CTXMEDIC Posted January 7, 2009 Posted January 7, 2009 True. i was just shooting down the possibilities of Tx for PE. Of course with thrombolytics youd have to screen the Pt well to rule out any contraindications like recent surgery, CVA, etc. I wouldnt be to comfortable at this point to start rtPA or Streptase pre-hospital anyway. the only indication this pt would have, as far as i know, that may require it is hypotension or systemic hypoperfusion with an accompanying Hx of clots. In the end, i want her on a cath table.
p3medic Posted January 7, 2009 Posted January 7, 2009 Bradycardia, except in the pending arrest patient is unlikely. The most common EKG finding with PE? Sinus Tachycardia.
AnthonyM83 Posted January 7, 2009 Posted January 7, 2009 Since no one left a follow-up question: Explain the concept of Cushing's Triad? Differentiate from Cushing's Reflex.
scubanurse Posted January 8, 2009 Posted January 8, 2009 Since no one left a follow-up question: Explain the concept of Cushing's Triad? Differentiate from Cushing's Reflex. Cushing Triad is relative hypertension, bradycardia, and irregular respirations. It indicates an increase in intracranial pressure. Cushings Reflex is the parasympathetic response to an increase in the intracranial pressure most likely due to ischemia secondary to a major bleed from a trauma or from a tumor. This happens when mean arterial pressure (MAP=2/3 * Diastolic pressure + 1/3 * systolic pressure) is less than the intracranial pressure (ICP) they hypothalamus will stimulate a response in the heart to increase the blood pressure (because the brain is thinking it is not getting enough oxygen it increases the force of the ventricular response to get more blood to the brain). The hypertension causes the baro-receptors in the vessels to cause the heart rate to decrease to let the pressure with in the vessel to decrease. Next Question: Beck's Triad What is it, why is it important, how do we treat?
CTXMEDIC Posted January 9, 2009 Posted January 9, 2009 Next Question: Beck's Triad What is it, why is it important, how do we treat? back to the tamponade, eh? becks triad is low arterial pressure, increased CVP and muffled/distant heart sounds. scroll up for treatment New question: Whats a Mobitz II and how do we treat?
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