Patient Monitoring

Overview

Patient Monitoring and Medical Emergencies covers the moments a patient stops being a positioning problem: the numbers that show someone is in trouble, the tubes and lines they arrive attached to, and the correct first actions when something goes wrong on the table. The ARRT exam tests it two ways, as bare number recall and as scenario questions where you pick the correct first action.

The numbers come first. Adult pulse runs 60 to 90 beats per minute, with tachycardia above 100 and bradycardia below 60. Respiration is 15 to 20 breaths per minute, blood pressure 90 to 120 over 50 to 70 mm Hg, and oxygen saturation 95 to 100 percent by pulse oximeter. Oxygen itself is a medication that supports combustion but does not burn, and a simple face mask never runs below 5 LPM because the flow has to flush carbon dioxide out of the mask.

The hardware has one rule per device. An endotracheal tube tip belongs 5 to 7 cm above the carina; a tube pushed too far enters the right main bronchus and collapses the left lung. A chest tube is never clamped and its drainage unit stays below the chest, while a urinary bag stays below the bladder and gets clamped before it is lifted.

The emergency half covers shock, diabetic events, syncope, seizure, stroke and arrest. In the compensatory stage of shock the blood pressure is still normal while the skin goes cold and clammy, neurogenic shock shows warm dry skin with bradycardia, and hypoglycemia arrives in minutes in the fasting diabetic patient. For every minute defibrillation is delayed, survival falls by 10 percent. The chapter closes with scheduling logic: barium studies go last, and the barium enema goes before the upper GI.