Exam 1 Flashcards
(74 cards)
1
Q
How many medical emergencies occur in a spand of 10 years within a U.S dental office?
A
7 1/2
2
Q
How many of the medical emergencies are life threatening?
A
1/3
3
Q
What occurs with increasing age of population?
A
The increase of medical emergencies
4
Q
What are the most common emergencies ?
A
- Syncope
- Mild allergic reaction
- angina pectoris
- Orthostatic hypotension
- Most likely to occur after the administration of a local anesthetic extraction or endodontics
5
Q
How do you try to prevent medical emergencies within a dental office?
A
- Thorough medical history
- Vital signs
- Preparing for a medical emergency
6
Q
What are a few conditions that patients may report within medical history that can increase the risk of medical emergencies?
A
- Heart conditons such as MI, CHF
- Asthma
- CVA, Frequent headaches or dizziness
- Epilepsy
- Thyroid problems
- diabetes
- Corticosteriod use
- Allergy
- Bleeding disorder
7
Q
What are some preparations for a medical emergencies in the dental office?
A
- Well-equipped medical emergency kit with o2 tank
- Current CPR training
- Attendance at CE courses on medical emergencies
- In office simulated medical emergencies
8
Q
What does vitals signs document?
A
- Pulse
- respiration
- Blood pressure
- Tempreature
9
Q
What is pulse?
A
Speed of heartbeat, its expansion and contraction of artery as blood is forced out of the heart.
10
Q
Where is pulse taken?
A
- Carotid neck
- Radial pulse in wrist
- Brachial pulse in arm
- Femoral pulse in groin
Most common site in dental office radial pulse
11
Q
What are normal pulse rate?
A
Healthy adult= 60-80 BPM
Individuals who excerise: 40-60 BPM
12
Q
Tachycardia
A
Rapid pulse rate
More than 100 BPM
13
Q
Why does tachycardia often occurs?
A
- Fever
- excersise
- nervousness
- excitment
- medications or stimulant type drugs
- disease states
14
Q
Bradycardia
A
Less than 60 BPM
Can cause:
* lightheadedness
* dizziness
* chest pain
* syncope
* circulatory collapse
15
Q
What do you treat bradycardia with/
A
Treat with atropine to increase heart rate
16
Q
Irregular pulse means?
A
Arrythmia
17
Q
Weak pulse (thready)?
A
Decrease stroke volume
18
Q
Respiration
A
- normal adult: 12-20
- Infants and children normal rate are quicker
- Newborns: 40-50
19
Q
Tachypnea
A
Abnormally fact more than 20
20
Q
Bradypnea
A
Slowed rate less than 12
*often seen in syncope
21
Q
What are abnormal breathing patterns ?
A
Biot-periods of shallow breathing alternating with apnea
Cheyne- Stokes: increased rate and depth alternating with apnea
Kussmaul- increased depth and rate greater than 20
Dyspnea- labored breathing
Stridor- harsh/Crowing ** associated with obstruction**
Wheezing- high pitch sound
22
Q
Pyrexia/fever
A
Increased temperature
23
Q
Hypothermia
A
reduced body tempreature
24
Q
What are causes of Hypothermia ?
A
- Illness
- Trauma
- Malnutrition
- Medications
25
Blood Pressure
Force exerted against the blood vessel walls
26
What is systolic and diastolic?
120/80 mmHg
Systolic- force of blood against blood vessel wall during ventricular contraction 100-120
Diastolic- force of blood against blood vessel wall during ventricular relaxation 60-80mmHg
27
What are the 10 most common medical emergencies?
* Syncope
* Mild allergic reaction
* Angina pectoris
* Postural hypotension
* Sezures
* asthma attack
* Epinerphrine reaction
* Hypoglycemia
* Cardiac arrest
* Hyperventilation
28
What are the 7 medications in a dental emergency kit?
Epinephrine (injection)
Diphenhydramine (injection or tabs)
Nitroglycerin (tabs or nitrolingual spray)
Albuterol
Glucose
Asprin (325 mg)
Oxygen
29
What is the use of the epinephrine?
Used for:
* severe allergic reactions
* anaphylaxis
* acute asthmatic episode ( to reduce bronchospasm)
30
Epinephrine causes?
vascocontriction that increases BP, heart rate and force of contaction, bronchial dilation and reduces the release of histamine.
31
Epinephrine can be ineffective if ?
Patient is taking beta blocker
32
What are adverse effects of Epinephrine?
* Cardiovascular: Tachyarrhythmias and hypertension
* Central nervous: Agitation, headache and tremors
* endocrine system : increase blood glucose
* Pregnant Female: Can decrease placental blood flow
33
Dose for Epinephrine?
Adult: .3mg
Child: .15mg
34
What is the function of Epinephrine?
Reduces hypotension, bronchospasm, laryngeal edema, prevents
additional release of histamine and other chemical mediators
35
What should Epi not be used with?
* ischemic heart disease
or severe hypertension
36
Where should Epi be administered?
