Medical Emergencies Strategies Flashcards
(95 cards)
1
Q
Overview of Myxedema Coma
A
Inability of the body to compensate for a severe deficiency of thyroid hormones
2
Q
Signs and Symptoms of Myxedema Coma
A
confusion apathy depression possible psychosis hypothermia < 95 dg F hair loss facial changes cool, dry skin bradycardia seizures
3
Q
Treatment of Myxedema Coma
A
position patient supinely normalize temperature with blankets administer 02 4-6L/minute monitor vital signs contact EMS
4
Q
Overview of obstructed airway
A
blocking of the airway by some object
5
Q
Signs and symptoms of obstructed airway
A
coughing stridor cyanosis placing hands in throat area eventual loss of consciousness if complete blockage
6
Q
Treatment of obstructed airway
A
sit patient upright
encourage coughing
do not apply back blows
if total blockage suspected in conscious patient, use Heimlich maneuver
if total blockage suspected in unconscious patient, place patient in supine position and perform procedure for obstructed airway determined by the American Heart Association
7
Q
Overview of Pulmonary edema
A
result of swift, abrupt accumulation of fluid in the alveolar spaces of lungs often as a result of heart failure
8
Q
Signs and symptoms of pulmonary edema
A
grasping for air rapid pulse cool, moister skin cyanotic lips, nail beds anxiety cough with frothy, blood-tinged sputum
9
Q
Treatment of pulmonary edema
A
position patient upright or semi upright perform CABs of CPR contact EMS administer O2 10L/minute monitor vital signs perform bloodless phlebotomy
10
Q
Overview of adrenal crisis
A
severe reduction in cortisol production
11
Q
Signs and symptoms of adrenal crisis
A
fatigue lethargy muscular weakness headache confusion fever nausea vomiting abdominal pain hypotension tachycardia diaphoresis dehydration
12
Q
Treatment of adrenal crisis
A
contact EMS
administer O2 4-6 L/minute
monitor vital signs
13
Q
Overview of mild allergic reaction
A
hypersensitive reaction to an allergen
IgE response followed by the release of histamine and other chemical mediators
14
Q
Signs and symptoms of mild allergic reaction
A
localized redness pruritus edema urticaria conjunctivitis pale or flushed skin rhinitis
15
Q
Treatment of mild allergic reaction
A
administer chlorpheniramine 10 mg orally for three days
16
Q
Overview of moderate allergic reaction
A
hypersensitive reaction to an allergen
IgE response followed by the release of histamine and other chemical mediators
17
Q
Signs and symptoms of moderate allergic reaction
A
systemic redness pruritus edema urticaria rhinitis abdominal pain cramping diarrhea bronchospasm/mild dyspnea
18
Q
Treatment of moderate allergic reaction
A
administer diphenhydramine 50 mg IM
administer chlorpheniramine 10 mg orally for three days
administer O2 as needed
monitor vital signs
19
Q
Overview of severe anaphylaxis allergic reaction
A
Type I allergic reaction with an immediate hypersensitivity
most severe allergic response
20
Q
Signs and symptoms of severe allergic reaction
A
systemic redness pruritus edema urticaria rhinitis angioedema of the lips, eyes, and larynx bronchospasm with sever dyspnea and wheezing hypotension tachycardia/arrhythmias decreased consciousness
21
Q
Treatment of severe allergic reaction
A
contact EMS
position patient supinely with legs elevated
administer epinephrine 0.2 mL - 0.5 mL IM
administer 02 4-6 L/minute
administer 100-500 mg hydrocortisone IM
administer diphenhydramine 50 mg IM
monitor vital signs
22
Q
Overview of angina pectoris
A
chest pain because of inadequate blood supply to heart muscle
23
Q
Signs and symptoms of angina pectoris
A
chest discomfort pressure burning heaviness squeezing choking radiates from shoulder down arm to neck, lower jaw, tongue diaphoresis nausea pallor duration of 1-15 minutes
24
Q
Treatment of angina pectoris
A
terminate procedure
position patient upright or semi supine
perform CABs of CPR
administer O2 4-6 L/minute
monitor vital signs
administer nitroglycerine if patient is not hypotensive-patient’s preferably, or spray from kit (can administer three doses in 15-minute period)
if episode ceases, can resume treatment if patient feels well enough
