Define:
Differential Field Diagnosis
A method used to identify potential diagnoses of the patient’s condition.
What does the acronym M-T-SHIP stand for in the context of field diagnosis?
M: Medication/overdose/compliance
T: Tumor/trauma/toxins
S: Seizures or stroke
H: Hypoxia/hyper or hypothermia/hyper or hypoglycemia/hypertension/hyper or hypokalemia
I: Infection or uremia
P: Psychiatric or behavioral
What is the Karl Weick process for communication of decisions?
- Here is what I think we’re dealing with
- Here is what I think we should do
- Here is why
- Here is what we should keep our eyes on
- Talk to me. Are there any other concerns?
Define:
Confirmation Bias
Tendency to rely on information that supports your existing views.
It downplays information that does not confirm your field diagnosis.
List H’s.
Possible reversible causes of cardiac arrest.
- Hypovolemia
- Hypoxia
- Hydrogen ion (acidosis)
- Hypo-/Hyperkalemia
- Hypothermia
List T’s.
Possible reversible causes of cardiac arrest.
- Tension Pneumothorax
- Tamponade
- Toxins
- Thrombosis (coronary and pulmonary)
- Trauma
Define:
shock
It is a failure of the cardiovascular system causing inadequate perfusion.
What is systemic vascular resistance?
It is the resistance of blood flow within all blood vessels.
Pulmonary vessels are not included.
What is the formula for MAP?
DBP(2) + SBP
3
Define:
Mean Arterial Pressure
The average arterial pressure needed to ensure organ perfusion.
What is the normal MAP?
70-100 mmHg
Minimum perfusion pressure is >60 mmHg.
What are the three components that make up the perfusion triangle?
- Heart
- Blood vessels
- Blood
Which two receptors are activated first for compensation during shock?
- Baroreceptors
- Chemoreceptors
Define:
Multiple-organ dysfunction syndrome
Failure of two or more organs or systems.
What are the three stages of shock?
- Compensated
- Decompensated
- Irreversible
What are the signs/symptoms of compensated shock
- Anxiety
- SOB
- Rapid/thready Pulse
- Pallor
- Normal BP
- Thirst
- Normal LOC
What are the signs/symptoms of decompensated shock
- AMS
- Hypotension
- Labored breathing
- Thready/absent pulses
- Mottled/cyanotic skin
- Dilated pupils
How much blood volume can pediatrics lose before signs of shock are present?
25-30%
What is the fluid bolus for someone in shock?
20 ml/kg
Define:
Cardiogenic Shock
The heart is unable to circulate adequate blood volumes.
What is an example of cardiogenic shock?
Acute myocardial infarction
Example: STEMI
Define:
Obstructive Shock
The blood flow in the heart becomes blocked, leading to inadequate perfusion of tissues and organs.
What are some examples of obstructive shock?
- Tension pneumothorax
- Cardiac tamponade
Define:
Distributive Shock
A condition characterized by systemic dilation of blood vessels.
The blood pools in the vascular beds.
