RET 1024L Introduction to Respiratory Therapy Lab

1
RET 1024LIntroduction to Respiratory TherapyLab

• Module 4.1
• Bedside Assessment of the Patient
• Vital Signs Pulse, Respiratory Rate,
• Blood Pressure, Pulse Oximetry

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Bedside Assessment of the Patient

• Physical Examination
• Vital Signs
• Pulse Rate
• Palpated at various sites
• Temporal
• Carotid
• Apical (heart)
• Brachial
• Radial
• Femoral
• Popliteal
• Posterior Tibial
• Dorsalis - Pedis

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Bedside Assessment of the Patient

• Physical Examination
• Vital Signs
• Pulse Rate
• Radial artery most common site to palpate pulse
• Use first, second, or third finger to palpate
  not thumb
• Ideally, counted for 1 minute, but can be
  counted over 15 or 30 seconds and then multiplied
  appropriately to determine the pulse per minute

4
Bedside Assessment of the Patient

• Physical Examination
• Vital Signs
• Respiratory Rate
• Counting breaths Breathing should be counted for
  one full minute (60 seconds)
• Look at chest and abdomen rise and fall
• Feel the chest or abdomen rise and fall by
  placing your hand on the person's chest or
  abdomen
• Listen to the breaths if the person is breathing
  loud enough

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Bedside Assessment of the Patient

• Physical Examination
• Vital Signs
• Respiratory Rate
• Do not ask the patient to breathe normally
  while you are counting respiratory rate they
  will inadvertently change the pattern and rate
• Try counting the respiratory rate by observing
  the chest and abdomen while continuing to palpate
  the radial artery. The patient will think you
  are still taking their pulse and will not change
  their respiratory pattern and rate

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Bedside Assessment of the Patient

• Physical Examination
• Measuring BP
• Commonly measured using auscultation
• Sphygmomanometer and stethoscope
• BP cuffs come in different sizes

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Bedside Assessment of the Patient

• Physical Examination
• Measuring BP
• Most BP cuffs are marked with an O or an ?
  indicating where the cuff should be placed over
  the brachial artery

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Bedside Assessment of the Patient

• Physical Examination
• Measuring BP
• Palpate the brachial artery and then wrap the
  deflated cuff snugly around the patients upper
  arm, ensuring it is properly positioned over the
  brachial artery. The lower edge should be about
  1 inch above the antecubital fossa

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Bedside Assessment of the Patient

• Physical Examination
• Measuring BP
• Grasp the inflation bulb in such a way that you
  can inflate the cuff and, with your thumb and
  index finger, easily open and close the valve

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Bedside Assessment of the Patient

• Physical Examination
• Measuring BP
• While palpating the brachial pulse, inflate the
  cuff to approximately 30 mm Hg above the point at
  which the pulse can no longer be felt

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Bedside Assessment of the Patient

• Physical Examination
• Measuring BP
• Place the diaphragm of the stethoscope over the
  artery and deflate the cuff at a rate of 2 3 mm
  Hg/sec while observing the manometer

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Bedside Assessment of the Patient

• Physical Examination
• Measuring BP
• The systolic pressure is recorded at the point at
  which the first Korotkoff sounds are heard. The
  point at which the sounds become muffled is the
  diastolic pressure

Korotkoff sounds partial obstruction of blood
flow creating turbulence and vibration
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Bedside Assessment of the Patient

• Measuring BP

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Bedside Assessment of the Patient

• Pulse oximetry
• SpO2