General and Office Emergencies Flashcards
Health Literacy
Written info should be at 5th grade level
Poor health literacy = poor outcomes
Use visual aids
Most common office emergencies
Anaphylaxis Cardiac arrhtymia Acute bronchospasm Shock Syncope
Key Components for Office Emergency Plan
Training Drills Education Tech / Resources Communication
Anaphylaxis
Protracted can take more than 24 hours for symptoms
Rhinitis, angioedema, N/V, rash, urticaria, resp. distress, palpitations, wheezing / stridor
Airway patency is priority
Epi 1:1000 0.2 - 0.5 mg IM
Benadryl 25-50 mg IM or IV
Beta agonist inhaled
Immediate ED referral / call 911
Bite / Stings Emergency
ED refer if anaphylaxis
ED refer all snake bites
ED refer Black Widow / Brown Recluse bites
Brown Recluse Bite
Firm, mild lesion that is PAINLESS
May become necrotic
Treatment is Td, Antibiotics, supportive
Black Widow Bite
PAINFUL redness / swelling
Muscle cramps
May mimic peritonitis
Treatment is Supportive, anti-venom is rare and seldom needed
A-Fib Emergency
Anti-coagulation to prevent thrombus Rate control (digoxin or diltaziem) Rhythm control (amiodarone) Risk modification Refer to cardiology
Orthostatic Hypotension
Decrease in systolic by 20 OR decrease in diastolic by 10
May be due to decreased baroreceptor from aging or other disease / hypovolemia
Causes of syncope
Neurally mediated (most common, more common in younger adults) Orthostatic hypotension (more common in elderly) Cardiac (mechanical or arrhythmia)
Systemic Inflammatory Response Syndrome
Two of:
- Temp >38.8 or < 35.5
- Pulse >90
- Resps >20 or ETCO2 <32
- WBC >12,000 or <4,000 or 10+ immature bands
Sepsis Management
ABCs Infection control - obtain blood cultures then antibiotics Steroids only for refractory shock Fluids Glycemic control Nutrition support
All suspected sepsis need ED refer
BMI
<18.5 - underweight 18.5-24.9 - normal 25-29.9 - overweight 30-34.9 Obese 1 35-39.9 Obese 2 40-49.9 Obese 3 50-59.9 Obese 4 60+ Obese 5
A sustained 7% reduction in weight improves outcomes / health
Central Adiposity
Increased waist circumference equals increased CV risks
Men waits 40+ = increased risk
Women waist 35+ = increased risk
Dietary Guidelines
Advice and guides on what to eat / drink to meet nutritional goals, promote health, and prevent disease
