Vital Signs: Non Limmer Flashcards

Question

Resp: Middle Adulthood

Answer 1

16-20 Late depends on pt health

Answer 2

70 Late depends on pt health

Answer 3

120/80 Late depends on pt health

Answer 4

10 - 12 or 1 every 5-6 seconds

Answer 5

12-20 or 1 every 3-5 seconds

Answer 6

40-60 or one every 1 to 1.5 seconds

Answer 7

30 compressions to 2 ventilation

Answer 8

3 compressions to 1 ventilation

Answer 9

30 compressions to 2 ventilation

Answer 10

8-10 per minute or one every 6-8 seconds | 100 compressions with no pause for ventilation

Answer 11

30 per minute or one ventilation after every 3 compressions

Answer 12

100 + age to 40: Diastolic 60-85

Answer 13

90 + age to 40: Diastolic 60-85

Answer 14

90mm lower limit normal: 2/3 of systolic

Answer 15

Upper Limit: 90 + 2x Age Middle Range: 80 + 2x Age Lower Limit: 70 + 2x Age

Answer 16

70 mm lower limit of normal: 2/3 of systolic

Answer 17

HR 60 bpm → Chest compressions can be stopped want to see improvement within 30 seconds baby placed in sniffing position Chest Compressions: Indications Heart rate remains less than 60 beats per minute (bpm) despite 30 seconds of effective positive pressure ventilation Chest Compressions: Coordination With Ventilation • One cycle of 3 compressions and 1 breath takes 2 seconds • The breathing rate is 30 breaths per minute and the compression rate is 90 compressions per minute. This equals 120 “events” per minute

Answer 18

Resp 100 bpm and breathing → Positivepressure ventilation can be stopped want to see improvement within 30 seconds baby placed in sniffing position

