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Flashcards in Chapter 8 Deck (64):
1

What is an Emergency?

Any situation in which the condition of a patient or a sudden change in medical status necessitates immediate attention and action

2

Types of Emergency

Pulmonary Embolus
Shock
Diabetic Reactions
Seizure
CVA
Syncope

3

Fainting also called

Syncope

4

Dizziness also called

Vertigo

5

Emergency Cart is also called

“Crash Cart”

6

Medical Imaging Professional’s Role

Preserve life
Avoid further harm to the patient
Obtain appropriate medical assistance as quickly as possible
Must be able to recognize emergency situation and initiate emergency measures

7

What does AED stand for?

automatic external defibrillator

8

What is Glasgow Coma Scale?

Address three (3) areas of neurological functioning
1. Eyes open
2. Motor response
3. Verbal response
Total of 15 pts possible

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A failure of the circulatory system to support vital body functions
Body’s reaction to illness, trauma or to severe physiologic or emotional stress

Shock

10

Shock is caused by

Loss in body fluid, cardiac failure, decrease blood vessel tone, or an obstruction in blood flow to vital organs

11

4 Classes of Shock

Neurogenic Shock
Hypovolemic Shock
Cardiogenic Shock
Vasogenic Shock

12

Caused by spinal anesthesia or damage to the upper spinal cord
Spinal cord injury, severe pain, neurologic damage
Blood vessels become relaxed and dilated
Pooling of blood in venous system

Neurogenic Shock

13

Caused by loss of blood or tissue fluid
Hemorrhage, burns, prolonged vomiting, diarrhea or medications, GI bleeding, bleeding after surgery
Insufficient amount of fluid & heart unable to pump enough to body

Hypovolemic Shock

14

Caused by a variety of cardiac disorders
Failure of heart to pump an adequate amount of blood to organs
7% of patient die from heart attack – most common cause is cardiogenic shock

Cardiogenic Shock

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Caused by sepsis, deep anesthesia, or anaphylaxis
Peripheral vascular dilation produced by factors such as toxins that directly affect blood vessels

Vasogenic Shock

16

Most common type of shock encountered in radiology dept is?

Anaphylactic Shock

17

Anaphylactic Shock is also a

Vasogenic shock

18

Anaphylactic Shock may occur

with contrast media administration
Meticulous history/questionnaire form

19

Signs & symptoms of Anaphylactic shock

must be monitored as routine procedure with contrast studies
Alert physician when signs occur (sneezing/itching……call nurse)
Mild/Moderate/Severe reactions

20

Localized itching
Injection site
Urticaria (hives)
Nasal congestion
Sneezing, coughing
Swelling – eyes, face
Tearing of eyes
Flushed, feeling of warmth (common site effect)
Nausea & vomiting

Mild Reaction

21

PE is

Occlusion of a pulmonary arteries by a thrombus
Blood clot forms and becomes lodged in the pulmonary artery

22

Decreased BP
Weak, thready pulse (rapid or shallow)
Bronchospasm, laryngeal edema, severe dyspnea, cyanosis
Dysphasia, abdominal cramping, vomiting, and diarrhea
Seizures, respiratory & cardiac arrest

Severe Reaction

23

Anaphylactic Shock Reaction

Stop the procedure & injection
Do not remove IV access
Notify the radiologist and nursing staff
Obtain crash cart
Place patient in a Semi-Fowler’s position or in a sitting position to facilitate breathing
Document reaction (important)

24

PE stands for

Pulmonary Embolus

25

PE is

Occlusion of a pulmonary arteries by a thrombus
Blood clot forms and becomes lodged in the pulmonary artery
Originates in the lower extremity and travels to the lungs (DVT)

26

PE originates

in the lower extremity and travels to the lungs (DVT)

27

PE caused by

Trauma, surgical procedures (orthopedic & abdominal), pregnancy, CHF, prolonged immobility (airplane or long car rides)
Swelling in lower extremities, pain, sudden onset

28

PE result in

50,000 deaths each year

29

A group of metabolic diseases which result from a disorder of carbohydrate metabolism

Diabetes Mellitus

30

Diabetes Mellitus is caused from

insufficient production of insulin or inadequate utilization of insulin

31

Diabetes Mellitus results in

abnormal amount of glucose in the blood or hyperglycemia

32

How many types of Diabetes?

