Emergency Care

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Author:
Anonymous
ID:
203606
Filename:
Emergency Care
Updated:
2013-02-26 16:26:15
Tags:
Respiratory Therapy
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Description:
Respiratory Therapy
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  1. CPR one rescuer unwitnessed
    • 1. Determine unresponsive-tap & shout
    • 2.Call for help-do not leave pt
    • 3.Established airway-position pt,open airway
    • 4.Check breathing
    • 5.Give 2 full breaths
    • 6.Check pulse-carotid artery
    • 7. Pulseless start chest compression
  2. What is the best way to establish patient airway
    • Head tilt/chin lift (hyperextend)
    • Jaw thrust/modified jaw thrust
  3. Contraindications for head tilt/chin lift
    Fractured neck, suspicion of neck fracture
  4. What method do you use with a patient with suspected neck fracture?
    Jaw thrust/modified jaw thrust
  5. Complications of CPR
    • Gastric distention-most common
    • Pneumothorax
    • Gastric Rupture
    • Cross Contamination
    • Aspiration
  6. Complications external cardiac compression
    Rib fractures-most common (Dont Stop CPR)
  7. How do you check effectiveness of cardiopulmonary resuscitation
    • Carotid pulse-during compressions
    • Dont remove cervical collar during resuscitation check femoral pulse
  8. CPR Breathing Rate 8yrs to Adult
    10-12 breaths/min every 5 sec
  9. CPR compression ventilation Ratio
    30:2 both one & two rescuer
  10. Pulseless ventricular tach
    • Defibrillation 360 joules
    • Unsuccessufl, Start CPR & administer epinephrine,amiodarone, lidocaine
  11. Ventricular Fib
    • Treat Defib 360 joules 
    • Unsuccessful, start CPR & give epinephrine,amiodarone, lidocaine
  12. Cardioversion
    • Low voltage to heart to convert cardiac dysrhythmia to normal sinus rhythm
    • Make sure its ON, electric shock delivered on R wave ECG.
    • Versed (midazlam)strong, short acting sedative prior cardioversion
  13. Defibrillation
    • Pulsess vent tach 
    • Ventricualr Fib 
    • Start 360 joules
  14. Troubleshooting Equipment
    • Bag fills rapidly & collapses on minimal pressure check inlet valve 
    • Bag becomes hard to compress & pt compliance normal, patient valve stuck open or closed
  15. Pneumothorax
    • Trachea deviated opposite side 
    • Hyperresonant 
    • Decreased BS affected side 
    • Recommend insertion Chest tube
  16. Hemothorax
    • Trachea deviated opposite side
    • Dull Percussion note
    • Decreased BS on affected side 
    • Recommned Chest tube
  17. Advantages of mouth to valve mask ventilation
    • Eliminates direct contact with patient 
    • Provide O2 up 50% w/ flow rate 10L/Min 
    • One way valve between mask & practitioners mouth elimination exposure to air
  18. Land/Air Transport
    • 0-80 miles: ambulance
    • 81-150 miles: helicopter
    • >150 miles: fixed wing aircraft (airplane)
  19. Pulmonary Edema/CHF
    • Left ventricular failure & lung reaction 
    • Excessive fluid accumulates in lungs & affects ventilation & oxygenation
  20. Treatment Pulmonary Edema / CHF
    • Improves gas exchange-give 100% nonrebreather IPPB 100% O2 PEEP or CPAP
    • Increase strength heart contraction (inotropy)
    • give digitalis
    • Decrese venous return-lasix,fowlers
  21. Pulmonary embolism
    • Blood clots in lungs 
    • Deadspace disease V/Q mismatch 
    • Risk post op, bedridden history circulation problems (DVT), longer period at rest
  22. Treatment Pulmonary Embolism
    • O2 therapy 100%
    • Anticogaulation therapy (heparin & coumadin)
    • Thrombolytic drugs/screens/surgery 
    • X-ray: peripheral wedge shaped infiltrate
    • V/Q scan/spiral CT scan
  23. Pneumothorax treatment
    • Air Pleural space affect ventilation 
    • Give 100% O2, nonrebreathing mask 
    • Immediate chest tube/thoracentisis to relieve pressure
  24. Status Asthmaticus
    • Unresponsive bronchodilator therapy 
    • Affect ventilation/oxygentionv
  25. Treatment status asthmaticus
    • 100% O2 nonrebreather mask 
    • Continuous bronchodilator therapy albulteral,ipratrioum 
    • Corticosteriods - IV & oral 
    • Mechanical Vent-sedate, paralyze
  26. CO poisoning
    • Inability HB to bind w/O2 due to CO2 binding. 
    • 100% non-rebreathing mask, CPAP< mask 
    • Hyperbaric Oxgyen

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