Question

List 10 different diagnostic tests used to diagnose alterations in central and tissue perfusion. Explain in your own words, what each test is and how it gives you information about perfusion status. At least one page

Answer 1

Perfusion : The amount of nutrients supplied by blood and the amount of cellular waste excreted from the body. Inadequate tissue perfusion indicates dehydration, shock, hypovolemia etc which results in death.

Tissue perfusion assessment is also considered as Focus examination.This assessment consists of 10 elements.

Physical Examination : Physical examination includes the entire body that is heart and it's sounds, lungs and the abnormalities, abdomen and the changes, nail beds, mucous membrane etc. which provides clear indication of altered tissue perfusion.

Vital signs : Temperature, Respiration, Blood pressure both Systolic and Mean Arterial Pressures and the Heart rate assessed at once gives a clear idea of altered tissue perfusion such as hyperthermia, tachycardia and hypotension.

Skin examination: Skin and examination of mucous membrane denotes altered perfusion , the abnormalities are pale coloured membranes, and excessive thirst showing dry mucous membranes which indicates inadequate tissue perfusion.

Capillary refill : Capillary refill gives the information regarding blood flow in the vessels.Capillary refill greater than 2 seconds indicates vasoconstriction that is constriction of blood vessels that makes blood flow difficult and takes longer time for the supply.This indicates altered or low tissue perfusion.

Cardiac output : Inadequate tissue perfusion results in abnormal cardiac output either may be the lower one or the higher one.

CO = Stroke volume / Heart Rate

Central Venous Pressure: CVP determines the body's fluid resuscitation which in terms is responsible for the flow of nutrients in the blood thus evaluating tissue perfusion.

Urine out put : Oliguria or decreased urinary output is one of the reasons for fall in the renal perfusion which makes individual tachycardia that results in decreased cardiac output and thus alteration of tissue perfusion takes place.

Nail bed pressure : This assessment provides information regarding the vascular system and it's functioning.If the nail bed after releasing pressure returns to pink in no longer than 2 seconds indicates adequate tissue perfusion.

Passive Leg Raise Examination : PLR examination is also one of the source to determine the fluid responsiveness based on cardiac output which indicates adequate tissue perfusion.

Pulse oximetry : This determines the static blood flow in the peripheral organs which is the sign of altered tissue perfusion evaluating the ratio of blood flow.