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  Epistasis  Cerumen Removal  Nebulizer Treatment  O2  Peak Flow  Spirometry  Burn Debridement  Splinting/Casting  Dressing Changes  Suture Removal  I & D & Laceration Trays

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 Rhythm Volume Condition of arterial wall Infant: bpm Child: bpm Adult: bpm

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 Rhythm Depth At birth: R/min Infant: R/min Child: R/min Adult: 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 ( is normal)

BLOOD PRESSURE Child: systolic mm/Hg diastolic60-80 Adult: systolic mm/Hg diastolic60-90 Elderly: systolic mm/Hg diastolic92-100

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 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; 2 nd diast.