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BVM 90-100% at 10-15LPM
- NRB 60-90% at 10-15LPM
- NC 25-30% at 2-6LPM
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Thoracic Trauma
- - tracheal deviation
- - Asymmetrical movement
- - Neck veins distended
- - Abnormal breath sounds
- - Shock
- - Subcutaneous emphysema
- - chest wall contusion / open wounds
- - Cyanosis, chest pain, SOB
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Open pheumothorax
- - open chest wound, air enteres into plural space, squishes lung to collapse, then possible tension pneumothorax
- - Hypoxia
- - shallow breathing
- - guarging wound
- initial=hand on wound
- secondary=3 sided occlusive dressing
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Flail Chest
- - 3+ ribs broken in 2+ places in succession
- - paridoxical motion
- - SOB
- - guarding
- - pulse up
- - BP up
- Watch out for pulinary contusion / Hemothorax / pneumothorax
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Tension Pneumothorax
- - Lungs popped, air fills plural space and begins to push on other chest cavity organs
- - SOB, fast and shallow
- - Breath sounds diminished
- - JVD
- - tracheal deviation
- - Tacypnea
- - Anxiety
- - Dyspnea
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Massive Hemothorax
- - Blood fills the plural space
- - anxiety and confusion
- - neck veins flat = hypovolemia
- - breath sounds decreased
- - Shock
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Cardiac Tamponalde
- - blood fills the sac around the heart
- -Becks Triad (hypotension, neck veins distended, heart sounds muffled)
- - peridoxical pulse
- - breath sounds equal
- Watch out for hemothorax and pneumothorax
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Myocardial Contusion
- - blunt chest injury
- - similar to MI and Angina
- Watch for cardiac tamponalde, hemothorax and pneumothorax
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AAA and Tramatic Aortic Rupture
- - MVC's and falls from height (90% immidiate death)
- - scene size up and history is extremely important
- (no obvious sign of chest trauma, hypertension in upper extremities
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What is shock?
Inadequate perfusion of tissues
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What are the 4 causes of shock?
- - pump problem (heart)
- - fluid volume issue
- - air exchange issue
- - Vascular system issue
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What are the 2 types of shock?
- Compinsated - Body is trying to fix itself
- Decompinsated - Body gives up
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Signs and symptoms of Compinsated shock?
- - thirst
- - diaphoresis (sweaty)
- - Breathing fast
- - fast pulse
- - periferal pulses weakened
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Signs and symptoms of decompinsated shock?
- - Altered mental status
- - Acidosis (less O2in body makes it acidic)
- - Leads to cardiac arrest
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What can we do for people with shock?
- - take care of bleeding
- - give O2
- - Shock position
- - Rapid transport
- - Cardiac monitor
- - Ongoing exam every 5 minutes
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What Are the Vital signs all FF's must know?
- - Pulse
- - BP
- - Respirations
- - Pupils
- - LOC
- - SPO2
- - Skin
- we dont check but we should know:
- - BGL
- - EtCO2
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What 7 places can we check the patients pulse?
corodid (neck), breakeal (bicep), radial (wrist), femorial, popliteal, dorsalis pedis, posterior tibialis
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What is the normal pulse range for an adult, child and infant?
- Adult - 60-100
- Child - 80-120
- Infant - 120-140
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What is EtCO2?
- the amount of Co2 being exhaled
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What is the normal range of EtCO2?
35-40mmHg
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How does EtCO2 help you?
- It tell you during CPR if you are:
- - If the EtCO2 reads high, speed up ventilations (hyperventilation)
- - If the EtCO2 reads low, slow down ventilations (hypoventilation)
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SpO2 is...
How many O2 is sticking to the hempglobin in the blood.
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What is the range of SPo2 readings?
90-100%
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What are the two substances that will give your SPO2 a false reading?
- carbon monoxide and cyonide
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How do you check LOC?
- AVPU - Alert, verbal, pain, unresponsive
- Orientation - Name, time, place, event
- A + O X 3
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What is the BP normal range?
100/76 - 140/90
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What are you checking on the skin?
Temperature, condition, colour
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What does it mean if the pupils are not even or reactive?
- swelling in your head. Possible head trauma.
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What is the normal temperature of a human?
- 36.9 or 98.6 degrees
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What is a normal BGL?
- 4-8
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Name a few Cardiac issues?
- Trauma
- - aortic disection, Cardiac Tamponade, Hypovolemia, Cardiac Contusion,
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Medical
- - Miocardial Infarction, AAA Abdominal Aortic anuerizm, Angina, Ateriosclerosis,
- Congestive Heart Failure, Stroke, Trans ischemic attack, Sepsis, Pericarditis.
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What is an MI?
- - Miocardial Infarction
- - death of tissue surrounding the heart
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What are some signs and symptoms of an MI?
- - Pain (clutching of the chest)
- - Reffered Pain (radiating) to the left arm, shoulder jaw.
- - Rapid Breathing, and increased heart rate.
- - irregular Pulse
- - Described like bad indigestion
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What two things make you think MI?
- 1. pain or discomfort in the chest/left arm/neck
- 2. SOB
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Angina?
- A temporary blockage around the heart, (fake MI)
- MI is imminant (sooner or later), take to hospital
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Stroke?
Blockage around the brain (MI of the brain)
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TIA?
- Temporary blockage around the brain.
- Stroke is imminant (sooner or later), take to hospital
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CHF?
- Conjestive heart failure (Fluid in Lungs)
- - usually smokers with COPD
- - do not lay them down
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Sepsis?
- - blood infection throughout body
- - look like shit and stink
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Aortic Dissection?
- Tearing of Aorta due to trauma
- trauma version of Abdominal Aortic anurism
- - good pulse above heart, poor pulse below heart
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Cardiac Tamponade
- - sqeezing of heart due to swelling
- - JVD is apparent
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How many compressions:breaths for 1 Rescuer Adult CPR.
- 30:2
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How many compressions:breaths for 2 Rescuer Adult CPR.
- 30:2
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How many compressions:breaths for 1 Rescuer Child CPR.
- 30:2
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How many compressions:breaths for 1 Rescuer Infant CPR.
- 30:2
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How many compressions:breaths for 2 Rescuer Child CPR.
- 15:2
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How many compressions:breaths for 2 Rescuer Infant CPR.
- 15:2
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