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Syncope Concept Map

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Jessica Sirek

on 30 October 2012

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Transcript of Syncope Concept Map

Syncope Cardiac Dysrhythmia Vagal Stimulation Hypovolemia Bradycardia Idioventricular SVT Junctional Escape Blocks Fear Pooping over-exertion Standing Sepsis Diarrhea/Vomitting Dehydration Heat Stroke/Exhaustion Bleeding Drug Induced Orthostasis General Assessment
Lung Sounds
Skin Color, Condition, Temp
Blood Glucose
Focused Physical Exam
Trauma Assessment Treatment
Bradycardia (w/pulse)
Cardiac monitor/vitals
IV access
Atropine .5mg repeat every 3-5 mins (max-3mg)
Trascutaneous pacing
Dopamine infusion-2-10mcg/kg/min
consider transvenous pacing (cath lab??) Treatment
IV/Fluids Focused assessment ?'s Dehydration
Poor skin turgor
vision disturbances
decreased Urine output
Sunken eyes
Fontanelle depression
Signs of Hypovolemic shock Pooping-
diet low in fiber
history of flu
low food intake over-exertion
Cardiac history? Treatment
Cardiac monitor/vitals
IV access
Atropine .5mg
Transcutaneous pacing (if symptomatic) Treatment
Cardiac monitor/vitals
IV access/fluid bolus
vagal stimulation
adenosine (if stable) 6mg/12mg
Lopressor 5mg slow (irregular) afib
unstable (syncronized cardiovert)
100 J for narrow/wide regular
200J for narrow & irregular emotional stress (especially in a warm, crowded room), after an injurious, shocking accident, and during pain. Mild blood loss, poor physical condition, prolonged bed rest, anemia, fever, organic heart disease, and fasting are other factors which increase the possibility of fainting in susceptible individuals. Orthostatic Hypotension Orthostatic Hypotension
Blood vessels need to maintain their tone so that the body can withstand the effects of gravity with changes in position. When the body position changes from lying down to standing, the autonomic nervous system, increases tone in the blood vessel walls, making them constrict, and at the same time increases the heart rate so that blood can be pumped upward to the brain. As people age, blood vessels may become less resilient, and orthostatic hypotension (relative low blood pressure with standing) may occur and cause syncope Drug inducted orthostasis-treatment/assessment
Other medications or drugs may also be potential causes of fainting or syncope including those for high blood pressure that can dilate blood vessels, antidepressants (treat with Sodium Bicarb for tricyclic) that can affect heart electrical activity (wide QRS), and those that affect mental status like pain medications, alcohol, and cocaine (narcan for opiates .4mg Max 2mg). Heat Exhaustion Treatment
Remove pt from hot environment.
Place in cool, shaded, or air-conditioned area.
Administer oral fluids if pt is alert and able to swallow/give IV fulids
Place patient in supine position
Remove some clothing and fan the pt. (dont cool to the point of causing chills or shivering.
Treat for shock. Heat Stroke Treatment
Remove pt from hot environment, place in a cool, shaded or air-conditioned area.
Initiate rapid active cooling en route to the hospital.
Remove clothing and cover pt with sheets soaked in tepid water.
Lower body temperature to 102 degrees F. Avoid cooling to a lower temp.
Administer 02
PT alert-give oral fluids/IV NS wide open.
Monitor ECG
Monitor body temperature Treatment
Must rehydrate the pt.
Oral fluidsif pt is alert and not nauseated.
IV fluids (espically if AMS or nauseated.
may require 2-3 liters (ocassionally more) Assessment Heat stress related
Cessation of sweating
Hot skin that is dry or moist
high core temp
deep respirations that become shallow
rapid pulse
hypotension (love or absent diastolic reading)
Confusion, disorientation, unconsciousness
seizures Assessment heat exhaustion
increased body temp 100 + degrees F
cool and clamy skin
heavy perspiration
breathing rapid and shallow
weak pulse
feeling weak or loss of consciousness Standing-
standing quickly fear-
sudden change in enviornment
Full transcript