外科急诊创伤(英文)-自主反射障碍.ppt
合集下载
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
his chest • You had just initiated a BP check which is
20 mmHg above the last one of 110 SBP
• Fortunately for both you and your patient you had recently been inserviced on autonomic dysreflexia and you immediately suspect this life threatening condition
• Dispatch says you have messed up the transport rotation of non-emergent transfers
• Well, your patient likes you anyway...
Βιβλιοθήκη Baidu
Pathophysiology
• Something is wrong which causes the body to send messages to the spinal cord
• The spinal cord attempts to send the message but the SCI blocks it
• An abnormal response to a problem somewhere below the injury level and usually due to bowel or bladder problems
Scenario
• You are in the middle of a routine transfer of a patient with a non acute SCI at T-6
Conclusion
• You are able to appropriately manage your patient and divert back to the ER for reevaluation of your patient
• All the staff is excited to see you and brings you cookies and a soft drink
Common Causes
• Overfull bladder or bowel • Any bindings below the site of injury • Catheter taped to leg • Pressure sores • Contact with hard or sharp objects • DVT’s or PE • Injuries • Too tight clothing, appliances, shoes • Extreme temperature changes
• Loosen or remove any tight clothing or appliances, tape etc...
• Empty catheter bags, assess for kinks • Assess BP q 5 minutes • Consider medications for BP control
• The autonomic NS is activated which causes vasoconstriction in the legs and abdomen
• Extra blood is forced into the rest of the body causing an abrupt increase in systemic BP
Autonomic Dysreflexia
Leaugeay Webre BS, CCEMT-P, NREMT-P
What is it?
• An emergency condition that requires immediate attention!
• Is most likely to occur in a patient with a spinal cord injury at or above T-6
• You notice your patient is becoming flushed and diaphoretic
• He is complaining of a pounding headache • Goosebumps appear above the injury site • The patient is anxious and c/o tightness in
• attempts to dilate vessels below SCI but the message is blocked
• BP continues to rise resulting in stroke, cardiac arrest and death
Management
• Immediately raise head to 90% and lower legs
• Baroreceptors tell the brain that the BP is getting too high and it sends out impulses to decrease the BP:
• slowing HR
• vasodilation in face, neck and upper chest
20 mmHg above the last one of 110 SBP
• Fortunately for both you and your patient you had recently been inserviced on autonomic dysreflexia and you immediately suspect this life threatening condition
• Dispatch says you have messed up the transport rotation of non-emergent transfers
• Well, your patient likes you anyway...
Βιβλιοθήκη Baidu
Pathophysiology
• Something is wrong which causes the body to send messages to the spinal cord
• The spinal cord attempts to send the message but the SCI blocks it
• An abnormal response to a problem somewhere below the injury level and usually due to bowel or bladder problems
Scenario
• You are in the middle of a routine transfer of a patient with a non acute SCI at T-6
Conclusion
• You are able to appropriately manage your patient and divert back to the ER for reevaluation of your patient
• All the staff is excited to see you and brings you cookies and a soft drink
Common Causes
• Overfull bladder or bowel • Any bindings below the site of injury • Catheter taped to leg • Pressure sores • Contact with hard or sharp objects • DVT’s or PE • Injuries • Too tight clothing, appliances, shoes • Extreme temperature changes
• Loosen or remove any tight clothing or appliances, tape etc...
• Empty catheter bags, assess for kinks • Assess BP q 5 minutes • Consider medications for BP control
• The autonomic NS is activated which causes vasoconstriction in the legs and abdomen
• Extra blood is forced into the rest of the body causing an abrupt increase in systemic BP
Autonomic Dysreflexia
Leaugeay Webre BS, CCEMT-P, NREMT-P
What is it?
• An emergency condition that requires immediate attention!
• Is most likely to occur in a patient with a spinal cord injury at or above T-6
• You notice your patient is becoming flushed and diaphoretic
• He is complaining of a pounding headache • Goosebumps appear above the injury site • The patient is anxious and c/o tightness in
• attempts to dilate vessels below SCI but the message is blocked
• BP continues to rise resulting in stroke, cardiac arrest and death
Management
• Immediately raise head to 90% and lower legs
• Baroreceptors tell the brain that the BP is getting too high and it sends out impulses to decrease the BP:
• slowing HR
• vasodilation in face, neck and upper chest