Answer 19

``` Pupils Dilate Saliva Decreases Bronchioles Dilate Blood Vessels Constrict Epinephrine Secreted Sweat Increases Gastric Juices Decrease Heart Rate Increases ```

Answer 20

Pupils constrict Saliva decreases Bronchioles Constrict Blood Vessels Dilate Gastric Juices increase Heart Rate decreases

Answer 21

vessels constrict - skin significantly affected (pale & cool) sweat glands release sweat - skin clammy

Answer 22

regulates the release of Alpha 1

Answer 23

Related to the heart HR increase Force of Contraction increase Electrical Impulses speed up One heart and two lungs

Answer 24

Dilate smooth muscle - especially bronchioles and some vessels One heart and two lungs

Answer 25

Has Alpha 1, 2, Beta 1, 2 The bronchodialation from Epi-Pen is a B2 effect Adverse reactions to adrenaline include palpitations, tachycardia, arrhythmia, anxiety, panic attack, headache, tremor, hypertension, and acute pulmonary edema.[49] Use is contraindicated in people on nonselective β-blockers, because severe hypertension and even cerebral hemorrhage may result. Although commonly believed that administration of adrenaline may cause heart failure by constricting coronary arteries, this is not the case. Coronary arteries have only β2 receptors, which cause vasodilation in the presence of adrenaline. Even so, administering high-dose adrenaline has not been definitively proven to improve survival or neurologic outcomes in adult victims of cardiac arrest.[52]

Answer 26

Difference between the Systolic and Diastolic is less the 25% of Systolic Narrow (low) pulse pressure: shock, cardiac tamponade (blood filling the pericardial sac, compressing the heart), tension pneumothorax (injury to one lung, causing pressure on the heart and the other lung). ⬇️ in cardiac output, ⬆️ SVR, ⬇️Systolic, ⬆️ Diastolic

Answer 27

Measures heart rate and blood pressure for a patient while supine and while standing up. A positive result occurs when the heart rate increases 10-20 bpm and the blood pressure decreases 10-20 mmHg up standing up. This indicates significant blood loss. it can mean that the patient is dehydrated, is experiencing hypovolemic shock, has some type of cardiac compromise or an arrythmia, is anemic, has a problem regulating their blood pressure, has an electrolyte imbalance, and a few other conditions. It can also be caused by medications such as Beta Blockers or even Viagra. Orthostatic Hypotension is also a common cause of Syncope, or fainting

Answer 28

Any burn injury complicated by respiratory tract injuries or other accompanying major traumatic injury Full or partial thickness burns involving the face, eyes, ears, hands, feet, genitalia, respiratory tract, or major joints Full or partial thickness burn injury covering 10% or more BSA An partial thickness burn injury covering 25% or more BSA in adults 50yr Burn injuries complicated by a suspected fracture to an extremity Any burn that encircles a body part (e.g. arm, leg, chest) Any burn classified as moderate in an adult younger than 55 is considered critical in adult older than 55 Children under age 5: full or partial > 20 % BSA Any burn involving the face, eyes, ears, hands, feet, genitalia, respiratory tract, or major joints Any burn classified as moderate for an adult

Answer 29

Full thickness burns with 2-10% BSA excluding the face, eyes, ears, hands, feet, genitalia, respiratory tract, or major joints Partial thickness burns with 15-25% BSA involvement Partial thickness burns of 20% or more in adults younger than 50 years or 10% or more in adults older than 50 Children under age 5: Any partial thickness burn of 10-20% BSA

Answer 30

full thickness burns involving less than 2% BSA partial thickness burns less than 15% BSA superficial burns less than 50% BSA children less than 5 any partial thickness burn less than 10% BSA

Answer 31

⬆️ Inter-cranial Pressure cardiac tamponade tension pneumotharax

Answer 32

It has been shown that there may be a normal 10 to 20mmHg difference in blood pressure between the arms in a small minority of patients. Therefore it is important to take blood pressure readings from both arms when diagnosing hypertension. It is also useful to note when there is a difference in readings above 20mmHg from one arm to another. This can be a sign of Increased intra-thoracic pressure, a Thoracic Aneurism, or something called “Subclavian Steal Syndrome”. In a thoracic aneurism, a condition with a mortality rate reaching up to 80%, the aortic arch in the chest is compromised. This results in severe pain (usually described as “ripping” or “tearing”), hypotension, and usually death if it ruptures. As the aneurism tears, it compromises the entrance to the right subclavian artery before the left, causing the blood pressure in the right arm to drop. This is an important diagnostic tool to use in diagnosing chest pain and should be documented.

Answer 33

is a condition where the heart’s pumping capacity is compromised by the thoracic pressure and the blood pressure rises and falls with inspiration and exhalation. The blood pressure drops (and sometimes even the radial pulse disappears) with inspiration and rises again with exhalation based upon the volume/pressure of air in the chest. The “paradox” results from the fact that you can hear cardiac beats on auscultation of (listening to) the chest, but cannot detect them with the blood pressure and/or pulse. What does this mean? Lots of conditions can cause Pulsus Paradoxus and roughly they can be broken down into three groups: Cardiac causes, Pulmonary Causes, and Other causes. First, let’s give a nod to the other causes, the non-cardiac and non-pulmonary causes, which are Anaphylaptic Shock and an obstruction of the superior vena cava. The cardiac causes can be: (and THANK YOU Wikipedia for being smarter than me and very accessible) cardiac tamponade – A “bruise” of the heart resulting in the pericardial sac filling with blood that cannot escape and compromises cardiac function. (Treated with a pericardiocentesis, which some EMS providers can do in the field. I can). constrictive pericarditis – Inflammation or purulent (puss-filled) infection of the heart which compromises pumping ability. pericardial effusion – Fluid around the heart pulmonary embolism – A blockage in the pulmonary artery or vein cardiogenic shock – Impaired pumping ability of the heart due to cardiac damage or other compromise. Commonly seen in severe myocardial infarctions. (Heart attacks) It can also be caused by pulmonary (lung) conditions, such as a tension pnuemothorax, COPD, and sometimes in severe and acute asthma, where the patient traps so much inhaled air in the lungs that they cannot exhale the excess pressure due to the inflammation of the air passages. When you see these signs, make sure to take multiple blood pressure measurements to trend the patient’s progression. Calculate their Pulse Pressures, as cardiac tamponade, tension pneumothorax, and other conditions are characterized by narrowing of pulse pressure and compromised cardiac output also resulting in hypotension.

Answer 34

Cushing’s reflex, is a group of symptoms that has been shown to reveal increased intracranial pressure (ICP), the pressure within the cranial vault around the brain. This reflex shows three distinct signs which are predictive of Stroke (both ischemic and hemorrhagic), intracranial bleeding, head trauma, and some other conditions that raise ICP. These signs are: Slowed pulse rate Markedly increased systolic pressure (high BP) with widened pulse pressure, as the diastolic pressure usually stays normal, and: Irregular breathing (Cheyne-Stokes pattern respirations) Any time you suspect an injury or condition that may raise ICP, check the blood pressure and look for Cushing’s Reflex. It can help you zero in on the patient’s condition.

Answer 35

breathing - mechanical process of moving air in and out of the lungs

Answer 36

gas exchange btwn the alveoli & surrounding pulmonary capillaries

Answer 37

cell/capillary gas exchange

Answer 38

aerobic metabolism - use of glucose and O2 to produce ATP releasing CO2 as a by-product

Answer 39

Tachypnea Dyspnea Cyanosis Tachycardia may lead to dysrhythmias and eventually bradycardia ``` Severe Confusion Loss of Coordination Sleepy Appearance Head Bobbing Slow Reaction Time Altered Mental Status Seizure ```

Answer 40