4 types
Type I: gestational diabetes
Type II: associated with other conditions

33


Hypoglycemia

Excessive insulin (sugar) is present (low blood sugar)
Characteristic of diabetes

34

Hypoglycemia occurs

If patient takes normal dose of insulin and does not eat (exam prep)
Example: inpatient comes to radiology after taking insulin but before eating breakfast

35

Hypoglycemia Rapid onset of symptoms:


Intense hunger, weakness, shaky, sweat excessively, confused or irritable
Need a quick form of carbohydrate or take a glucose tablet

36

Diabetic Ketoacidosis

Insufficient insulin causes liver to produce more glucose resulting in hyperglycemia
Kidneys then excrete glucose with water & electrolytes resulting in polyuria, dehydration & electrolyte imbalance

37

Hyperglycemia develops

Gradually over a period of hours/days
Excessive thirst & urination, dry mucosa, rapid and deep breathing, drowsiness & confusion
Insulin required – leads to diabetic coma if left untreated

38

Diabetic Ketoacidosis may result from

a patient being detained within the imaging department and missing their insulin medication

39

Without insulin

Cells cannot use the sugar in the blood and the cells need energy to survive.
Body switches to a back up mechanism.
Affects patients with Type 1 diabetes

40

Diabetic Ketoacidosis Symptoms

Tachycardia
Headache
Blurred or double vision
Extreme thirst
Sweet odor to the breath

41

Responsibility for Diabetic Ketoacidosis

Stop the procedure and notify nursing staff/radiologist
Do not leave the patient unattended

42

Cerebral Vascular Accident (CVA) also called

“Stroke or Brain Attack”

43

What is CVA?

Due to occlusion or rupture of the blood supply to the brain

44

CVA range from

Mild attacks to severe
Life-threatening situations

45

CVA symptoms are

Paralysis on one or both sides
Slurred or no speech
Extreme dizziness
Loss of vision
Severe headache
Temporary loss of consciousness

46

Generalized brain function disturbance and are accompanied by changes in LOC

Seizures

47

Seizures Symptoms

A symptom of an underlying condition
Little or no warning and lasting only seconds to several minutes

48

Seizures caused by

Infectious disease
Extreme stress
Head trauma
Brain tumors
Vascular disease
Congenital malformation
Odors and flashing lights – seizure prone patients

49

Generalized Seizures

Affects both sides of brain
Different types: Tonic-clonic or Grand mal seizure; absence or petit mal seizure

50

Generalized Seizures Symptoms

Utter a sharp cry as air is rapidly exhaled
Muscles become rigid and eyes open wide
Jerky body movements & rapid, irregular respirations
Vomit or froth
Urinary or fecal incontinence
Falls into a deep sleep after seizure

51

Patients who have reoccurring seizures due to brain disorder

Epilepsy

52

Affects one side of brain

Focal or Partial Seizure: Complex

53

Symptoms of Focal or Partial Seizure: Complex

Remain motionless or experience emotional outburst of fear, crying, or anger
Facial grimacing, lip smacking, swallowing movements, or panting
Confusion for several minutes after episode with no memory of incident (affects memory)

54

Condition of Focal or Partial Seizure: Complex

Finger or hand may shake
Speak unintelligibly (?
Dizzy
Sense strange odors, tastes, or sounds
Does not lose consciousness
Does not affect memory
(Can have both general and simple)

55

How to deal with Seizures pt?

Call for assistance
Protect patient’s privacy
Place pillow under patient’s head
Do not restrain the patient
Do not attempt to insert a hard object into the patient’s mouth
Prevent patient from falling; if patient knows of pending seizure (aura) assist to floor
Turn patient to a Sim’s position (pane procedure)

56

What cause Syncope?

Transient loss of consciousness
Due to insufficient blood supply to the brain

57

Syncope Reaction

Watch for orthostatic hypotension
Assist patient to a recumbent position with feet elevated
Loosen any tight clothing
Patient falling
Do NOT try to keep them up
Place knees behind patient with arms around waist & assist to floor

58

History of outbursts or history of growing confusion/disorientation

Agitated/Confused Patient

59

Increasing agitation

Rapid pacing back and forth
Animated and increasing noisy conversation with someone who is not present
Illogical thought processes
Refusal to cooperative

60

Dealing with Agitated/Confused Patient

Consult with the patient’s nurse
Request assistance (don’t handle yourself)
Leave a door open and a clear path to leave room if necessary
Approach from the side, not face to face
Do not touch patient before asking permission
Use simple (not specific), concise statements to explain purpose & procedure
Do not become involved in conversation

61

Quarrelsome & reluctant to cooperate

Intoxicated Patient

62

Neglect all rules for safety

Risk of falling from stretcher or imaging table
Keep communication simple, direct & non-judgemental
Do not leave the patient alone
Observe the patient at all times
Ask for assistance if necessary
If refuses, stop procedure

63

Moderate Reaction

Tachycardia/Bradycardia
Hypotension/Hypertension
Bronchospasm, wheezing
Constriction of the air passageways
Dyspnea
Laryngeal edema
Acute inflammation causing obstruction to air flow

64

Vertigo is a precursor (sign) to

Syncope