if pain more severe than normal or if pain does not cease, contact EMS and treat as myocardial infarction
25
Overview of asthma attack
chronic respiratory disorder with narrowing of the bronchial airways
26
Signs and symptoms of asthma attack
```
dyspnea
wheezing
coughing
chest tightness
pallor
```
27
Treatment of asthma attack
position patient upright with arms forward
have patient self-administer own bronchodilator
if patient does not have bronchodilator use one form emergency kit - albuterol
administer O2 4-6 L/minute
monitor vital signs
28
Overview of broken instrument tip
broken instrument tip in gingival tissue
29
Signs and symptoms of broken instrument tip
missing tip from end of instrument
30
Treatment of broken instrument tip
isolate area
ask patient not to swallow
examine sulcus for tip
remove with curette or magnetized retriever
if tip cannot be located clinically, take radiograph to locate tip and remove
31
Overview of cardiac pacemaker malfunction/implantable cardioverter defibrillator
malfunction of cardiac pacemaker or ICD possibly because of electromagnetic interference
32
Signs and symptoms of cardiac pacemaker malfunction/implantable cardioverter defibrillator
```
lightheadedness
dizziness
dyspnea
moist, pale skin
weakness
bradycardia or tachycardia depending on reason for implantation
chest pain
swelling in extremities
prolonged hiccoughing
muscle twitching
possible altered mental status
```
33
Treatment of cardiac pacemaker malfunction/implantable cardioverter defibrillator
position patient comfortably, probably upright
turn off interference
check pulse rate
if normal pulse rate does not resume or if consciousness is lost, contact EMS and prepare for CPR
34
Overview of cerebrovascular accident
abnormal condition of the brain characterized by occlusion or hemorrhage of a blood vessel resulting in a lack of oxygen to brain tissues
35
Signs and symptoms of cerebrovascular accident
```
severe headache
increased BP
neck pain or stiffness
inability to stand or walk
unequal pupils
vision changes
difficulty swalling
nausea and vomiting
facial paralysis
paresthesia on one side of body
speech impairment
altered level of consciousness
```
36
Treatment of cerebrovascular accident
position patient semi upright
contact EMS
administer O2 if needed
monitor vital signs
37
Overview of diabetic ketoacidosis
severe hyperglycemia because of insufficient blood glucose levels
38
Signs and symptoms of diabetic ketoacidosis
```
poor skin turgor
warm, dry skin
thirst
muscle weakness
fatigue
nausea/vomiting
blurred vision
tachypnea/kussmaul breathing
fruity odor on breath
hypotension
tachycardia
```
39
Treatment of diabetic ketoacidosis
contact EMS
determine blood glucose level
monitor vital signs
administer O2 4-6 L/minute
40
Overview of amphetamine toxicity
overdose of amphetamines resulting in overstimulation of the CNS
41
Signs and symptoms amphetamine toxicity
```
euphoria
restlessness
talkativeness
anxiety
agitation
confusion
flushing
diaphoresis
anorexia
seizures
tachycardia
hypertension
intercranial hemorrhage
chest pains
heart palpitations
```
42
Treatment of amphetamine toxicity
```
contact EMS
provide basic life support (BLS)
monitor vital signs frequently
provide external cooling measures
can administer a benzodiazepine to control agitation
```
43
Overview of cocaine toxicity
overdose of cocaine resulting in overstimulation of the CNS
44
Signs and symptoms of cocaine toxicity
```
anxiety
agitation
hyperthermia
chest pain
tachycardia
hypertension
arrhythmias
dyspnea
seizuers
hallucinations
cerebral hemorrhage
ventricular fibrillation
MI
cardiovascular accident
```
45
Treatment of cocaine toxicity
```
contact EMS
provide BLS
monitor vital signs frequently
provide external cooling measures
can administer a benzodiazepine to control agitation
```
46
Overview of opiate/opioid toxicity
overdose of opiates or opioids resulting in CNS depression
47
Signs and symptoms and opiate/opioid toxicity
```
lethargy
myosis
shallow respirations
hypotension
hypothermia
bradycardia
flaccid muscles
severe overdose; coma, respiratory depression, death
```
48
Treatment of opiate/opioid toxicity
```
