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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!