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72 Cards in this Set
- Front
- Back
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One skill that will be used on every patient |
Patient assessment |
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Vital signs |
Outward signs that give you clues to what is happening inside the body |
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Vital signs |
Respiratory, pulse, blood pressure, pulse oximetry, skin, pupils |
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What is the first set of vital signs known as? |
Baseline vital signs |
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Commonly used and maintened equipment for checking vital signs |
Sphygmomanometer (blood pressure cuff) Stethoscope Wristwatch light Emt shears Pen light Emt shears Pen and notebook Pen and notebook PPE Pulse oximeter |
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General ranges for respirations per minute |
Adults--8 to 24 Adolescents ---12-20 Children ---15- 30 Infants---20 to 40 Newborn--- 30 to 60 |
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If either of these are inadequate, respiratory status is inadequate?? |
Tidal volume and respiratory rate |
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Normal respirations |
Chest rise and fall; no use of asscesory, abdomen or neck muslces; rate is normal and does not produce abnormal sounds |
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Shallow respiration |
Slight chest expansion; inadequate tidal volume. |
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Labored respiration |
Patient is working hard to breathe; abnormal breathe sounds; use of assessors muscles |
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Use of accessory muscles in neck and chest usually mean the patient is struggling to... |
Inhale |
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Excessive use of abdominal muscles indicates trouble with... |
Exhalation |
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Noisy respiration |
Abnormal breathing sounds; (trauma--ausculate lungs for present breathe sounds) (Medical---focused on abnormal breathing sounds) |
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Sounds in lungs audible with a stethoscope?? |
Wheezing, crackles (rales), Rhonchi |
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Wheezing? |
Construction and inflammation reducing diameter of bronchioles. |
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Crackles (rales) |
Fluid surrounding and filling the alveoli |
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Rhonchi |
Mucus blocking the larger bronchioles |
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What is a pulse? |
General pressure wave generated by the contraction of the left ventricle |
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Which pulses are central? |
Carotid (neck) and femoral (thigh, inner near groin) |
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Which pulses are peripheral? |
Brachial ( middle of arm) , radial (wrist), popliteal (behind the knee), dorsalis Pedis (top of foot-great toe side, used to assess trauma patient blood flow to lower limbs) |
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Generally, a pulse higher than 100 bpm is known as |
Tachycardia |
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Generally a pulse less than 60 bpm is considered... |
Bradycardia |
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The normal pulse of an elderly patient (75 and older) is... |
90 bpm |
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Average adult bpm? |
60-100 |
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Average adolescent bpm? |
60-105 |
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Average child (5-12) years bpm?? |
60-120 |
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Child (1 to 5) bpm??? |
80-150 |
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Infant bpm |
120-150 |
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Newborn bpm |
100-180 |
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Bonding pulse |
Abnormally strong |
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An irregular pulse may be a sign of... |
Cardiac disease |
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What is pulse paradoxus |
Decrease in the strength of the pulse inspiration...may indicate severe cardiac or respiratory injury or illness...or significant blood loss |
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Skin color indicates what about blood perfusion? |
How well the blood is being circulated in areas. |
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Abnormal Skin colors in patients and associated symptoms |
Pallor (white)----vasoconstricion, blood loss, shock, heart attack, fright, anemia Cyanosis----inadequate oxygenation or perfusion, inadequate respiration or heart attack Flushing red---heat exposure, carbon monoxide posioning. Jaundice (yellow) ---liver disease |
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Abnormal skin conditions and associated symptoms |
Wet--shock, heat emergency, diabetic emergency Dry---spinal injury, dehydration, heat stroke, posioning, hypothyroidism |
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What is diaphoresis? |
Profuse sweating. |
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Capillary refill |
Time it takes for compressed capillaries to fill up again with blood Usually about >2 seconds is normal. More useful In children |
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Pupils and size |