contact EMS
provide BLS
administer O2 4-6 L/minute
monitor vital signs frequently
provide external warning measures
```
49
Overview of barbiturate toxicity
overdose of barbiturates resulting in CNS depression
50
Signs and symptoms of barbiturate toxicity
```
dose dependent
moderate toxicity:
lethargy
slurred speech
ataxia
nystagmus
severe toxicity:
hypothermia
myosis
hypotension
bradycardia
pulmonary edema
coma
respiratory arrest
```
51
Treatment of barbiturate toxicity
contact EMS
provide BLS
monitor vital signs frequently
provide external warming measures
52
Overview of benzodiazepine toxicity
overdoes of benzodiazepines resulting in CNS depression
53
Signs and symptoms benzodiazepine toxicity
```
lethargy
slurred speech
ataxia
mental confusion
hypotension
coma
respiratory arrest
```
54
Treatment of benzodiazepine toxicity
```
contact EMS
position patient supinely
provide BLS
administer O2 4-6 L/minute
monitor vital signs frequently
provide external warming measures
```
55
Overview of epistaxis
blood exuding from nasal cavity
56
Signs and symptoms epistaxis
nasal bleeding
bright red color-anterior nose bleed
dark red color-posterior nosebleed
57
Treatment of epistaxis
```
use personal protective equipment
position patient upright
maintain airway
suction blood from mouth if necessary
have patient tilt head slightly forward
apply direct pressure by pinching lower part of nose for 15-20 minutes
have patient breathe through mouth
place ice pack over bridge of nose
```
58
Overview of excessive bleeding following an extraction
heavy or steady bleeding for more than two hours following extraction
59
Signs and symptoms of bleeding following an extraction
heavy or steady bleeding for more than two hours
hematoma
fatigue
60
Treatment of bleeding following an extraction
compression with gauze
tea bag with firm pressure for 20 minutes
if bleeding persists, contact physician for follow-up treatment
61
Overview of heart failure
clinical syndrome that occurs when the heart muscle is impaired and no longer effectively pumps sufficient volumes of blood
62
Overview of left heart failure
inadequate blood pumped to circulation; blood coming to left ventricle from lungs "backs up" causing fluid to leak into the lungs
63
Signs and symptoms of left heart failure
```
dyspnea
orthopnea
nocturnal dyspnea
cheyne-stokes respirations
dry, nonproductive cough
pallor
diaphoresis
elevated BP
rapid, thready pulse
```
64
Treatment of left heart failure
```
position patient upright or semi upright
perform CABs of CPR
administer O2 3-5 L/minute
monitor vital signs
contact EMS if symptoms not alleviated
```
65
Overview of right heart failure
inability of heart to pump blood from systemic venous circulation to lungs for oxygenation systemic congestion in venous system
66
Signs and symptoms of right heart failure
```
fatigue, weakness
peripheral edema
pitting edema
reduction in renal blood flow
nocturia
distended jugular vein
```
67
Overview of hypertensive emergency
extremely high blood pressure with target end organ damage
68
Signs and symptoms of hypertensive emergency
```
BP > 220/140
shortness of breath
chest pain
nocturia
dysarthria
weakness
altered consciousness
vision loss
seizures
congestive heart failure
nausea
vomiting
eventually coma
```
69
Treatment of hypertensive emergency
retake BP to ensure accuracy
position conscious patient upright/unconscious patient supine
treat whatever target end organ damage is occurring
monitor vital signs/take blood pressure every 5 minutes
administer oxygen if needed
contact EMS
70
Overview of hypertensive urgency
extremely high blood pressure without target end organ damage
71
Signs and symptoms of hypertensive urgency
```
BP > 180/110
moderate to severe headache
anxiety
shortness of breath
edema epistaxis
```
72
Treatment of hypertensive urgency
retake BP to ensure accuracy
position conscious patient upright/unconscious patient supine
monitor vital signs/take blood pressure every 5 minutes
administer O2 if needed
contact EMS
73
Overview hyperventilation
increased respirations that are faster and/or deeper than the metabolic needs of the body while eliminating more CO2 than is produced
