Shade et al.: Mosby’s EMT-Intermediate Textbook for the ...brainspew.com/advanced/emt/notes/intChapter_010.pdfmembrane in the function of the cell ... Revised Edition PowerPoint
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ObjectivesObjectivesDiscuss the role of water in its relationship Discuss the role of water in its relationship with body functionwith body function
Discuss the fluid compartments of the bodyDiscuss the fluid compartments of the body
Identify the significant anions and cations in Identify the significant anions and cations in the bodythe body
Explain the role of the Explain the role of the semipermeablesemipermeablemembrane in the function of the cellmembrane in the function of the cell
Shade et al.: Mosby’s EMT-Intermediate Textbook for the 1985 National StandardCurriculum, Revised Edition PowerPoint Lecture Notes Chapter 10: Assessment and Management of Shock
ObjectivesObjectivesDiscuss the concepts of diffusion, facilitated Discuss the concepts of diffusion, facilitated diffusion, osmosis, osmotic pressure, and diffusion, osmosis, osmotic pressure, and active transportactive transport
Give examples of isotonic, hypotonic, and Give examples of isotonic, hypotonic, and hypertonic solutionshypertonic solutions
Explain the function of plasma, erthrocytes, Explain the function of plasma, erthrocytes, platelets, hemoglobin, and hematocrit in platelets, hemoglobin, and hematocrit in bloodblood
ObjectivesObjectivesDescribe the role of antigens and antibodies Describe the role of antigens and antibodies in the bodyin the body
Explain the Rh factor in bloodExplain the Rh factor in blood
Describe acids and bases in relation to pHDescribe acids and bases in relation to pH
Explain how the buffer systems, respiration, Explain how the buffer systems, respiration, and kidney function help to maintain acidand kidney function help to maintain acid--base balance in the bodybase balance in the body
FickFick principleprincipleAdequate ventilationAdequate ventilationOO2 2 binds with binds with hemoglobinhemoglobinOO22 transported via transported via circulatory systemcirculatory systemOO22 offoff--loaded in loaded in capillariescapillaries
The Cardiovascular SystemThe Cardiovascular System
ContractilityContractilityExtent and velocity of muscle fiber shorteningExtent and velocity of muscle fiber shorteningInfluenced byInfluenced by
•• OO22 supply and demandsupply and demand•• Degree of sympathetic stimulationDegree of sympathetic stimulation•• Electrolyte balanceElectrolyte balance•• Drug effectsDrug effects•• DiseaseDisease
The Cardiovascular SystemThe Cardiovascular System
PreloadPreloadAffected by volume of Affected by volume of blood returningblood returningMore blood More blood ↑↑ preloadpreloadLess blood Less blood ↓↓
The Cardiovascular SystemThe Cardiovascular System
AfterloadAfterloadAffects stroke volumeAffects stroke volumeDictated by arterial blood Dictated by arterial blood pressurepressureFactors that increase Factors that increase afterloadafterload
•• Obstruction of aortic Obstruction of aortic valvevalve
The Cardiovascular SystemThe Cardiovascular System
Blood pressureBlood pressureForce exerted against Force exerted against arterial wallsarterial wallsCardiac output times Cardiac output times peripheral resistanceperipheral resistance
Isotonic solutionIsotonic solutionOsmotic pressure equal to normal body fluidOsmotic pressure equal to normal body fluid09% normal saline, 09% normal saline, lactated Ringerlactated Ringer’’ss
Hypotonic solutionHypotonic solutionOsmotic pressure less than body fluidOsmotic pressure less than body fluid
Hypertonic solutionHypertonic solutionOsmotic pressure greater than body fluidOsmotic pressure greater than body fluid
BloodBloodBlood type is determined by the antigens present on blood cell mBlood type is determined by the antigens present on blood cell membranesembranes
Buffer systemsBuffer systemsFastest acting defensesFastest acting defensesAct as chemical spongeAct as chemical spongeMajor buffer systemMajor buffer system
Assessment and Management Assessment and Management of the Patient in Shockof the Patient in Shock
Level of responsivenessLevel of responsivenessAssessed throughout surveyAssessed throughout surveyBetter indicatorBetter indicatorSignificant alteration Significant alteration Alcohol and drugsAlcohol and drugs
Assessment and Management Assessment and Management of the Patient in Shockof the Patient in Shock
Breathing and oxygenation assessmentBreathing and oxygenation assessmentAdequacy of air exchangeAdequacy of air exchangeRate and depth of respirationsRate and depth of respirations
Assessment and Management Assessment and Management of the Patient in Shockof the Patient in Shock
Focus history and physical examinationFocus history and physical examinationThoroughness depends on patientThoroughness depends on patient’’s conditions conditionObvious lifeObvious life--threatening problemsthreatening problemsContinual reassessmentContinual reassessmentAsk the patientAsk the patient
LongLong--term survival depends on delivery of adequate term survival depends on delivery of adequate amounts of oxygen amounts of oxygen and glucose to individual cellsand glucose to individual cells
Shock is inadequate tissue perfusion, causing lack of Shock is inadequate tissue perfusion, causing lack of tissue oxygenation, tissue oxygenation, which leads to anaerobic which leads to anaerobic metabolismmetabolism
Decreased blood flow is common in shock, may Decreased blood flow is common in shock, may occur from hemorrhage, occur from hemorrhage, pump failure, or pump failure, or inappropriate systemic vascular resistanceinappropriate systemic vascular resistance
Signs and symptoms become more apparent Signs and symptoms become more apparent during progressive shockduring progressive shock
Survival depends on prompt recognition, Survival depends on prompt recognition, rapid care, and prompt transportrapid care, and prompt transport
As shock progresses, oxygen supply to cells As shock progresses, oxygen supply to cells decreases and cells resort to decreases and cells resort to anaerobic anaerobic metabolism; leads to production of lactic acid metabolism; leads to production of lactic acid and to acidosisand to acidosis
Treatment for shock includes adequate Treatment for shock includes adequate ventilation and oxygenation and ventilation and oxygenation and further further prevention of shock processprevention of shock process
Rapid transport is imperativeRapid transport is imperative
Low blood pressure is late sign of shockLow blood pressure is late sign of shock
Evaluation of shock begins with scene Evaluation of shock begins with scene survey, mechanism of injury, and survey, mechanism of injury, and historyhistory
If these factors indicate shock is or could be If these factors indicate shock is or could be present, take measures to present, take measures to counter effects of counter effects of shockshock