NURS 471 Lecture Notes - Lecture 13: Oxygen Saturation (Medicine), Telemetry, Capillary Refill
Document Summary
Represents a critical assessment skill: patients who have a threat to life, vision, or limb are treated before other patients. Triage system: categorizes patients so most critical are treated first: emergency severity index (esi) -five-level triage system that incorporates illness severity and resource utilization don"t need to memorize o. Airway with cervical spine stabilization and/or immobilization: assessment. Check for loose teeth or foreign bodies. Assess for bleeding, vomitus, edema: manifestations of compromised airway. Trauma to face or neck: maintain airway: least to most invasive method. Insert nasopharyngeal/oropharyngeal airway- only if unconscious bc if conscious will stimulate gag reflex and may vomit. Involves sedation or anesthesia and paralysis: jaw thrust maneuver. Recommended for neck or spinal injury: stabilize/immobilize cervical spine: Face, head, or neck trauma and/or significant upper torso injuries. Cervical spine immobilized with cervical collar & cervical immobilization device. Breathing: assess for dyspnea, cyanosis paradoxic/asymmetric chest wall movement, decreased/absent breath sounds, tachycardia, hypotension. Administer high-flow o2 via a nonrebreather mask.