74
Signs and symptoms of hyperventilation
```
prolonged, rapid, and deep respirations
22-40 breaths/minute
heart palpitations
impaired problem solving, motor coordination, balance and perceptual tasks
lightheadedness
dizziness
impaired vision
muscle twtiching or carpopedal spasm
diaphoresis
circumoral paresthesia
```
75
Treatment of hyperventilation
position patient upright
loosen tight clothing
work with patient to control breathing
76
Overview of hypoglycemia
severe hypoglycemia with a blood glucose level lower than 40-50 mg/dL
77
Signs and symptoms of hypoglycemia
```
confusion
seizures
dizziness
weakness
headache
hunger
cold, clammy skin
diaphoresis
irritability of aggressive behavior
```
78
Treatment of hypoglycemia
```
conscious patient:
provide 20 gm of some form of sugar
maintain airway
monitor vital signs
unconscious patient:
EMS
glucagon 1 mg SC or IM
20 ml of 50% IV dextrose
monitor vital signs
administer O2 4-6 L/minute
```
79
Overview of intraocular foreign object
foreign object in eye
80
Signs and symptoms of intraocular foreign object
sensation in eye ranging rom itching to severe pain
tear production
double vision
light sensitivity
81
Treatment of intraocular foreign object
locate foreign body
lower eyelid and have patient look up
saturate cotton tip with saline and gently rub tarsal or sclera area OR
irrigate with saline from lateral to medial surface or use eyewash station
82
Overview of myocardial infarction
necrosis of the myocardium because of total or partial occlusion of a coronary artery
83
Signs and symptoms of myocardial infarction
```
chest pain or discomfort lasting 20 minutes or longer: pressure, tightness, heaviness, burning, squeezing, or crushing - may radiate down arms, shoulders, neck, jaw, or back
weakness
dyspnea
diaphoresis
irregular pulse
nausea
vomiting
sense of impending doom
levine sign
women may have a typical discomfort, upper abdominal pain, shortness of breath, fatigue
```
84
Treatment of myocardial infarction
```
terminate treatment
if history of angina treat for angina
if no history:
position patient comfortably
perform CABs of CPR
contact EMS
administer O2 4-6 L/minute
monitor vital signs
administer nitroglycerine from kit if patient not hypotensive
if pain is not relieved in two to four minutes, administer two more doses of nitroglycerine
if pain not relieved, administer 162-325 mg chewable aspirin
monitor vital signs
prepare for CPR if necessary
```
85
Overview of generalized tonic-clonic seizures
generalized electrical abnormality throughout the brain with a loss of consciousness
86
Signs and symptoms of generalized tonic-clonic
four phases:
prodromal - aura (sensation that preceded seizure)
preictal - loss of consciousness
ictal - muscle contraction and relaxation
posticatal - cessation of seizure with generalized depression
87
Treatment of generalized tonic-clonic seizure
```
position patient supinely
maintain open airway
prevent injury to patient
gently restrain patient
monitor vital signs
```
88
Overview of generalized absence seizure
generalized electrical abnormality throughout the brain without a loss of consciousness
89
Signs and symptoms of generalized absence seizure
brief change in level of consciousness
blinking or eye rolling
blank stare
duration of 5-30 seconds
90
Treatment of generalized absence seizure
reassure patient
| most resolve without incident
91
Overview of hypovolemic shock
failure of the cardiovascular pulmonary system to deliver enough oxygenated blood to body tissues because of fluid loss
92
Signs and symptoms of hypovolemic shock
rapid, thready pulse
cool skin
reduced urine output
93
Treatment of hypovolemic shock
```
position the patient supinely
arrest cause of fluid loss
contact EMS
perform CABs of CPR
monitor vital signs
oxygenate 4-6 L/min
administer fluid therapy required
```
94
Overview of cardiogenic shock
failure of the cardiovascular pulmonary system to deliver enough oxygenated blood to body tissues because of decreased cardiac output
95
Signs and symptoms of cardiogenic shock
```
decreased BP systolic < 90 mmHg
fast, weak pulse
cool, clammy skin
cyanosis
nonspecific chest pain
shortness of breath
```