``` Tachypnea Dyspnea Pale, cool, clammy skin (early) Tacycardia ⬆️BP Restlessness and agitation Disorientation & confusion Headache ```

Answer 41

a early sign of hypoxia | ie a HR of 80 in a weak old infant may be an indication of hypoxia as you would expect a HR of 120-150

Answer 42

both rate and tidal volume must be ok ✅Normal respiratory rate ✅clear and equal breath sounds ✅adequate air movement heard and felt from nose and mouth good chest rise and fall what is the rate, rhythm and quality is breathing full and deep shallow and fast...

Answer 43

the amount of air that reaches the alveoli dead volume ~150ml in an adult

Answer 44

patient is working harder to breath rate and volume are still adequate needs supplemental O2

Answer 45

30-70 psi tank full at 2000 PSI controls flow from 1-15

Answer 46

• Any patient in cardiac arrest or respiratory arrest (100 percent oxygen, or as close to 100 percent as possible, attached to a ventilation device) • Any patient who is being ventilated via positive pressure ventilation • Any signs of hypoxia in a patient with an adequate respiratory rate and an adequate tidal volume (amount of air breathed in and out) • Any patient with an SpO2 reading less than 94%, depending on the condition • Medical conditions that may cause hypoxia to cells or organs, such as stroke, heart attack, drug overdose, toxic inhalation, suffocation, foreign body airway obstruction, drowning, asthma attack, allergic reaction, seizures, poisoning, and environmental emergencies where the patient is exhibiting signs and symptoms of hypoxia, shock, or heart failure, or complains of dyspnea. • Any patient with an altered mental status or who is unresponsive • Injuries to any body cavity or central nervous system component, including head, spine, chest, abdomen, and pelvis • Multiple fractures and multiple soft tissue injuries • Severe bleeding that is either external or internal • Any evidence of hypoperfusion (shock) • Exposure to toxins (e.g., carbon monoxide, cyanide) There are conditions such as ischemic stroke, acute coronary syndrome, and post-resuscitation from cardiac arrest in which making too much oxygen available in the arterial blood may increase the damage to the tissue once reperfusion of the ischemic area is achieved. Based on the current research, found in the American Heart Association guidelines of 2010, patients with acute coronary syndrome who are exhibiting evidence of hypoxia or hypoxemia, have a complaint of dyspnea, have signs of heart failure, and have an SpO2 of 94% should receive supplemental oxygen. In these cases, a nasal cannula, not a nonrebreather mask, will be applied, starting with a liter flow of 2 lpm and titrated upward based on the patient’s response to the oxygen therapy. the AHA 2010 guidelines, a patient suspected of having an acute ischemic stroke should receive oxygen only if evidence of hypoxemia is present, such as an SpO2 reading of <94%, a nasal cannula is applied and 2 to 4 lpm of oxygen is administered. It is no longer deemed appropriate to provide oxygen by a nonrebreather mask at 15 lpm in an attempt to maximize the oxygen concentration in the arterial blood.

