Term
| "summarize steps in performing basic CPR" |
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Definition
| """determine unresponsiveness; call for help; establish airway (headtilt/chin lift); check breathing; give two full breaths; check for pulse; if pulseless, begin chest compressions; provide 100% O2""" |
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Term
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Definition
| "gastric distention; pneumothorax; gastric rupture; cross contamination; aspiration" |
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Term
| "complications of external cardiac compression" |
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Definition
| "rib fractures; fractured sternum/clavicle; contusions to heart/lungs; lacerated liver and/or spleen; pulmonary/fat embolism; pneumothorax/hemothorax" |
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Term
| "evaluation of effectiveness of CPR" |
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Definition
| """carotid pulse felt during compressions; color returns to normal; if pt has cervical collar, do not remove; ECG shows sinus rhythm with no pulse - continue CPR""" |
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Term
| "various methods of emergency ventilation" |
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Definition
| "mouth to mouth; mouth to nose; mouth to tube/mask; mouth to valve/mask; bag and mask; cricothyrotomy and transtracheal catheter; intubation/tracheostomy" |
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Term
| "problems with manual ventilation pneumothorax called air in pleural space" |
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Definition
| """trachea deviated to opporsite side, hyperresonant percussion , decreased breath sounds - recommend insertion of chest tube""" |
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Term
| "problems with manual ventilation hemothorax (blood in pleural space)" |
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Definition
| """trachea deviated to opposite side; dull percussion note, decreased breath sounds - recommend insertion of chest tube""" |
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Term
| "problems with manual ventilation ET obstruction" |
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Definition
| """cannot pass suction catheter, decreased breath sounds; remove tube and use alternative ventilation""" |
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Term
| "problems with manual ventilation right mainstem intubation" |
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Definition
| """trachea deviated to the left, hyper-resonant on right, dull on left, increased chest movement on right, decreased on left - withdraw slightly and listen for improved breath sounds and observe for bilateral chest movement""" |
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Term
| "CPR steps one rescuar CPR unwitnessed cardiac arrest child 1 through 8" |
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Definition
| """determine unresponsiveness; shout for help and start CPR; establish airway; check for breathing, give two full breaths; check pulse and if pulseless, begin chest compressions, provide compressions and ventilations for 20 cycles (1 minute); call for help; administer 100% O2 and draw ABG""" |
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Term
| "CPR unwitnessed cardiopulmonary arrest infant (less than 1 year old)" |
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Definition
| """determine unresponsiveness; shout for help and start CPR; establish airway, check for breathing, give two full breaths (mouth to mouth and nose ventilation); check pulse - brachial; if pulseless, start chest compressions one minute or 20 cycles 5:1 ratio with pause after 5th compression; call for help; administer 100% oxygen and ABG""" |
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Term
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Definition
| """determine unresponsiveness by tactile stimulation (flicking extremeties, tapping soles of feet, rubbing back sides); call for help; establish airway - sniffing position, clear airway with bulb syringe, suction mouth then nose; check for breathing by watching chest (3-5 seconds), listen for sounds of ventilation, listen and feel for exhaled flow, give two puffs if not ventilating; check pulse and observe chest for 5 seconds; perform external cardiac cmpression after establishing pulselessness. hand position - hand around chest using thumbs for sternal cmpression or two fingers perpendicular on lower third of sternum below nipple line; 1/2 -3/4 in depth of compressions at 90/min and 30 vents/min; neonate - 3:1""" |
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Term
| "characteristics and tx for hypotension" |
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Definition
| """low blood pressure; poor capillary refill; weak, thready pulse - fluid challenge, dopamine, dobutamine""" |
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Term
| "characteristics and tx for bradycardia" |
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Definition
| """heart rate less than 60 for adults; < 100 infants - tx with atropine, dopamine and epi for adults; epi and atro for children; external pacemaker""" |
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Term
| "characteristics and tx for ventricular arrythmias" |
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Definition
| """PVD - oxygen and lidocaine; pulseless ventricular tachy - defib 360 joules, start cpr and epi, amiodarone or lido if defib unsuccessful; v-fib - defib at 360 joules, if unsuccessful, CPR with epi amiodarone or lido. Administer bicarb if acidosis is confirmed via blood gas; asystole - confirm in two leads, tx with epi, atro and do not defibrillate""" |
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Term
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Definition
| """low voltage current converts cardiac dysrrhythmia to normal cardiac rhythm and current is synchronized to patient's own rhythm; syncronizing switch is ON; 50 - 100 joules, oxygen resus equip and emergency drugs present; if v-fib occurs, check pulse and then turn of syncronizing switch and increase to 200 and immediately defibrillate; midazolam (versed) is a strong short acting sedative to be used prior to cardioversion""" |
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Term
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Definition
| """indications - pulseless V-tach; ventricular flutter, ventricular fibrillation - 360 joules""" |
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Term
| "criteria for ideal resus bag (self inflating)" |
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Definition
| """ideal stroke volume, safety features (non-rebreathing valve); mask design; reservoir""" |
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Term
| "troubleshooting resus bag" |
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Definition
