A patient calls approximately six hours after a tooth extraction to report an increase in bleeding. What is a likely cause of the increased bleeding?
What will be an ideal response?
Epinephrine provides nearly equal ? and ? effects; however, not at the same time. Initial ? vasoconstriction of peripheral vasculature allows time for the anesthetic drugs to bind to receptor sites. Later, ?2 vasodilatation predominates. This has been observed before and after surgery when epinephrine has been administered. Initially, the ? effect enhances profound, durable anesthesia and reduces hemorrhaging at surgical sites. Postoperatively, the dominant ?2 effects can result in increased bleeding approximately six hours after surgery.
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On-scene you are presented with a confused patient suffering from altered mental status. Additionally, in front of the family, the patient is very irritable and verbally abusive toward all present, including EMS. His wife states that his "kidneys are no good" and he also has "sugar" problems. Your assessment indicates that he is dyspneic with pale skin that is covered with a fine white sediment
His radial pulse is weak, rapid, and irregular. Additionally, you note edema to his hands, feet, and face. Crackles are noted to the lungs bilaterally and he has a dialysis graft on his right forearm. Your partner reports that his heart rate is 164, respirations 26, blood pressure 176/90, and SpO2 89%. After applying high-concentration oxygen, which of the following would you perform next? A) Administer furosemide, 120 mg B) Infuse a 1000 mL bolus of NS C) Determine the blood glucose level D) Administer sodium bicarbonate, 50 mEq
Ideally, the ITLS Primary Survey should take less than:
a. 5 minutes b. 2 minutes c. 3 minutes d. 4 minutes