Answer 47

If either the respiratory rate or the tidal volume is inadequate, immediately begin positive pressure ventilation with oxygen flowing at 15 lpm to the ventilation device. A patient who exhibits any evidence of hypoxia, hypoxemia, or poor perfusion should receive supplemental oxygen. Supplemental oxygen should also be administered if any of the following are present: • The patient has an SpO2 reading of <94% or the oxygen saturation level is unknown • The patient complains of dyspnea or exhibits signs of respiratory distress • Signs of poor perfusion are present (pale, cool, and clammy skin; delayed capillary refill; hypotension; decreased mental status) • Obvious signs of heart failure • Suspected shock • Any situation or condition in which hypoxia or hypoxemia is suspected

Answer 48

``` Signs of Inadequate Breathing and need PPV Abnormal work of breathing • retractions • nasal flaring • abdominal breathing • diaphoresis • Abnormal breath sounds • stridor • wheezing • crackles • silent chest (no breath sounds heard) • unequal breath sounds (trauma, infection,pneumothorax) • Reduced minute ventilation • decreased tidal volume • inadequate respiratory rate • Inadequate chest wall movement or chest wall injury • paradoxical chest wall movement • splinting of the chest wall • asymmetrical chest wall movement • Irregular respiratory pattern (head injury, stroke, metabolic derangement, toxic inhalation) • Rapid respiratory rate without clinical improvement in the patient’s condition ```

Answer 49

``` Congestive Heart failure Chronic Bronchitis Pulmonary Embolism Pneumonia Pulmonary Edema Heart Attach Asthma Emphysema ```

Answer 50

``` Head Injury Cardiac dysrhythmias and acure coronary syndromes Delirium, dementia and Alzheimer disease Seizure Infection Medication or drug toxicity Shock or sever dehydration Hypoxia or hyperthermia Stroke and TIA Blood glucose abnormality ```

Answer 51

the resting RR is normally higher the resting HR in normally higher The skin is normally dry & less elastic Fever is less common, even with infection systolic BP will increase, making systolic hypertension more common..the hypertension may give a false reading with blood loss or dehydration & will fall rapidly in decompensation The pupils are more sluggish to respond to light

Answer 52

``` Thermal Radiological Asphyxiation Chemical Etiological Mechanical ```

Answer 53

Health Hazard | Higher the #, higher the hazard

Answer 54

Reactivity

Answer 55

Symbols like radioactivity, oxidation, PPE

Answer 56

Recognize Avoid Isolate Notify

Answer 57

Incident Command Operations Section Chief EMS Branch Director Triage Unit Leader Triage Personnel Primary and Secondary Triage

Answer 58

Incident Command Operations Section Chief EMS Branch Director Tx Unit Leader Immediate Tx Delayed Tx Minor Tx

Answer 59

Incident Command Operations Section Chief EMS Branch Director Transport Unit Leader Ground Ambulance Air Ambulance Medical Command

Answer 60

Incident Command Operations Section Chief EMS Branch Director Staging Unit Leader Ground Ambulance Air Ambulance Medical Equipment Unit Leader

Answer 61

Incident Command Operations Section Chief EMS Branch Director Morgue Unit Leader

Answer 62

Simple Triage and Rapid Transport Used older than 8 and greater than 100 ponds Uses RPM Walking Wounded - Green No Open airway/respiration-Black Red

Answer 63

Respiration Perfusion Mental Status

Answer 64

Resp >30 Cap refill >2 sec Altered Mental Status - Doesn't Obey Commands ``` Pediatric Breathing after opening airway & 5 rescue breaths Resp Rate >15 and <45 No palpable pulse Inappropriate posturing or unresponsive ``` ``` Secondary Triage: Airway and breathing difficulties Uncontrolled of severe bleeding Decreased Mental Status Severe Medical Problems: poisoning, diabetic and cardiac emergencies Severe burns shock (hypoperfusion) ```

Answer 65

Unable to walk Resp rate 15 and <45 Palpable Pulse Alert or responds to verbal or painful stimuli Secondary Triage Burns without airway problems Major or Multiple bone or joint injuries back injuries with or without spinal cord damage