Vital Signs and Medical Emergencies

Homeostasis, mechanisms that we use to evaluate vital signs

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Vital Signs

• HOMEOSTASIS

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HOMEOSTASIS

A CONSTANCY IN THE INTERNAL ENVIRONMENT OF THE BODY3

HOMEOSTASIS

Primary mechanisms:

HeartbeatBlood pressureBody temperatureRespiratory rateSensorium

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Heart Rate (Pulse)

• Adult – 60 to 100 beats per

minute

• Children under 10– 70 to 120 beats per

minute

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Heart Rate (Pulse)

• Radial artery• Brachial• Carotid artery• Apical pulses

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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

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Blood Pressure

• 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

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Abnormalities of Blood Pressure

• Hypertension– Persistently elevation– above 140/90 mmHg

• Hypotension– Persistently less – than 95/60 mmHg

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Breathes per minute

Normal Values:

– Adults: 12 – 20 bpm

– Children: 20 – 30 bpm

– Newborns: 30 – 60 bpm

Respiratory Rate

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Know normal values

• Respiratory

System

delivers oxygen to

the body’s tissues

and eliminates

carbon dioxide

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Pulse Oximeter

• Normal Pulse Oximeter = 95% to 100%

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Ventilators

Nasal Cannula

Oxyhood

Masks

Methods of Delivering Oxygen

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Abnormalities of Respiratory Rate

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

• Bradypnea – decrease is breathing

• Dyspnea- difficulty breathing

• Apnea- no breathing

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ELECTROLYTE BALANCE

ALTERED LEVEL OF CONSCIOUSNESS

SENSORIUM-MENTAL ALERTNESSSENSORIUM-MENTAL ALERTNESS 15

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Medical Emergencies

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Medical Emergencies

• Major Emergency– Remain calm

– Know your role

– Be prepared

– Seen mostly in the ER

• Minor Emergency– Remain calm

– Know your role

– Be prepared

– Most common in x-ray department

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TRAUMA- X-RAY READY

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SPINAL INJURY PT

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X-TABLE LATERAL CERVICAL SPINE

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Dislocation of the C3 and C4 articular processes

Note that C7 is not well demonstrated

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Some studies of spinal trauma have recorded a missed injury rate as high as 33%.

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GSW TO ABD

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General Priorities

1. Ensure an open airway (ABC’s)

2. Control Bleeding

3. Take Measures to Prevent shock

4. Attend to wounds or fractures

5.Provide emotional support

6. Continually reevaluate and follow up

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Fractured Forearm

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Trauma and Surgical Radiography

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Major Medical Emergencies

1. ALOC2. Shock3. Anaphylactic shock4. Diabetic Crisis5. Respiratory Distress6. Cardiac Arrest7. Cerebrovascular accident34

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

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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

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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

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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

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Diabetic Crisis

1. Hypoglycemia

2. Hyperglycemia

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Hypoglycemia

• Excessive insulin- low blood sugar• Can result from normal dose of insulin & no food• Need carbohydrate

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Hyperglycemia

• Excessive sugar- low insulin • Usually seen in diabetics• Pt. needs insulin

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Respiratory Distress

Asthma

Choking

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Asthma

1. Stressful situations

2. Inhaler or medical assistance

3. Remain calm and confident

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

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Cardiac Arrest

Crushing pain in chest

Pain down arm

Begin CPR and use AED

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Cerebrovascular Accident

Paralysis on one or both sidesSlurred or loss of speechDizzinessLoss of visionComplete unconsciousness

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Nausea and Vomiting

• Tell patient to breath deeply and slowly

• Turn on side if possible or turn head

• Get emesis basin and moist cloths47

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!