Recognition and Assessment of the Seriously Ill Exam 2 Critical Care

What should be done first when first recognizing an illness?

stabilize the patient first and then do your assessments

First address physiological problem to prevent further deterioration

What would you do in assessment during an emergent situation?

Airway

Breathing

Circulation

Disability

Environment and Vitals

Get Adjuncts

What is tracheal tugging?

It is an airway problem when the middle portion of the neck area where the trachea is going down when breathing in

What does stridor indicate?

that there is a narrowing of the airway may be caused by an obstruction, swelling, or infection

What are assessment findings of failing airways?

stridor, tracheal tugging, GCS score is low, accessory muslce use, and foreign object

In terms of breathing what is an indicator of a critical illness?

tachypnea

What does a thready pulse mean?

when it is weak, and disappears upon palpation

At what HR would HR be emergent?

over 120

What are some assessments for disability?

GCS score, posturing (decerebrate is more serious, which is the one on the side, decorticate is toward the center), spontaneous movements, lack of sensation, cognitive impairment

What do you do for E and F?

Environment: check if environment is safe, if there was a violent altercation, make sure pt does not have any weapons

F: full set of vitals during assessment

What is something that you can ask a patient do to make sure they are neurologically sound?

ask them to cross their legs

What happens in G?

Get adjuncts: labs, EKG/telemetry, ABGs, tube placement, O2

What is an acronym commonly used in secondary survey for rapid assessment?

SAMPLE

Symptoms

Allergies

Medications

Past medical hx

Last oral intake

Events leading up to it

What are common reasons RRTs are called?

respiratory distress, cardiac alterations (MI), sepsis, hypotension, change in LOC

What is the purpose of EWS? What can they look at for EWS?

Early Warning Scores

Used to identify the in between of “sick” (septic shock, more serious conditions) and “not sick” (otitis, less serious complications)

Can help identify who is at risk of getting sicker

Can look at RR, O2 levels, pulse, temp. etc.