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Flashcards in Medical Emergencies Deck (30)
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1

Types of Emergencies

Shock
Anaphylaxis
Pulmonary Embolism
Diabetes related
Cerebral Vascular Accident (CVA) (stroke)
Cardiac/Respiratory failure
Syncope (fainting)
Seizures

2

What is shock and the 3 stages

Bodies pathological reactions to illness, trauma or stress

1. Compensatory
2. Progressive
3. Irreversible

3

Compensatory Stage
(5)

1. Skin cold and clammy
2. Nausea, dizziness
3. Respiratory increase (SOB)
4. BP decrease/pulse rate increase
5. Anxiety increase , patient may be uncooperative

4

Progressive Stage
(7)

1. BP ⬇️ sig, ⬆️pulse rate
2. Respiration shallow/rapid
3 Pulmonary edema (acute resp distress)
4. Tachycardia (as high as 150bpm)
5. Complaints of chest pain
6. Mental status/behavior changes, may LOC
7. Renal, hepatitis, GI, hematologist problems occur

5

Irreversible Stage

1. BP remains low
2. Renal and liver failure
3. Release of necrotic tissue toxins, acidosis occurs

6

Types of shock

-Hypovolemic
-Cadiogenic
-Distributive (neurogenic, septic, anaphylactic)

7

Hypovolemic Shock what is it and classes.

Loss of intravscular fluid 15-40% (blood, plasma, vomiting/diarrhea, meds)
Class 1: blood loss of 15%
Class 2: 15-30%
Class 3: 30-40%
Class 4: 40% or more
S&S: excessive thirst, cold extremities, cold/clammy skin, cyanosis lips/nails, can lead to respiratory/cardiac failure if not tx

8

Cardiogenic Shock what is it and S&S

Failure of heart to pump adequate amount blood to vital organs. Most vulnerable: myocardial infarction, cardiac tamponade, dysthymia, cardiac pathology
S&S: chest pain, dizzy/resp distress, cyanosis, restless/anxiety, change in consciousness, irregular/slow pulse, tachycardia/tachypnea, hard to find carotid pulse, ⬇️BP, ⬇️ urinary output, cool/clammy skin

9

Distributive shock. What is it?
3 types?

Pooling of blood in peripheral blood vessels-⬇️ venous return to heart, ⬇️BP, ⬇️ tissue perfusion, blood vessel inability to return blood to heart

Neurogenic, septic, anaphylactic

10

Neurogenic shock. What is it? Symptoms? People susceptible?

Disruption of autonomic pathways in spinal cord causing vasodilation of peripheral vessels

S: hypotension, Bradycardia, warm dry skin, cool extremities, ⬇️ peripheral pulse

People: Severe pain, neurological damage, spinal cord injury, meds, adverse effect of anesthesia, blood sugar levels

11

What is septic shock? Phases

Body invading by bacteria, body releases chemicals that ⬆️ capillary permeability and vasodilation
First phase: hot/dry/flushed skin, ⬆️HR/resp, fever, nausea/vomiting/diarrhea, normal-excessive urine output, poss confusion
Second phase: cool/pale skin, norm/subnorm temp, ⬇️BP, ⬆️HR/resp, oliguria/Anuria, seizures/ organ failure

12

What is Anaphylactic Shock? Levels of reaction

Exaggerated hypersensitivity to exposure to antigen, allergic reaction
Mild: within 2hrs, congestion, eye swelling, itching, tightness in chest/mouth/throat, anxiety
Moderate: all same as mild except faster, warmth/itching/urticaria, anxiety, bronchospasms/edema of airway, dyspnea/cough/wheezing
Severe: same but abrupt, ⬇️BP/weak/thready, rapid progression of bronchospasm/laryngeal edema/severe dyspnea/cyanosis, dysphasia/ab cramp/vomiting/diarrhea, seizures/resp/cardiac arrest

13

What is diabetic ketoacidosis?
S&S

Life threatening, uses fat instead of glucose due to no insulin, fat breakdown builds up ketones in blood/urine, ⬆️levels poisonous/acidify urine
S&S: sweet odor breath, warm/dry skin/mouth, thirst, deep rapid resp, tachycardia/weak/thread pulse/coma, weak, drowsy, pain, nausea

14

What is hyperosmolar hyperglycemia nonketotic syndrome (HHNS)
S&S

high blood sugar common in type 2
Dehydrated/dry skin/sunken eyes, hypotension/tachycardia/⬆️temp, confused/seizure/coma

15

What is hypoglycemia? What to do?