Dilated-- may indicate cardiac arrest or drug use Constricted-- Central nervous system disorder, drugs(usually depressants), glaucoma medications |
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Pupils and equality |
Unequal size may indicate a stroke, head injury, artifical eye, disease of the eye, injury to the eye or pupil nerve. Eye drops |
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Pupils and reactivity |
Pupils that retain midsize may indicate cranial damage Pupils react at the same time (consensual reflex) |
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Sluggish pupils may indicate.... |
Poor oxygen state---hypoxia, drug overdose or inadequate perfusion. |
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Extremely poor perfusion to the brain may cause... |
Fixed and dilated pupils |
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Blood pressure comes In two units |
Systolic and diastolic |
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Systolic blood pressure is |
Amount of pressure during the contraction and release of blood from the left ventricle. |
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Diastolic blood pressure is.... |
Amount of pressure on the artery walls whole the ventricle is at rest and not contracting |
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During auscualtion, the diastolic pressure is... |
When the sounds stops or changes drastically |
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Blood pressure is always expressed as an .... |
Even number... manually obtained |
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Normal systolic pressure in adults is less than |
140 mmHg |
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Normal diastolic blood pressure in adults is less than... |
85 mmHg |
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Estimating average systolic and diastolic BP of adult male |
Systolic-- 100+ age in years up to 40 Diastolic---60 to 85 mmHg |
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Estimating adult female systolic and Diastolic BP... |
Systolic--90+ age in years up to 40 Diastolic--60 to 85 mmHg |
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Adolescent estimated BP |
Systolic-- 90 mmHg (lower limit) |
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Children 1-10 years estimated BP |
90+ (2 × age in years) middle range |
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Infant 1-12 months estimated BP |
70 mmHg (lower limit) |
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Diastolic BP estimated of adolescents, children and infants... |
2/3 systolic pressure |
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Cardiac tamponade |
Sac around the heart that is filled with blood and compressing the heart |
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Tension pneumothorax |
One lung is injured and collapses, compressing the heart and uninjured lung |
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At what age is gathering blood pressure an inadequate form of obtaining vitals |
3 and below....use skin temp and color, mental status quality and location of impulses |
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What systolic blood pressure is needed to produce a pulse in the carotid, femoral and radial pulses? |
60 mmHg |
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A drop of 20 mmHg in BP may indicate a problem with the.... |
Aorta |
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Orthostatic vital signs (also known as the Tilt test) |
Assess the patients blood pressure laying, sitting and standing at 2 minute intervals. If the patient is standing and there heart rate increase 10-20 bpm and there systolic BP decreases 10-20 mmHg it is know as a positive reading and indicates blood loss Used in a patient with suspected volume loss. |
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Stable patients vital signs should be taken every |
15 minutes |
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Unstable patients vital signs should be taken every ... |
5 minutes |
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Pulse oximetry is a method of |
Detecting hypoxia in patients by measuring oxygen saturation levels in the blood. |
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Most common placement of a pulse oximeter |
The finger or big toe |
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Reading of hemoglobin saturated with oxygen is... |
%Sp02 |
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High pulse ox readings are |
Sp02 % of 97 to 100 |
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A pulse ox reading of less 94% Sp02 may indicate |
Hypoxia |
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A pulse ox reading of 90% or less Sp02 is considered |
Severe hypoxia |
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Problems with pulse oximeter |
*shock, hypothermia, excessive movement, nail Polish, carbon monoxide, cigarette smokers and anemia may give off abnormal readings |
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SAMPLE History |
Method used to take a patients history S -Signs and symptoms A- allergies M- medications P- pertinent past history L- last oral intake E- events leading to injury or illness ----------------------------------------------------- Associated Signs and symptoms Pertinent Negatives |
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OPQRST |
mnemonic used when accessing a patient chief complaint or major symptoms O- onset P- provocation Q- quality (type of pain) R- radiation (where do feel the pain and where does it go?) S- severity T- time (how long has the symptom been there) |
