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
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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
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