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EMERGENCY CARE 2

EMERGENCY CARE 2 Review

QuestionAnswer
What are the limitations of pneumatic resuscitation devices? Inability to dectect changes in PTs Lung compliance and resistance,Possible self-triggering and premature termination,High turbulent flows/create high resistance,High risk of gastric insufflation,Must have 50 psi gas source,Cannot be used for infants
Describe the role of the respiratory thearphy department in the case of an internal or external disater: Have established call-in list,keep supply of humidifers,cannulas,masks and flowmeters,Be prepared to assist,Keep resusciation equipment in working order and accessable, Be prepared to obtain additional equipment
Describe a medical emergency team and their responsibilties Group of healthcare workers who respond tp PTs with declining conditions and can prevent potential emergencies before they occur.
List the equipment required for a safe transport of a PT? Intubation equip,Portable Oxy,Manual Resusitation device,Transport Vent,Pulse Ox,Appropriate Meds,Portable ECG monitor.Stethoscope and spirometer for tidal vol. assessment
During air transport of a mechanially ventilated PT the FIO2 measured with an in-line analyzer is less than the set oxygen percentage. Why might this occurt? Oxygen partial pressure decreases as altitude increases
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PULMONARY EDEMA/COGESTIVE HEART FAILURE DESCRIPTION Left Ventricular and lung reaction. Excessive fluid accumulates in lungs and affects ventilation and especially oxygenation
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PULMONARY EDEMA/COGESTIVE HEART FAILURE ASSESSMENT Orthopnea,Pitting Edema, Distended neck veins and increased respiratory distress Pink/Frothy/Watery Secretions, Fine crepitant audible rales or crackles; Chest X-ray: Fluffy Infiltrates, Butterfly or Batwing Pattern.
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PULMONARY EDEMA/COGESTIVE HEART FAILURE TREATMENT Improve gas exchange- give 100% 02 via non-rebreather,IPPB with 100% 02 and PEEP or CPAP if necessary, Increase strength of heart contraction (inotropy) - give digitals, Decrease Venous return-Give lasix (diuretic), body position (Fowlers)
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PULMONARY EMBOLI DESCRIPTION Deadspace disease (ventilation without perfusion). Caused by blood clots in the lungs and will affect oxygenation and circulation
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PULMONARY EMBOLI ASSESSMENT Sudden onset of dyspna,tachypnea,PT appears to be hyperventilating(tachypnea) but is not normal PaC02,Anxious,Chest Pain,CHEST X-RAY Periphearal Wedge shaped infilitrate Ventilation/Perfusion(V/Q)scan or spiral CT shows no perfusion/ventilation=deadspace
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PULMONARY EMBOLI TREATMENT Oxygen 100%, Anticoagulation theraphy (heparin & coumadin), Thrombolytic drugs/screens/surgery
For each of the emergency Pathologies listed,give a brief description;explain how it would be recognized,and how to treat the problem PNEUMOTHORAX DESCRIPTION Presence of air in the pleural space that can seriously affect ventilation
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PNEUMOTHORAX ASSESSMENT Sunden onset of dynpnea with decreased breath sounds and tracheal shift away from the affected side, Decreased vocal fremitus,percussion note is hyperresonant or tympanic, X-RAY shows hyperlucrncy without vascular markings and a flattened diaphragm
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem PNEUMOTHORAX TREATMENT Give 100% 02 via non-rebreathing mask, Immediate chest tube/thoracentesis, or relieve pressure with needle and tubing inserted into pleural space (needle aspiration)
For each of the emergency Pathologies listed,give a brief description;explain how it would be recognized,and how to treat the problem STATUS ASTHMATICUS DESCRIPTION Sustained asthma attack unresponsive to bronchodilator therapy. Will have marked affect on ventilation and oxygenation.
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem STATUS ASTHMATICUS ASSESSMENT Diagnosis made by history,Retractions and pulsus paradoxus,ABG indicating respiratory acidosis or respiratory failure (PCO2.45).
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem STATUS ASTHMATICUS TREATMENT 100% 02 therapy via non-rebreathing mask,Continuous bronchodilator therapy (albuterol and ipratropium, Corticosteroids-IV and oral,Mechanical ventilation-sedate,paralyze,contol if necessary
For each of the emergency Pathologies listed,give a brief description;explain how it would be recognized,and how to treat the problem TRAUMA Examples Head Trauma,Chest trauma,Neck trauma,Burn victims,Near drowning,
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem TRAUMA TREATMENT Always start Basic Life Support; Compressions-Airway_Breathing,Administer 100% Oxygen,Administer drugs/or fluids based upon bedside and laboratory assessment,Remainder of treatment is based upon careful PT assessment
For each of the emergency Pathologies listed,give a brief description;explain how it would be recognized,and how to treat the problem CO POISONING DESCRIPTION The inability of hemoglobin to bind with oxygen due to binding of carbon monoxide. This can seriously affect oxygenation
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem CO POISONING ASSESSMENT History of present illness will be important,Redness of the skin,Breathing labored and deep(tachypnea,hypernea),Tachycardia with normal ABG,Increase COHb on co-oximeter (>20%, DO NOT rely onpulse oximetry (Sp02)
For each of the emergency Pathologies listed, give a brief description;explain how it would be recognized,and how to treat the problem CO POISONING TREATMENT 100% 02 Via-non-rebreathing mask,CPAP mask,Hyperbaric Oxygen
Created by: Cam1228