| """if bag fills rapidly and collapses easily, check inlet valve; if bag becomes difficult ot compress and patient compliance is normal, pt valve may be stuck open or closed; excessively high flow may cause valves to jam so use 15 l/min or low range of flush; when there is a problem, do not attempt to fix bag but get another form of ventilation""" |
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Term
| "mouth-to-valve mask ventilation" |
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Definition
| """head tilt, mask placed on face of patient (oropharyngeal airway can be used)""" |
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Term
| "RT role in disaster plan" |
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Definition
| """established call-in list; adequate supply of humidifiers, cannulas, masks and flowmeters; be prepared to assist in tx areas; keep resus equipment in working order and in easy access; be prepared to obtain additional equpipment needed for the situation""" |
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Term
| "what must the transport team monitor " |
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Definition
| """the patient, maintain ventilation, and anticipate problems""" |
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Term
| "what equipment is needed for transport " |
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Definition
| """intubation equipment, portable oxygen, resus device, transport vent, pulse ox, appropriate meds, portable ECG, stethoscope and spirometer""" |
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Term
| "when is transport successful" |
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Definition
| "when the patient arrives at destination without complication" |
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Term
| """during emergency transport, if respiratory rate or tidal volume decreases on pneumatic transport ventilator what to do""" |
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Definition
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Term
| "what happens to oxygen partial pressure as altitude increases" |
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Definition
| "oxygen partial pressure will decrease" |
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Term
| "pulmonary edema/CHF description" |
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Definition
| "left ventricular failure and lung reaction. Excessive fluids accumulate in lungs that affect ventilation and especially oxygenation" |
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Term
| "pulmonary edema/CHF assessment" |
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Definition
| """orthopnea, pitting edema, distended neck veins and increased respiratory distress, fine crepitant audible rales or crackles pink/frothy/watery secretions""" |
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Term
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Definition
| """improve gas exchange - 100% 02 non-rebreather, IPPB with 100% O2 and ethanol, PEEP/CPAP if necessary; increase strength of heart contraction - give digitalis; decrease venus return - give lasix (diuretic), body position (fowlers)""" |
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Term
| "pulmonary emboli description" |
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Definition
| "deadspace disease (ventilation without perfusion) caused by blood clots in the lungs and will affect oxygenation and circulation" |
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Term
| "pulmonary emboli assessment " |
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Definition
| """sudden onset of dyspnea, tachypnea; pt appears to be hyperventilating but blood gas doesn't show; anxious and has chest pain; v/q scan shows no perfusion with ventilation""" |
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Term
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Definition
| """anticoagulation therapy, oxygen therapy, thrombolytic drugs/screens/surgery""" |
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Term
| "pneumothorax description" |
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Definition
| "presence of gas in the pleural space that can seriously affect ventilation" |
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Term
| "pneumothorax assessment" |
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Definition
| """sudden onset of dyspnea with decreased breath sounds and tracheal shift away from affected side; decreased vocal fremitus, percussion is hyperresonant or tympanic, x-ray shows hyperlucency without vascular markings and a flattened diaphragm""" |
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Term
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Definition
| """100% O2 via non-rebreathing mask; immediate chest tube/thoracentesis, or relieve pressure with needle and tubing inserted into a glass of water""" |
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Term
| "CO poisoning description" |
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Definition
| "inability of hemoglobin to bind with oxygen due to binding of carbon monoxide. Seriously affects oxygenation" |
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Term
| "CO poisoning assessment" |
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Definition
| "hx of present illness will be important; redness of skin; breathing labored and deep; tachycardia with normal ABG's; increase COHb on co-oximeter; do not rely on pulse ox" |
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Term
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Definition
| """100% O2 via non-rebreathing mask, CPAP maks, etc; hyperbaric oxygen""" |
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Term
| "status asthmaticus description" |
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Definition
| "sustained asthma attack unresponsive to bronchodilator therapy. Will have marked affect on ventilation and oxygenation" |
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Term
| "status asthmaticus assessment" |
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Definition
| "diagnosis made by hx; retractions and pulsus paradoxus; ABG's indicating respiratory acidosis or respiratory failure" |
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Term
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Definition
| "100% O2 via non-rebreathing mask; subcutaneous epinephrine x 3; mechanical ventilation - sedate and paralyze and control if necessary; bronchodilator and steroid therapy" |
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Term
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Definition
| """head trauma, chest trauma, neck trauma, burn victims, near drowning""" |
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Term
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Definition
| """always start with airway, breathing and circulation; administer 100% O2; adminster drugs and/or fluids based upon bedside and lab assesment; remainder of tx is bawed on careful patient assessment""" |
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