patient may need to be stimulated with medications or evaluated for intubation. The respiratory rate is too high, the critical care physicians should worry about the patients tiring out and progressing to respiratory arrest. A low pulse oximetry, less than 90%, can be the result of damage to the lung tissue, infection, a low respiratory rate, or a combination of factors. Circulation is then evaluated buy checking a patient’s blood pressure, peripheral pulse, and peripheral capillary refill. A pulse-less patient requires immediate chest compressions. Patients with a low blood pressure or delayed capillary refill may require intravenous fluids or pharmacologic vasopressors. Commonly used vasopressors include intravenous dopamine and intravenous norepinephrine. Vital signs monitored during this phase of evaluation include the pulse and blood pressure. Additionally, a patient’s capillary refill can be evaluated. Elevated blood pressure, or hypertension, can cause damage to the brain, kidneys, and heart. Low blood pressure can cause hypoperfusion of peripheral organs and lead to tissue damage. Similarly, both a fast heart rate and a slow heart rate can be dangerous for a patient and cause organ damage or failure. Complete the evaluation by evaluating a patient’s disability. The evaluation and treatment of disability includes evaluation for injuries, neurological deficits, and hypothermia (low temperature) or hyperthermia (high temperature). In addition to checking the patient’s temperature, they should be completely undressed to look for wounds, infections, or foreign bodies. A complete neurological exam should be performed. The neurological exam should include an evaluation of the patient’s level of alertness, movement in all extremities, mental status, and pupils.
SHOCK This section will discuss the concept of shock. Shock is a life-threatening condition whereby circulation is inadequate to ensure blood flow to peripheral organs. All types of shock are characterized by low blood pressure which leads to hypoperfusion. This results in end organ damage and the buildup of waste
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