Patient Vital Signs and Medical Emergencies Orientation Fall 2011

Patient Vital Signsand

Medical Emergencies

Orientation

Fall 2011

Homeostasis

• A constancy in the internal environment of the body

• Naturally maintained by adaptive responses that promote healthy survival

• Primary mechanisms:– Heartbeat– Blood pressure– Body temperature– Respiratory rate– Electrolyte balance

Vital Signs• Body Temperature

• Respiratory Rate

• Pulse / Heart Rate

• Blood Pressure

• Sensorium (mental alertness)

Importance of Vital Signs

• Indicates the patient’s immediate condition

• Can show improvement due to treatment

• Can show a decline in condition

Body Temperature

• Normal temperature: 98.6 ° F – 1° - 2°F daily variation – Still considered normal: 97.7 °F – 99.5 °F

• Human body functions within a narrow range of temperature variations– Humans can survive between 93.2 ° F

and 106 ° F

Thermoregulation

Shivering when cold

Sweating when hot

Measuring Body Temperature

– Oral– Rectal– Axillary– Tympanic– Temporal

Abnormalities in Body Temperature

Hyperthermia– Fever, febrile– Temperature higher than

99.5 °F

Hypothermia – below normal range of 97.7

°F– Due to

• Environment

• Medically induced

• Damage to hypothalamus

Respiratory Rate

• Respiratory System delivers oxygen to the body’s tissues & eliminates carbon dioxide– Pt will die without the removal of CO2 and addition

of O2

• Major muscle of ventilation: diaphragm

• Measured in • “breaths per minute”

– Adults: 12 – 20 bpm– Children: 20 – 30 bpm– Newborns: 30 – 60 bpm

Abnormalities of Respiratory Rate

• Tachypnea– Greater than 20 breaths per minute (adult)

• Bradypnea – decrease is breathing

• Dyspnea- difficulty breathing

• Apnea- no breathing

Methods of Delivering Oxygen

Ventilators

Nasal Cannula

Oxyhood

Masks

Pulse

• Adult – 60 to 100 beats

per minute

• Children under 10– 70 to 120 beats

per minute

Measurement

• Radial artery

• Brachial

• Carotid artery

• Apical pulses

Abnormalities of Pulse Rate

• Tachycardia– Pulse rate increases by more than

20 bpm in resting adult

– Greater than 100 bpm

• Bradycardia– Decrease in heart rate

Blood Pressure• Measure of the force exerted by blood on the

arterial walls during contraction & relaxation.

• Measured pressure when the heart is relaxed: Diastolic

• Measured pressure when the heart is contracted: Systolic

• Measured with a Sphygmomanometer

Blood Pressure cont’d

• Recorded in millimeters of mercury(mm Hg) with systolic over diastolic

• Normal adult systolic: 95-140 mm Hg

• Normal adult diastolic: 60-90 mm Hg

• 120/80 mmHg considered normal

Abnormalities of Pulse Rate

• Hypertension– Persistent elevation above 140/90 mmHg

• Hypotension– Persistent less than 95/60 mmHg

Medical Emergencies

Medical Emergencies

• What a Radioilogic technologist should know

• Common Radiology Emergencies

Medical Emergencies

• Sudden change in medical status requiring immediate action.

• For RT’s medical emergencies are rare– Recognize emergencies– Remain calm and confident– Avoid additional harm to the patient– Obtain appropriate medical assistance quickly– Know where crash cart is, emergency phone

and code blue buttons

Emergency Cart (crash cart)

• Know where it is in your department

• Familiarize yourself with its contents– Have BLS with AED

training

• Have one in the room when an iodinated contrast media will be used

MajorMajor Medical Medical EmergenciesEmergencies

1.1. ALOCALOC2.2. ShockShock3.3. Anaphylactic shockAnaphylactic shock4.4. Diabetic CrisisDiabetic Crisis5.5. Respiratory DistressRespiratory Distress6.6. Cardiac ArrestCardiac Arrest7.7. Cerebrovascular accidentCerebrovascular accident

Head Injuries

Levels of consciousness1. Least severe

– Responsive

2. More serious– Can be roused, but drowsy

3. Even more serious– Responds to pinches or

pinpricks

4. Most serious– Comatose, non-responsive

Shock

• Hypovolemic– Loss of blood or tissue

• Cardiogenic– Cardiac disorders

• Neurogenic– Spinal anesthesia or damage to spinal cord

• Vasogenic– Caused by sepsis, deep anesthesia or anaphylaxis

Anaphylactic Shock

• An allergic reaction to contrast media– Iodinated

• Can happen quickly or have a delayed reaction– Requires prompt recognition and treatment

from the technologist– More severe usually have quick onset– Less severe takes longer for reaction

Water Soluble Iodine• High atomic # 53• Radiopaque• Used to radiograph

– Vessels– Arteries– Veins– Function of internal

organs

Prevention and Signs - Symptoms

• Maintain normal body temperature

• Handle pt’s gently

• RT should work calmly and confidently

• Restlessness

• Apprehension– Anxiety

• Tachycardia

• Sudden blood pressure drop

• Cold –clammy skin– pallor

Diabetic CrisisDiabetic Crisis

1.1. HypoglycemiaHypoglycemia

2.2. HyperglycemiaHyperglycemia

Hypoglycemia

• Excessive insulin

• Can result from normal dose of insulin & no food

• Need carbohydrate

Hyperglycemia

• Excessive sugar

• Usually seen in diabetics

• Pt. needs insulin

Respiratory DistressRespiratory Distress

1.1. AsthmaAsthma

2.2. ChokingChoking

Asthma

1. Stressful situations

2. Inhaler or medical assistance

3. Remain calm and confident

Choking 1.Cannot speak2.Universal distress signal3.Encourage to cough4.Heimlich Maneuver

Cardiac Arrest

1. Crushing pain in chest

2. Pain down arm

3. Begin CPR and use AED

4.

5.

Cerebrovascular Accident

1.Paralysis on one or both sides2.Slurred or loss of speech3.Dizziness4.Loss of vision5.Complete unconsciousness

Minor Medical Minor Medical EmergenciesEmergencies

1.1. Nausea and vomitingNausea and vomiting2.2. EpistaxisEpistaxis3.3. Vertigo and syncopeVertigo and syncope4.4. SeizuresSeizures5.5. FallsFalls6.6. WoundsWounds7.7. BurnsBurns

Nausea and Vomiting

• Tell pt to breath deeply and slowly

• Turn on side if possible or turn head

• Get emesis basin and moist cloths

Epistaxis - nosebleed

Vertigo and Syncope

1. Lack of blood flow to brain

2. Feel dizzy after laying down or standing for awhile

3. Lay patient down

4. Orthostatic hypotension

5. Loosen tight clothes and put moist cloth on head

Seizures• Minor

– Brief LOC– Stare into space– Slightly confused and weak

• Severe– Muscle contractions on one or both sides– Drool– Aura may occur and you must lay them on floor

• Pillow under head and move all objects around them

– Afterwards • ABC check• Clear mucus• PT is weak, disoriented and has no memory of seizure

Falls, wounds and burns

• Falls– Get appropriate help as needed and report incident to

supervisor and get a medical assessment of pt

• Wounds– Do not remove dressing– Pay attn to any changes in dressing– Place extremity above level of heart– Apply pressure

• Burns– Maintain sterile precautions– Be extra gentle

Radiologic Technology

• You never know when a medical emergency may occur.

• Helping your patients depends on your abilities to stay calm and perform you duties!