Have you ever wondered how do our medical teams know how to treat somebody who's had a cardiac
arrest, or maybe you're the healthcare worker, and you're like, I don't know what I'm looking for?
Well, in this video, I want to share with you the H's and the T's. There. It's a mnemonic
that we use in advanced cardiac life support, to help us identify the cause and treatment
for our patients so that we can reverse the situation. Now, this is important for health
care providers at any stage of their career to know if you're working in emergency ICU
or in a step down unit, where you know, your patients are at risk of having a cardiac event,
knowing this information may be the thing that helps prevent a cardiac event as you start to
assess your patient with these in the back of your mind. So you have a patient that's crashing,
doesn't look so good, or maybe has already crashed and they're in cardiac arrest. You
need to know the H's and the T's in order to help troubleshoot any potential reversible causes,
so that you can anticipate your nursing interventions, tests that are going to be ordered,
and be a part of the solution. When people are asking when the doctor says alright guys, what do
you think's going on, you can pull information from your H's and T's it's a handy mnemonic.
To help you identify the most potential causes of your patient's current condition. Let's quickly
run down the ages. And then we'll talk about them here briefly. So when we think of the
H's think of everything to do with the blood, we have volume, we have sugars, we have temperature,
we have oxygen, we have electrolytes. And so we have hypovolemia, low in volume, hypoxia,
low in oxygen, hyperkalemia, high in potassium, or hypokalemia, low in potassium, we can also have
hypoglycemia, low and sugar, hypo thermia. Very cold temperature, and then the acid base balance
is represented by hydrogen ions. So let's take a look at these individually. Alright, so now that
we know what the H's are, we need to understand how do we evaluate for them. So if we have an
assessment, we can evaluate to rule in or rule out if this is the cause. And then that information
will help us determine the interventions that this patient needs. In the case of hypovolemia,
you're going to be looking for obvious signs of blood loss, you may need an ultrasound to check
for internal bleeding, but the treatment is going to be to start an IV and replace those fluids.
When it comes to hypoxia, you can put on your O to SAP probe right at the bedside. And of course,
a blood draw will be done as well. Your treatment will be to administer oxygen
and put in an advanced airway hyperkalemia, high potassium, we're going to need a blood draw and
check the history for things like renal failure and diabetes. If it is we're going to treat with
calcium chloride, sodium bicarb, glucose plus insulin hypokalemia. Again, another blood draw,
checking for the history of use of diuretics or loss of fluids from vomiting, and the treatment
will be magnesium and potassium infusion. Hypoglycemia can be tested right at the bedside
with a bedside glucometer testing. And if they are low, we're going to treat that with IV dextrose.
When it comes to hypothermia, we want to core body temperature.
And we're going to treat this with gradual warming such as fluids, a blanket or even a warmer
hydrogen ions. So acidotic patients and other lab drugs will be done. It's an
arterial blood gas, you may notice a free order on the breath. And we will treat that with sodium
bicarb and ventilation. Okay, so let's look at our T's. Now, when you're thinking about teeth, I want
you to think about a gun, lead bullet being shot through your chest on the side in which your heart
is okay, because this is going to be critical to understanding some of the elements. So think about
this. This is traumatic, isn't it? Right? So trauma is one of the first T's to think about
I'm shooting a lead bullet a lead is a toxin. So toxin is our second T tablets and toxins.
This is piercing into the chest cavity where I have my lungs and my heart. So it can create a
tamponade a cardiac tamponade in which there's blood that surrounds the outer membrane of the
heart and squeezes it. You can also cause a tension pneumo where air is escaping from the
lungs, but it's staying within the pleural membrane and putting pressure on the lung
collapsing it towards the other side. And then the last thing you can do is because it's just
pierced the vascular system is it may release a clot so it can cause a thrombosis,
which is a clot either that goes into the lung, a pulmonary embolus
for one that goes into the heart, which is going to cause myocardial infarction.
So here's a quick rundown again, of the T's we have the gun shooting a lead bullet into
our chest trauma, toxins, cardiac tamponade pneumothorax and then we have thrombosis of
the lung or the heart. Those are your teeth. So let's go back to these now. So trauma.
If we're looking at Trauma we need to have a history of presenting illness we may see ECG
changes of various presentations and our treatment will depend on the information received. If we're
looking at tablets and toxins, we need to do a lab draw urine samples medical history to find
out what may be the cause of this. And we'll be looking for any antidotes and reversals
that we can use or symptomatic treatment, cardiac tamponade, we're going to find no pulse width CPR,
vein distension. And our treatment is going to be a Pericardiocentesis, we need to get that blood
out of there. thrombosis of the lung, again, we need a blood draw in history, the treatment
is going to be surgical embolectomy, we need to remove that clot and maybe fiber analytics.
And if it's a thrombosis of the heart cardiac, we're going to do a 12 lead ECG blood draw and the
treatment is likely going to be CPR and it depends on how the patient responds. It's extremely
beneficial for you to know the H's and the T's both and working with your patients pre cardiac
arrest and post cardiac arrest. You may be able to head off a cardiac event by being aware of these
situations and the assessments that go with it. And post cardiac arrest you may be able to reverse
the patient's condition. This is Tammy from Nurseminder, go out there and make it a great day.
Transcribed by https://otter.ai