PEA H's and T's

• stands for Pulseless Electrical Activity
• a type of pulseless arrest
• other types of pulseless arrest are: Asystole, Ventricular Fibrillation, and Ventricular Tachycardia

• EKG Tracing: narrow complex; rapid rate
• H & P Clues: flat neck veins
• Treatment: volume infusion

• EKG Tracing: slow rate
• H & P Clues: cyanosis; blood gases; airway problems
• Treatment: oxygenation; ventilation

A physical sign causing bluish discoloration of the skin and mucous membranes. Cyanosis is caused by a lack of oxygen in the blood.

the partial pressures of oxygen and carbon dioxide in blood

• EKG Tracing: smaller amplitude; QRS complexes
• H & P Clues: hx of diabetes; preexisting bicarbonate responsive acidosis; renal failure
• Treatment: sodium bicarbonate; hyperventilation

(medical) history

An abnormal increase in the acidity of body fluids, caused either by accumulation of acids or by depletion of bicarbonates.

used to make blood less acidic

Abnormally fast or deep respiration resulting in the loss of carbon dioxide from the blood, thereby causing a decrease in blood pressure and sometimes fainting.

• EKG Tracing: wide QRS complexes; T waves taller and peaked; P waves get smaller 
• H & P Clues: hx of renal failure; diabetes; recent dialysis; dialysis fistula medication Treatment: sodium bicarbonate; glucose pulse insulin; calcium chloride; kayexalate/sorbitol dialysis; long term possibly albuterol

a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs

• EKG Tracing: low T waves; flat and prominent U waves or QT prolonged; wide complex; tachycardia
• H & P Clues: abnormal loss of potassium; diuretic use
• Treatment: infusion of potassium, add magnesium if in cardiac arrest

• EKG Tracing: J (or Osborne) wave
• H & P Clues: hx of exposure to cold; central body temperature
• Treatment: see hypothermia algorithm

http://www.hypothermia.org/images/jamafig2.gif

• EKG Tracing: various effects, predominately prolongation of QTI
• H & P Clues: bradycardia; empty bottles at the scene; pupils; neurologic exam
• Treatment: drug screens; intubation; lavage; activated charcoal; lactulose per local protocols; specific antidotes and agents per toxidrome

The insertion of a tube into a body canal or hollow organ, as into the trachea.

The irrigation or washing out of an organ, as of the stomach or bowel.

The irrigation or washing out of an organ, as of the stomach or bowel.

Activated charcoal has often been used since ancient times to cure a variety of ailments including poisoning.

Lactulose is used to treat chronic constipation.Lactulose is sometimes used to treat or prevent certain conditions of the brain that are caused by liver failure, which can lead to confusion, problems with memory or thinking, behavior changes, tremors, feeling irritable, sleep problems, loss of coordination, and loss of consciousness.

a set of clinical signs that suggest a specific class of poisoning

• EKG Tracing: narrow complex; rapid rate
• H & P Clues: no pulse felt with CPR; vein distention
• Treatment: pericardiocentesis

a vein expanding by stretching

a procedure where fluid is aspirated from the pericardium (the sac enveloping the heart).

The removal of a gas or fluid by suction.

• EKG Tracing: narrow complex; slow rate; hypoxia
• H & P Clues: no pulse felt with CPR; neck vein distention; unequal breath sounds, difficult to ventilate patient  
• Treatment: needle depcompression

This is the removal of fluid or air from the chest cavity or pleural space by puncturing with a needle.

• A pleura is the thin serous membrane that envelops each lung and folds back to make a lining for the chest cavity. This lining creates a potential space with is the pleural space (or pleural cavity).
•  

pertaining to or resembling serum

• EKG Tracing: Q waves and ST segments change; T wave invert
• H & P Clues: hx cardiac markers
• Treatment: fibrinolytic agents

The formation or presence of a thrombus (a stationary blood clot along the wall of a blood vessel, frequently causing vascular obstruction).

Of or relating to a disease or a condition with a rapid onset and a short, severe course.

A substance in the blood whose level rises following a myocardial infarction.

Substances that stimulate or inhibit fibrinolysis (the breakdown of fibrin, usually by the enzymatic action of plasmin).

• EKG Tracing: narrow complex; rapid rate
• H & P Clues: no pulse felt with CPR; distended neck veins; prior positive test for DVT or PE
• Treatment: surgical embolectomy; fibrinolytics

A mass, such as an air bubble, detached blood clot, or foreign body, that travels in the bloodstream, lodges in a blood vessel, and obstructs or occludes it. AKA embolus.

deep vein thrombosis

pulmonary embolism

Surgical removal of an embolus.