Medical Emergencies Flashcards
(26 cards)
What are the symptoms of an acute/severe asthma attack?
What are the symptoms of life threatening asthma attack?
severe:
>25 breathes per minute
tachycardia, 110 beats per minute
inbility to complete sentences in one breathe
life threatening:
<8 breathes per minute
bradycardia, <50 beats per minute
exhaustion, confusion, decreased level of consciousness
Why does asthma occur?
- person comes into contact with irritant
- smooth muscle around airway tightens
- airway becomes narrow
- lining of airway becomes inflamed and swells
what is the trreatment for an asthma attack?
- use Salbutamol inhaler, relaxes smooth muscle (Beta adrenoreceptor stimulant)
- each puff: 100 micrograms
- use large space inhaler if required
- give 10 puffs and oxygen (15 litre/minute)
- repeat this every 10 minutes
- if not responding call ambulance
why does anaphylaxis occur?
when would it occur in practice?
- it is a hypersensitivity reaction
- when giving LA, or in contact with certain materials (latex gloves)
what are the symptoms of anaphylaxis?
- urticaria (rash, swelling)
- erythema
- conjunctivitis
- rhinitis (inflammation of the nose)
- flushing/pallor
- upper airway (laryngeal) oedema, bronchospasm causing wheezing/hoarse voice
- respiratory arrest, can lead to cardiac arrest
- blood pressure falls
What is the treatment for anaphylaxis?
1) manage airway and breathing
2) restore blood pressure: lay patient flat and raise legs
3) give oxygen (15 litres/minute)
for severe reaction (bronchospasm, collaspe, rash, semi-conscious)
- give adrenaline, intramuscular injection (dorsogluteal or deltoid muscle)
- repeat every 5 minutes
- if difficulty breathing give Salbutamol inhaler
- send to hospital
- antihistamines may be used but not first line of treatment
What medication do you give for anaphlaxis?
- how much for adult (over 12 yrs)?
- 6-12 yrs?
- under 6 yrs?
-adrenaline as an intramuscular injection (dorsogluteal or deltoid muscle)
- over 12 yrs: 500 micrograms
- 6-12 yrs: 300 micrograms
- under 6 yrs: 150 micrograms
What is angina?
reduced blood flow to heart muscle, results in chest pain
What are the symptoms of angina?
- chest pain
- shortness of breathe
- fast/slow heart rate
- increased respiratory rate
- low blood pressure
- poor perfusion(capillary refill time)
- altered mental state
What is the treatment for angina?
- of the patient has their own GTN spray/tablets allow them to use it
- place under tongue
- mild symptoms may resolve and may/may not be able to continue with appointment (up to GDP). Hospital admission may not be necessary
-severe or prolonged symptoms: abandon dental treatment and call ambulance
what is a myocardial infarction?
blood supply to heart muscle stops
what are the symptoms of a myocardial infarction?
- severe crushing chest pain, radiates down arm and into jaw/neck
- pale, clammy
- nauseated
- weak pulse
- low blood pressure
- shortness of breath
What is the treatment for a myocardial infarction?
-call 999
allow patient to be in most comfortable position
-give GTN
- if not allergic: give aspirin 300mg crushe/chewed
-give oxygen 15litre/minute
-if unresponsive, check for signs of life and start CPR
NAO: nitrates, aspirin, oxygen
what is an epileptic seizure?
what type of phases are there?
- neurological disorder
- involves irregular electrical activity of the brain
- often has warning before known as aura
- tonic phase: sudden loss of consciousness, patient becomes rigid, falls to floor, cyanosis (blue fingers)
- clonic phase: limbs jerk, may lose control of bladder, may bite tongue/cheek
- seizure often lasts a few minutes
- patient will be very tired and may be confused when recovers
What is the treatment for epileptic seizure?
1) clear the area
2) ensure nothing is in their mouth
3) do not restrain the patient
4) time seizure
5) administer oxygen 15 lire/minute
6) once fit is over, place in recovery position
7) If unresponsive check for signs of life
- Consider Hypoglycaemia
- Check bp as if low can cause cerebral hypoxia leading to a seizure
8) if seizure lasts more tha 5 minutes: call ambulance
9) administer Midazolam bucally
What medication is given for epileptic seizure?
What are the doses for adults over 10yrs
children 5-10 yrs?
children 1-5 yrs?
Midazolam
over 10 yrs: 10mg
5-10 yrs: 7.5mg
children 1-5 yrs: 5mg
What is hypoglycaemia?
who often gets it?
when is it lowest?
when blood glucose drops below 4.0mmol/L
diabetics, their insulin levels aren’t normal
most lowest in the morning
What are the symptoms of hypoglycaemia?
sweating, headache difficulty concentrating aggression/irritated slurred speech shaking, seizure
what is the treatment for hypoglycaemia?
in early stages?
if severe?
1) can check blood glucose using a pin-prick tester
early stages, note patient is cooperative and has gag reflex:
1) give oral glucose/gel
2) repeat every 10-15 minutes
if severe, patient is impaired and unable to swallow:
1) give glucose gel buccaly
2) adminster Glucagon injection- intramuscular
3) check blood glucose after 10 minutes
- if unresponsive: check signs for life and start CPR
4) if responsive give glucose/carbohydrates
5) if they have been accompanied they can go home, do not allow them to drive
6) inform GP
What medication is given for severe hypoglycaemia?
what are the doses for adults >8 yrs?
for under 8 yrs?
Glucagon
adults >8 yrs: 1.0mg
under 8 yrs: 0.5mg
What is fainting?
poor cerebral perfusion and oxygenation leads to loss of consciousness.
causes:
- low bp from vagal overactivity
- stress/pain
- hyperventilation
medication:
- ACE inhibitors
- angiotensin
what are the symptoms of fainting?
- Patient feels faint / dizzy / light headed
- Slow pulse rate
- Low blood pressure
- Pallor & sweating
- Nausea & vomiting
- Loss of consciousness
What is the treatment for fainting?
- Lay patient flat and raise legs
- Loosen tight clothing
- Give O2 (15 litres/min)
what can cause choking/ asphyxiation in dental environment?
- working with small instruments (burs, metal clamps, crowns, cotton wool roll)
- Anaesthetic can reduce normal protective pharyngeal reflexes
