darryl-medical emergencies Flashcards
(38 cards)
1
Q
What is key in medical emergencies
A
recognition
2
Q
What happens to the brain under stress
A
shuts down
3
Q
Outline how a medical emergency should be dealt with
A
- keep calm
- take charge of the situation
- systematic approach
- protocols
4
Q
What is the signigicance of medical history
A
- often helpful in identifying potential problems
- medication list
5
Q
What needs to be known about chronic disorders
A
- onset of problems
- when was it diagnosed
- how was it diagnosed
- triggers and patterns
- how is it managed
- is it getting better? worse? same?
- severity of problem
- hospitalisations
6
Q
List medical emergencies (10)
A
- syncope
- angina attack
- myocardial infarction
- cardiac arrest
- acute asthma attack
- hyperventilation
- seizure
- unconscious diabetic
- anaphylaxis
- choking
7
Q
Describe syncope and what causes it
A
- most common cause of sudden loss of consciousness
- vaso-vagal reaction
- postural hypotension
- large psychological component
- young males
8
Q
what are symptoms of syncope
A
- sweating, irritability, anxiety
- may complain about feeling hot
- previous history of fainting
- medications may predispose
9
Q
what to do for syncope
A
- lie patient flat
- feet up head down position
- Drs ABCDE
- Vital signs
- cool towel on head, reassurance (palliative)
- consider oxygen
- sit up slowly
10
Q
what to do after syncope
A
- reassurance
- prevention of future episodes
- consider other forms of management
- document
- gp review if medically related
11
Q
Describe angina and symptoms
A
- acute chest pain due to myocardial ischaemia
- substernal crushing pain
- radiates through to back
- radiates to left arm and into neck and jaw
- shortness of breath
- sometimes atypical presentation
12
Q
What are some considerations for angina patients
A
- can be precipitated by exertion, cold weather, stress
- chairside manner is important
- review medical history and triggers
- ensure pt had GTN on hand if needed
13
Q
What to do in angina episode
A
- recognise symptoms
- stop procedure
- administer GTN sublingually, if not helping after 2 repeats consider MI and dial 111 (1-111 if in dent school)
14
Q
What to do while waiting for help-angina attack
A
- monitor vital signs
- oxygen
- reassurance
- record GTN doses given and what route
- NO2
15
Q
Describe myocardial infarction and symptoms
A
- may be end result of angina
- end point of acute coronary syndrome
- symptoms may begin like angina
- nausea, sweatiness, pallor
- may not necessarily lead to cardiac arrest
16
Q
What to do for myocardial infarction
A
- Call 111 or 1-111
- monitor vital signs
- administer 400mcg GTN
- aspirin-300mg
- oxygen if low oxygen sat, in heart failure or cardiogenic shock
17
Q
What to do for cardiac arrest
A
- 111
- consider precipitating events
- medical history clues
- render pt safe
- DRS ABC
- CPR until help arrives
- for adults, usually cardiogenic
- for kids, usually respiratory
18
Q
outline DRSABCD
A
- Dangers
- Responsive
- Send for help
- Airways
- Breathing
- CPR
- Defib
19
Q
What are symptoms of stroke and what to do
A
- FAST (face, arms, speech, time) drooping
- recognise
- call 111 immediately
- consider oxygen
- monitor vitals
- comfort patient
20
Q
What are some considerations for asthmatic pts.
A
- identify medical history
- review MH and symptoms
- triggers include stress and anxiety
- pre-op inhaler dose prior to starting procedure
21
Q
What are symptoms of asthma attack
A
- pt can breathe in but not out
- pt distress
- polyphonic wheeze (rule out foreign body obstruction)
- shortness of breath
- tightening of chest
22
Q
What to do for asthma attack
A
- stop procedure
- sit pt upright or slightly forward
- administer salbutamol (beta 2 adrenergic receptor agonist) for bronchodilation
- 2 puffs every 6 mins up to 3 times
23
Q
What are some extra considerations for asthma attack
A
- use of spacer
- nebuliser?
- oxygen
- oral steroid
- 111
- anaphylaxis as alternate scenario?
24
Q
What are signs of a life threatening asthma attack
A
- silent chest
- cyanosis
- confusion/agitation
- bradycardia
- unable to speak
25
What to do for hyperventilation
- stress/emotion induced
- blowing off CO2
- acute respiratory alkalosis-can progress to syncope
- sit pt upright
- reassure
- breathe into cupped hands
- oxygen?
26
What to know abt seizure pts
- past medical history and meds
- current med levels
- last event
- triggers
- aura?
- how long does the event last?
- patterns?
27
What to do for seizure
- have pt signal
- remove everything from mouth
- clear a safe zone around pt
- do not place anything in pt's mouth
- maintain airway
- recovery position when possible
- record start and finish time
- call 111
28
What to do after seizure
- pt will be tired
- pt may be messy-incontinence
- reassurance
- GP review
29
What to do for long seizure/status epilepticus
consider benzodiazepines (IV access)- diazepam 5-10mg
- midazolam 10mg IV
- diazepam 0.5mg rectally
30
Describe symptoms of hypoglycaemia
- sweaty, pale
- rapid pulse
- tremors or shaking
- feeling hungry
- dizziness, confusion
- slurred speech
- unresponsive
31
What to do for unconscious diabetic
- DRSABCDE
- 111
- identify diabetic history
- never give insulin
- glucagon 1mg IM or IV- 5 mins to act
- 20-50ml 20% dextrose soln. IV over 1-3mins
- Check BSL and vitals
- diabetic ketoacidosis is a metabolic emergency, IV if possible
32
Describe anaphylaxis
- massive release of histamine
- feeling of impending doom
- cold, clammy, unwell
- swelling/oedema
- airway compromise
- loss of consciousness
- hypotension
- peripheral shutdown
33
What to do for anaphylaxis
- lie pt flat
- DRSABCDE
- 111
- oxygen, 8-10l/min
- maintain airway: consider adjuncts or surgical airway
- adrenaline
- IV if possible
- consider steroids and H1 antihistamine (0.5mg)
- Epipen (0.3mg)
34
Describe symptoms of choking
- universal sign of choking
- distress
- ineffective cough
- cyanosis
- loss of consciousness
35
What to do for choking
- 5 back blows
- 5 chest thrusts
- no heimlich?
- repeat until cleared or LOC
- call 111 if unconsious-consult collapse algorithm
36
What is some basic emergency equipment
- oxygen apparatus
- syringes and needles
- spacer
- oropharyngeal airways
- AED
37
What are some basic emergency drugs
- Glyceryl trinitrate
- adrenaline 1:1000 soln
- soluble aspirin 300mg
- salbutamol
- dextrose 10%
- glucagon
- normal saline
- antagonists for sedation agents
- corticosteroid injectable
38
revision points
- anywhere, anytime, anybody
- MH clues
- keep calm, take control
- know who and what to call
- know protocols
-practice scenarios
- basic emergency kit
