretions, pt resisting vent, pneumothorax, herniated cuff)
- vent (water in circuit, kinked tube, alarm setting)
low PIP alarm
1,patient (chest tube leak, partial extubation, deflated cuff)
2.vent (disconnection from pt, circuit leak, low flowrate)
troubleshooting alarms
always start by manual ventilation and then troubleshoot
*start at patient and work your way to machine
tube completely blocked
remove tube and manually ventilate
herniated cuff
deflate n replace tube
ruptured cuff
extubate/replace tube
v-fib to v-tach
treat w precordial thump
v-fib
may adm bicarb to correct metabolic acidosis
asystole
- cardiac compressions and pacing
- epi, atropine
NO DEFIBRILLATION
cold, clammy skin
myocardial infarction
- give O2
- do ECG
suddenly short of breath
pulmonary embolism
- 100% O2
- V/Q scan
- anticoagulants
sudden onset of tachypnea
pneumothorax
- 100% O2
- chest xray
- chest tubes if possible
pitting edema
CHF
- cardiac drugs
- digitalis
- digoxin
- diuretics
“marked”/”severe”
emergency!
lethargic, sleepy, somnolent
COPD O2 overdose
stuporous, confused, inappropriate responses
drug overdose
- protect airway
- narcan
angry, irritable, combative
electrolyte imbalance
orthopnea
CHF
general malaise
electrolyte imbalance
diaphoresis
heart failure/fever
ashen, pollar color
anemia, acute blood loss
1.stop bleeding/give blood
pulses paradoxus
status asthmaticus, severe air-trapping
flattened t wave
hypokalemia
spiked t wave
hyperkalemia
