Signs of Pneumonia: 1. Shortness of breath 2. Rapid, shallow breathing 3. Auscultation: Isolated crac les or crac les!ronchi throughout ".

Sp#2 le$els decreasing below patient normal $alue %. &ough: either dr' or producti$e (green, brown, 'ellow, blood') *. &hest pain that worsens with deep breath or when coughing +. ,e$er, sha ing, chills -. .ab /alues: Increased 01& and!or increased neutrophils 2. 34Ra' 15. #rganisms in sputum 11. Pt. ma' be pale, dus ', blue 12. 6iaphoretic, loss of appetite, fatigue and (in elderl') confusion 8arl' signs of Sepsis: (A1 iller in of &ritical &are patients) 1. Suspected Infection 2. :wo out of four: a. :empB155.", C2*.b. 7RB25 c. RR B25 or P&#2C32 d. 01& B12,555 or C"555 or 15; bands 3. S1P C25 after 25435cc! g fluid bolus (1.%43 liters of fluid) ". 8le$ated lactic acid ( .67, .actate) %. 6ecreased platelets *. 6ecreased P#2 below patient normal ". Altered mental status not due to drugs ma' signif' organ failure. Signs of Se$ere Sepsis: 1. Patient recei$ing antibiotics = needs /asopressor (this is a dangerous sign). 2. Pt showing signs of organ failure in 2 D s'stems for CE 2" hrs. 3. AR6S, 6I&, 9S#, &riteria for #rgan ,ailure: 1. &ardio$ascular: a. S1P CE 25 b. 9AP CE +5 for 1 hour or &/P B-412 c. &F, &F91, :roponin ele$ated 2. 7emod'namics: a. Platelets C-5,555 b. %5; decrease in platelets o$er 3 da's 3. Renal: a. G#P C 25cc!hour (with &/P B-412) b. 7igh &reatinin and 1GH , <,R B22 c. Increased electrol'tes (7igh F, 9g, and Ha) d. Increased Gric Acid e. 9etabolic Acidosis f. Increased 1P g. Prolonged bleeding ". 7epatic: a. Iaundice b. 7igh AS: and A.:, 1iliruben, <amma4<t c. 6ecreased Albumin d. &oagulation abnormalities %. 9etabolic: a. CE+.35 b. 18 BE % c. .actate B2.5 once &/PB -412 *. Respirator': a. Pa#2!,i#2 CE 2%5 b. 8arl' A1< E Respirator' Al alosis due to high RR a. .ater A1< E 9etabolic Al alosis due to low perfusion

7igh Ris for 6I&: 1. Infection in blood (Sepsis) 2. Se$ere tissue inJur', as in burns, head inJur', trauma. 3. Recent surger' or anesthesia ". Reaction to transfusions %. .abor = deli$er' problems *. .i$er disease 7igh Ris for AR6S: 1. Aspiration 2. Pneumonia 3. Sepsis ". :ransfusion %. .ung contusion *. Inhalation inJur' +. Hear 6rowning -. &hemical inhalation Signs of AR6S 1, S#1 2. .abored 3. &'anosis ". :ach'pnea %. 6ecreased 1P (Shoc ) *. #rgan failure +. Rales! crac les (fluid) -. A1< E Respirator' Acidosis 2. &hest 34Ra' 7igh Ris for P8: 1. Prolonged bed rest, long car car or plane rides, etc. 2. Surger', especiall' pel$ic 3. &hild birth ". 9assi$e trauma %. &ancer *. Stro e +. 7eart attac -. 7eart surger' 2. ,racture of hip or femur Signs of P8: 1. :ach'pnea: increased rate and depth. (+5; of cases) 2. Rales (%5; of cases) 3. A1< is normal ". 6'spnea at rest %. 6iaphoretic *. &hest pain occurs suddenl' = ma' worsen with deep breath, cough, mo$ement +. &ough began suddenl', ma' be blood' sputum -. :ach'cardia (35; of cases) 2. An>iet' 15. 1luish or dus ' s in 11. 646imer (+5; false positi$e). 12. /!? Scan (best indicator -+;) 13. :reatment @ pre$entati$e (support $entilation, anticoagulants)