Too much insulin or not enough food.
Mild: mild tremor, sweating, hunger, tachycardia, nervousness/irritability
Moderate: h/a numb lips/tongue, confusion, sweating, cold/clammy skin, blurred vision, slurred speech, irrational behavior
Severe: disoriented, impaired motor function, unarousable, ⬇️LOC, seizure, coma

Give 2-4 glucose tabs, vitals

16

What is pulmonary embolism? Signs? What to do?

Blood clot in pulmonary artery.

Caused by trauma, surgery, CHF, pregnancy, prolonged immobility

Signs: rapid/weak pulse/tachycardia, dsy/tachypnea, cough, syncope, hypotension, change in LOC, sudden death

Crash cart, monitor vitals, prepare to assist with O2

17

What is CVA? Signs?
What to do?

Blockage/rupture of blood supple to brain.

Tech Must be quick!!! 5 min or less.
Numbness, one sided weakness, confusion, dizzy, stiff neck, ataxia, nausea/committing, LOC

Prepare to assist with 02, IV, meds

18

What is cardiac arrest? Signs? What to do?

Heart stops beating effectively.
Electrical activity disrupted, hypovolemic Shock, cardiac tamponade, hypothermia, pulmonary embolism, over dose, MI

Signs: LOC, pulse, BP, dilation of pupils, seizure

Shake and ask if ok, call code if unresponsive, carotid pulse, supine, cpr

19

What is respiratory arrest? Signs? What to do?

Gas exchange not adequate to meet needs of body due toblocked airway, overdose, injury, coma, disease

Pt not responding, pulse cont then stops, chest movt stops

Shake and ask if ok, call code if unresponsive, carotid pulse, supine, cpr

20

What is syncope? Causes? Signs? What to do?

Fainting/LOC

Heart disease, hungry, poor ventilation, emotional trauma, extreme fatigue

Pallor/dizzy/nausea, hyperpnea/tachycardia, cold/clammy skin
Elderly may have orthostatic hypotension(bp⬇️ when standing)

Watch NPO's, lie down, place supine w/legs up, assist to ground, kidney basin

21

What is seizure and types?

Uncontrolled electrical activity of brain
Generalized and partial (Complex and simple)

22

Signs of generalized seizure what to do?

Sharp cry, rigid muscles, rapid irregular movements, froth, incontinence, vomit

Don't put anything in mouth, remove dentures, track time of seizure, sims after face down, don't restrain

23

Signs of complex and partial

Complex- motionless or emotional outburst, facial grimacing, confusion, doesn't know it happened

Simple- finger/hand may shake, can't speak properly, dizzy, strange smells/tastes/odors, no LOC

24

Types of head injuries? Signs of each. What to do

Closed- degrees of LOC, lucid and unconscious, loss reflexes, change in vitals, headache/dizzy/visual disturbance, unequal pupils, sz, vomit, hemiparesis

Open- degrees of LOC, hemorrhage, hearing loss, CSF cans drop from nose/ears, periorbital ecchymosis

Head/neck immobilized elevate 15-30 degrees,
Don't remove dressings/collars/sandbags, keep temp normal, check pulse and resp, never suction through nose

25

Most common area for spinal cord injury? 2 types. How to move them?

C and L spine
Complete partial
Log roll

26

Signs of complete and partial spinal cord injury. What to do?

Complete- paralysis, loss of sensation, resp distress, bradycardia, loss temp control, unstable BP, bowel/bladder incontinence, loss of sweating

Partial- asymmetrical paralysis, asymmetrical loss of reflexes, some sensory retention, more stable BP, sweat unilaterally

Monitor vitals, maintain airway, log roll, don't move head/spine, don't remove collars etc, observe any changes, keep warm

27

Open and closed fractures, what to do

If possible don't remove splints, support limb above and below fracture when moving, try to keep limb immobilized

28

What to do with unconscious patient?

Never leave unattended, maintain airway, keep pts NPO, be aware of decubitus ulcers, still explain procedure

29

What is on a crash cart?

Backboard, stethoscope/cuff, ambu bag, laryngoscopes, oxygen flow meter, airway tubes, endotracheal tubes, suction, gloves, needles syringes, sterile gauze, alcohol swabs

30

Drugs on crash cart

Adrenaline, Benadryl, caffeine sodium benzonate, glucagon, heparin, lasix, nitrostat, Valium