Thigh
37
What is Diphenhydramie/chlorpheneramine?
Antihistamine or Intramuscluar histamine blocker
38
What is Diphenhydramie used for?
Slow to moderate allergic reactions
**When the airway is not compromised**
39
What is the difference btween Diphenhydramie/chlorpheneramine?
Chlorpheneramine does not cause as much
drowsiness
40
Nitrogylcerin Indications
Angina pectoris
Heart attack or heart failure
41
What is Nitrogylcerin?
Potent coronary vasodilator: opens up the coronary circulation
42
When not to give nitroglycerine?
* When the pt has viagra or levitra with 24 hrs
* Cialis within the last 48 hrs
* PT is on vasodilator ( because adding nitroglycerine will critically decrease BP)
43
How to administer nitroglycerine?
Adminster sublingually
* should not administer of Systolic BP is less than 90
44
Nitrogylcerin is given with pain of angina because what happens?
because there is a mismatch b/ oxygen demand and oxygen supply in the coronary circulation.
45
What are the risk of nitrogylcerine?
* If Pt is already on vasodilator and adding nitrogylcerin as another vasodilator will critically decrease the blood pressure
46
who are the most importanty people to ask if they are taking nitrogylcerine?
* Patients suffering from pulmonary hypertension
* on vasodilator or blood pressure management medications
47
How to use nitroglycerin in the forms of spray and tablet?
Tablet: Adults-1 tablet placed under the tongue or between the cheek and gum at the first sign of an angina attack,
1 Tablet every 5 mintes as needed for up to 15min.
Spray: spray in mouth, shelf life two yeats
48
How to administer nitroglycerine?
Administer sublingually
Administer at five minute intervals- uo to three doses
Should not administer if systolic BP is less than 90 mmHg
49
Oxygen is used to?
For all emergencies except for hyperventilation
50
Asprin
* Reduces overal mortality from MI (heart attack)
* Prevents progression of cardiac ischemia to cardiac injury or tissue death
* Check medical hx for allergy first
51
When such asprin not be used?
Hemorrhagic stroke
52
What is an example of a Bronchodilator
Albuterol inhaler
53
Albuterol is used for?
Asthma attack or bronchospasm
54
What is the drug effect of Albuterol ?
Dilation of bronchioles with minimal cardiobascular effects
Peaks 30-60 min
Duration- 4-6 hours
55
What is the dose of Albuterol?
Adult two sprays
Peds: 1
56
Oral Carbohydrate/ glucose symptoms
* appears confused
* cool, mosit skin
* may be hungry
* may seem drunk but not breath odor
* slurred speech
57
What should gluscose not be used for?
Can increase intra cerebral pressure but is critical for hypoglycemia
Stroke can minic hypoglycemia
58
How to treat low blood sugar
* eat/drink 15g carbs
* wait 15 min
* check blood
* less than 70mh/dl repeat steps
59
Naloxone is used for?
Opioid overdose
60
How is naloxone used?
Spray every 2-3 min into one nostril
61
What is the dose of asprin recommended?
162-325mg or 2-4 baby asprin (.81 mg each)
62
What are the factors for choosing a drug?
Convenience
Cost
Efficacy
Safety
63
What defines a medical emergency in a dental office?
An unexpected event that can include accidental or willful bodily injury, central nervous system stimulation and depression, respiratory and circulatory disturbances as well as allergic reactions.
64
What is the importance of a medical emergency team response?
- having roles to ensure coordinated and efficient response to the situation
- assigning specific roles helps create a structured and organized approach to managing th emergency.
65
What are the expectations of everyone?
1. identify emergency equipment location
2. periodically review medical emergency signs/symptoms, procedures, use and administration of emergency drugs
66
What is the GSU communications center phone numbers?
Office phone: 3-3333
Personal Cell: 404-413-3333
67
What is the address to GSU and clinic?
2101 womack road dunwoody GA 30338
Building: NC
Main clinic: 1200
mini clinic: NC 1240
Lab: NC1375
68
What are the roles of person 1:
Assess the nature and severity of the problem
Stay with the Patient
Instruct others
Provide care
69
What are the roles of person 2:
* Check time
* Assit with Vitals and oxygen
* Be the second person in two-person CPR for healthcare providers
* Bring oxygen and the emergency cart, AED and emergency form
* Prepare drugs
* Assist as needed
70
What are the roles of person 3
Notifies faculty members
Calls campus police in downtown
Record data
assist tem leader
suction if necessary
relieve others in CPR
71
After contacting 3-3333 What should you provide?
* location
* state of emergency: is the person conscious, is the person bleeding? How much?
72
What type of communication should each person of a medical emergency have?
Closed loop
73
All persons invovled in an medical emergency needs to ?
* Record their version of what happen ASAP and ensure all paperwork has been completed.
* Inform clinic assitant of any supplies used so that they may be replaced
74
Incident Report Forms are for?
* Emergency treatment record
* Needle stick incident
