Patient Vital Signs and Medical Emergencies

1
Patient Vital SignsandMedical Emergencies

• Orientation
• Fall 2009

2
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

3
Vital Signs

• Body Temperature
• Respiratory Rate
• Pulse / Heart Rate
• Blood Pressure
• Sensorium (mental alertness)

4
Importance of Vital Signs

• Indicates the patients immediate condition
• Can show improvement due to treatment
• Can show a decline in condition

5
Body Temperature

• Normal temperature 98.6 F
• 1 - 2F 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

6
Thermoregulation
Shivering when cold Sweating when hot
7
Measuring Body Temperature

• Oral
• Rectal
• Axillary
• Tympanic
• Temporal

8
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

9
Respiratory Rate

• Respiratory System delivers oxygen to the bodys
  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

10
Abnormalities of Respiratory Rate

• Tachypnea
• Greater than 20 breaths per minute (adult)
• Bradypnea decrease is breathing
• Dyspnea- difficulty breathing
• Apnea- no breathing

11
Methods of Delivering Oxygen
Nasal Cannula
Masks
Oxyhood
Ventilators
12
Pulse Oximeter

• Normal Pulse Oximeter 95 to 100

13
Pulse

• Adult
• 60 to 100 beats per minute
• Children under 10
• 70 to 120 beats per minute

14
Measurement

• Radial artery
• Brachial
• Carotid artery
• Apical pulses

15
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

16
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

17
Blood Pressure contd

• 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

18
Abnormalities of Pulse Rate

• Hypertension
• Persistent elevation above 140/90 mmHg
• Hypotension
• Persistent less than 95/60 mmHg

19
Medical Emergencies
20
Medical Emergencies

• What a Radioilogic technologist should know
• Common Radiology Emergencies

21
Medical Emergencies

• Sudden change in medical status requiring
  immediate action.
• For RTs 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

22
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

23
General Priorities

• Ensure an open airway (ABCs)
• Control Bleeding
• Take Measures to Prevent shock

• 4. Attend to wounds or fractures
• 5.Provide emotional support
• 6. Continually reevaluate and follow up

24
ABC and D

• A Air Way
• B Breathing
• C Circulation
• D Defibrillation

25
Major Medical Emergencies

• ALOC
• Shock
• Anaphylactic shock
• Diabetic Crisis
• Respiratory Distress
• Cardiac Arrest
• Cerebrovascular accident

26
Head Injuries

• Levels of consciousness
• Least severe
• Responsive
• More serious
• Can be roused, but drowsy
• Even more serious
• Responds to pinches or pinpricks
• Most serious
• Comatose, non-responsive

27
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

28
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

29
Water Soluble Iodine

• High atomic 53
• Radiopaque
• Used to radiograph
• Vessels
• Arteries
• Veins
• Function of internal organs

30
Prevention and Signs - Symptoms

• Restlessness
• Apprehension
• Anxiety
• Tachycardia
• Sudden blood pressure drop
• Cold clammy skin
• pallor

• Maintain normal body temperature
• Handle pts gently
• RT should work calmly and confidently

31
Diabetic Crisis

• Hypoglycemia
• Hyperglycemia

32
Hypoglycemia

• Excessive insulin
• Can result from normal dose of insulin no food
• Need carbohydrate

33
Hyperglycemia

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

34
Respiratory Distress

• Asthma
• Choking

35
Asthma

• Stressful situations
• Inhaler or medical assistance
• Remain calm and confident

36
Choking

• Cannot speak
• Universal distress signal
• Encourage to cough
• Heimlich Maneuver

37
Cardiac Arrest

• Crushing pain in chest
• Pain down arm
• 3. Begin CPR and use AED
• 4.
• 5.

38
Cerebrovascular Accident

• Paralysis on one or both sides
• Slurred or loss of speech
• Dizziness
• Loss of vision
• Complete unconsciousness

39
Minor Medical Emergencies

• Nausea and vomiting
• Epistaxis
• Vertigo and syncope
• Seizures
• Falls
• Wounds
• Burns

40
Nausea and Vomiting

• Tell pt to breath deeply and slowly
• Turn on side if possible or turn head
• Get emesis basin and moist cloths

41
Epistaxis - nosebleed
42
Vertigo and Syncope

• Lack of blood flow to brain
• Feel dizzy after laying down or standing for
  awhile
• Lay patient down
• Orthostatic hypotension
• Loosen tight clothes and put moist cloth on head

43
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

44
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

45
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!