Urgent Care/Clinical Settings Teamwork between physician and technologist No call Low Stress Flextime More hands on with Patient Care No Heirarchy No problems with departmental communication PATIENT CARE PROCEDURES Laboratory Urine Collection Blood Draws Specimen Collection IV Therapy & Heparin Lock Medication Administration Eye Exams Sterile and Non-Sterile Physicals Orthostatic Vitals Universal Precautions Infection Control EVEN MORE COOL PROCEDURES Histofreeze Spirometry Epistasis Burn Debridement Cerumen Removal Splinting/Casting Dressing Changes Suture Removal I & D & Laceration Trays Nebulizer Treatment O2 Peak Flow VITALS Vital signs are measurable, concrete indicators that pertain to and are essential for life. GETTING VITALS Height/weight Temperature Pulse Respirations Blood Pressure Evaluation of pain Height/weight Provide information for diagnosing, treating, preventing, or evaluating a condition Growth pattern Dosage for certain drugs Weight determined for certain specialty exams. OVERWEIGHT PROBLEMS Hypertension Heart disease Diabetes mellitus Psychologic problems UNDERWEIGHT PROBLEMS Malnourishment Metabolic disorders Psychologic problems PROCEDURE Scales should be located in private area Patient stand with back to numbers TEMPERATURE Body temperature is a result of the balance maintained between heat produced and heat lost by the body. Regulated by hypothalamus 85% body heat lost through convection 15% lost through respiratory tract/mouth and feces/urine. TEMPERATURE Oral: 98.6 F (+/- 1F), 37 C Rectal: 99.6 F, 37.6 C Axillary: 97.6 F, 36.4 C Tympanic: read in oral or rectal PULSE The wave of blood that travels along the arteries with each contraction of the heart’s left ventricle. Best felt when a superficial artery is pressed against a firm structure. PULSE Rate Infant: 100-180 bpm Rhythm Child: 70-110 bpm Volume Adult: 55-90 bpm Condition of arterial wall PULSE Apical pulse Pulse deficit RESPIRATION The taking in of O2, its use in the tissues, and the giving off of CO2. Controlled by the medulla oblongata. Ratio of respiration to pulse is typically 1:4 RESPIRATION Rate At birth: 30-60 R/min Rhythm Infant: 30-38 R/min Depth Child: 20-26 R/min Adult: 12-20 R/min BLOOD PRESSURE Pressure of the blood against the walls of the blood vessels. Systolic Pressure – ventricles of the heart in a state of contraction. Diastolic Pressure – ventricles of the heart in a state of relaxation. Pulse Pressure – difference of the two (3050 is normal) BLOOD PRESSURE Child: systolic diastolic Adult: systolic diastolic Elderly: systolic diastolic 100-120 mm/Hg 60-80 90-140 mm/Hg 60-90 140-170 mm/Hg 92-100 BLOOD PRESSURE Hypertension – increase in blood pressure “Silent Killer” never based on one reading Hypotension – decrease in blood pressure INSTRUMENTS Sphygmo (pulse) mano (slight) meter (to measure) Mercury – column Aneroid – a, not neroid, liquid Manometer parts: Cuff, inflation bulb, control valve, pressure indicator Stethoscope Auscultation Method Brachial artery @ antecubital space Korotkoff sounds Phase I: faint tapping (systolic) Phase II: swishing; Phase III: crisp, loud Phase IV: Sound becomes dull/muffled (diastolic) Phase V: All sound disappears; 2nd diast.