Signs of potential airway obstruction
- agitation, restlessness, panic & confusion, progressing to lots of consciousness
- gasping for air & chocking
- clutching upper chest or throat
- progressive cyanosis (cyanosis is a late sign of airway obstruction)
- high pitched stridor, wheezing crowing or whistling on inspiration
- noisy or gurgling inspiration
- snoring respirations
what do the aplha receptors do?
- alpha causes vasoconstriction, oxygenated blood from least important to most important (least important is the periphery- that’s why important to check cap refills (will cause ulceration & necrosis)) then GI tract that is not getting enough blood empties, vomits & incontinent of stool, will not have bowel sounds), also liver is part of digestive systtem
- Next the kidneys (decreased urine output, if less than 30ml/hr kidneys may not be adequately perfused)
what do the aplha receptors do? beta 1 receptors? and Beta 2 recpetors?
- alpha receptors cause vasoconstriction
- B1 heart increases HR & contractility
- B2 lungs (bronchodilation to get as much oxygen as can)
what are interventions for an airway problem?
- Open airway (techniques are head tilt chin lift-which manipulates spine a lot) (modified jaw thrust maneuver-then bag valve mask)
- Oral airway insertion- holds tongue up from back of throat, but oral airway increases risk of aspiration
what are the three causes of hypoxia?
problems with:
- ventilation
- diffusion
- perfusion
what are some interventions for breathing problems?
- nasal prongs (oxymizer)
- face mask (turn up till not fogging, fogging means re breathing carbon dioxide)
- BVM for ventilating someone
In the primary survey how do you check if there C- circulation is good?
- do they have adequate cardiac output
- palpable radial pulse is cardiac output
- Brisk capillary refill?
what are three things that cause circulation problems?
problems with:
- Heart
- Vessels
- Volume
what are some interventions for circulation problems
-volume resuscitation (isotonic solution - NS or LR)
what does D stand for in ABCD?
disability assessment: what is there neurological status (AVPU- awake, verbal stimulus, physical stimulus, unresponsive even to pain)
discomfort assessment:
what is wrong with a patient that has a decreased LOC, what are you worried about with someone that has a GCS of 8 or lower
Airway
What are some airway findings of concern?
- absence of breathing
- trauma to the face, mouth, pharynx, neck or chest
- inability to speak (age appropriate)
- substernal or intercostal retractions
- depressed level of cnsiousness
- inspiratory or expiatory stridor
- pale, cyanotic or dusky-gray skin color or ruddy or bright purple colouring
what is trauma?
-trauma is an injury to human tissues & organs resulting form the transfer of energy from the environment
trauma is _________ potential problems may become actual problems
insidious
With Trauma if ABC’s aren’t kept stable than body’s cells being to metabolize anaerobically which can lead to
Multi-organ failure (Kidneys, liver, pancreas)
what is the priority if a patient is burned?
-you need to put the fire out stop the burning (why do we run burns under water stop the burn, chemical burns need to be flushed)
what is mannatol?
used as a diuretic to decrease volume of brain (decrease water in brain) with increasing ICP
it is a high molecular weight sugar that sucks water from interstitial to intravascular able to pee out,
mannatol doesn’t work with leaking capillaries
what are the first sign s of increasing ICP?
agitation & restlessness, which then leads to a decrease in LOC
when do vital signs change with ICP
-vital signs change (cushings traid) right before almost dead
what is shock
-inadequate perfusion of body tissues with oxygenated blood
If mean arterial pressure is 70 or above that means that?
all organs are perfusing
what does a person look like that is adequately perfused (not experiencing shock)
NS: awake & alert RS: spo2 greater than 94% on RA CVS: palpable radial pulse, brisk cap refill GI: BS GU: urine output greater than 30ml, hr
what does a person that is inadequately perfused look like? (experiencing shock)
NS: agitation & restlessness (always assume cerebral hypoixa until proven otherwise)
RS: cannot maintain spo2 greater than 94%, may need rebreather mask
CVS: delayed cap refill, no radial pulse,then go to carotid
-GI: no BS, N&V& incontinence
-GU: urine output is less than 30 ml/hr
pulse pressure is what? and what number should it be above? and if it is not what does that indicate?
- systolic-diastolic
- should be above 40
- if not above 40,
- loosing stroke volume or volume, therefore not adequately perfused
