Condition |
Assessment: Signs and Symptoms |
Prehospitalization Nursing Care |
In-hospital Nursing Care |
|---|---|---|---|
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Unconscious victim:
Lay rescuers - proceed to CPR. No abdominal thrusts or blind finger sweeps
EMS responders Try to ventilate; if unsuccessful, deliver abdominal thrusts using technique described for obstructive airway; probe mouth for foreign object;
keep repeating above procedure until ventilation occurs; as victim becomes more deprived of air, muscles will relax and maneuvers that were previously unsuccessful will begin to work; when successful in removing obstruction, give two breaths; check pulse; start CPR if indicated
On obese or pregnant victims - use chest thrusts instead of abdominal thrusts
You are victim and alone: Place your two fists for abdominal thrusts; bend over back of chair, sink, etc. and exert hard, repeated pressure on abdomen to force object up; push fingers down your throat to encourage regurgitation
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As in prehospital care; when probing mouth for foreign object, turn head to side, unless patient has neck injury, in event of neck injury, raise the arm opposite you and roll the head and shoulders as a unit, so that head ends up supported on the arm
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Acute respiratory failure - sudden onset of an abnormally low Pao, (<60 mm Hg) or high Pco, (>60 mm Hg) secondary to: lung disease or trauma, peripheral or central nervous system depression, cardiac failure, severe obesity, airway obstruction, environmental abnormality
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Hypoxia
Sensorium: acute apprehension Respiration: dyspnea; shallow, rapid respirations Skin: circumoral cyanosis; pale, dusky skin and nailbeds C/V: slight hypertension and tachycardia, or hypotension and bradycardia Hypercapnia Sensorium: decreasing mentation; headache Skin: flushed, warm, moist C/V: hypertension; tachycardia |
If you suspect respiratory distress, call physician; calm and reassure patient place position; keep warm but not hot; phone for ambulance; if respirations cease or patient becomes unconscious, clear airway and commence respiratory resuscitation; check pulse: initiate CPR if necessary, continue resuscitation until help arrives
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Check patient’s ability to speak; maintain airway by placing in E high Fowler’s position; check vital signs: BP, pulse rate and rhythm, temperature, skin color, rate and depth of respirations
Prepare for intubation if:
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