Patient Assessment
What are the four main ways to assess a patient?
Auscultation
Inspection
Palpation
Percussion
What are the steps from least invasive to most invasive of Hemorrhage control?
Direct Manual/Digital Pressure
Abdo Pad with Pressure
Tournequet
Tournequet
Hemostatic Dressing
What is the calculation for Blood Pressure?
Cardiac output (Stroke Volume x Heart Rate) x Systemic Vascular Resistance
What are the different pacemaker sites of the heart?
SA Node
AV Node
Bundle of His
Perkinje Fibres
Bonus: What are their intrinsic rates?
P wave- Upright, morphologically similar
PRI- Normal range 0.12-0.20
QRS- Narrow, Upright, 0.08-0.12
Regularity - Regular
Rate - 40 bpm
What rhythm am I?
Sinus Bradycardia
Where do you auscultate the chest? Show me spots on the front and the back
4 spots on the front
6 spots on the back (Preffered)
What are the two mneumonics for the Oxygen Therapy Standard?
CUSCOS
ARCAA
What are the lengths of the PRI and QRS?
PRI 0.12s-0.20s
QRS 0.08s-0.12s
What are Dromotropic, Chronotropic, and Ionotripic?
Speed of electricity, Speed of Contraction, Force of contraction
P wave- Indecernable
PRI- Indecernable
QRS- Narrow, Upright, 0.08-0.12
Regularity - Irregularly Irregular
Rate - 137
What rhythm am I?
Atrial Fibrillation
Name 3 different adventitious sounds
Stridor, Wheezing, rubs, crackles, rales, ronchi
A patient who weighs 130lbs has bilateral femur fractures, how many pounds of traction can you pull with the sager?
What is Frank Starling's Law?
The greater the stretch the greater the contraction of the heart.
What are the different phases of the cardiac action potential?
Rapid Depolarization
Early Repolarization
Plateau Phase (Contraction)
Rapid Repolarization
Resting Phase
Bonus (What is the electrical value of each phase)
P wave- Upright, Morphologically similar
PRI- Progressively longer
QRS- Narrow, Upright, 0.08-0.12
Regularity - Regular
Rate - 86 bpm
What rhythm am I?
2nd Degree Type 1 Heart Block (Winkebach)
You arrive on scene to a patient who was choking and is now unconscious. You are performing CPR and ventilations in an attempt to expel the object. What else is important in this scenario?
Checking the mouth for the object between breaths.
Suction in case the patient vomits.
Call for additional resources.
Ask bystanders how big a bite they took.
Why do you cover both eyes when there is a penetrating injury to only one of the eyes?
Because the eyes move together, not independently.
What is the RAAS System?
Dehydration - drop in BP, blood volume
Renin released from kidney and angiotensinogen released from liver
Interacct and form Angiotensin I
Angiotensin I moves through the Lungs and interacts with Angiotensin Converting Enzyme (ACE) to form Angiotensin II
Angiotensin II causes vasoconstriction of the arterioles. Also interacts with the adrenal Cortex to waste K+ and retain NA+ causing a fluid shift to retain H2O
Both cause an increase in blood volume and pressure
What are the names of the 5 different waves seen on ECGs?
They represent the difference in electrical flow across the heart.
Bonus - What does each wave represent?
P wave- Occasionally absent or inverted
PRI- Indecernable
QRS- Narrow, Upright, 0.08-0.12
Regularity - Regular
Rate - 75 bpm
What rhythm am I?
When are you supposed to manipulate an obvious deformity?
When there is comprimise to distal CSM
What are the contraindications for SGA's?
Trauma to the oropharynx
Airway obstruction by a foreign object
Caustic Ingestion
Known Esophageal disease
What are your H's and T's?
Hyperkalemia, Hypoxia, Hypothermia, Hydrogen Ion Access (acidosis), Hypovoleia, Hypoglycemia
Tamponade (Cardiac), Tension Pneumothorax, Thrombosis (PE), Thrombosis (MI), Toxins, Trauma
On the board, draw Einthoven's Triangle
You did your best
P wave- Upright, Morphologically similar
PRI- Indecenrable
QRS- Upright, Wide >0.12
Regularity - Regular
Rate - 40
What rhythm am I?
3rd Degree Heart Block