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Patient Management > Unit 3 - Medical Emergencies > Flashcards

Unit 3 - Medical Emergencies Flashcards

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1
Q

Traumatic Head Injury

OPEN

A

Appearance: Big goose egg on side of head
Bone window CT shows depression in skull

NO MRT TREATMENT

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2
Q

Traumatic Head Injury

CLOSED

A

CT appearance: midline shift, bleed, swelling, increased pressure

Symptoms: Changes in LOC, seizures, deficits, stroke, respiratory arrest, death

NO MRT TREATMENT

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3
Q

Traumatic Head Injury

Basal Skull Fracture

A

Appearance
Battle Sign: Bruising right behind the ear
Racoon eyes: bruising around the eyes
Symptoms
Face Fractures, shearing of the meninges and leakage of CSF or blood through ear and nose

NO MRT TREATMENT

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4
Q

Seizure

A

Can smell burnt toast
Muscles become rigid
**Jerky body movements **
Rapid irregular respiration
May vomit or froth
Urinary or fecal incontinence
Falls into deep sleep after

MRT Treatment:
Protect the patient
Call for assistance
Observe: How did it start & document length of seizure
Do not attempt to put anything in the patients mouth
Position in recovery position

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5
Q

Medical Emergency

A

A situation of sudden change in a patients status requires immediate intervention

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6
Q

MRT Role in a medical emergency

A

Preserve life
Avoid further harm
Obtain assistance ASAP

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7
Q

Recognizing Medial Emergencies

A

Establish baseline
Early detection= successful treatment management

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8
Q

Steps during an emergencies

A

Step 1: Call a code, note time
Step 2: Locate crash cart
Step 3: Locate O2 and fluid management equipment

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9
Q

Shock

A

Infection (UTI, etc)

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10
Q

Anaphylaxis

A

Reaction to contrast or meds

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11
Q

Pulmonary embolism

A

Air introduced via IV (tech induced embolism)

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12
Q

Diabetes Mellitus Reactions

A

Hypoglycemic event

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13
Q

Level of Consciousness

A

most sensitive indicator of neurological condition
- pupillary response
- limb movement/strength
- vital signs

for unconscious patients this is not effective

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14
Q

Pain LOC assesment

Trapezius Squeeze

Central stimulus

A
  • using thumb and 2 fingers pinch and squeeze
  • twist and gradually apply pressure for 10-20 seconds to elicit a response
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15
Q

Pain LOC assessment

Supraorbital Pressure

Central stimulus

A
  • Flat of thumb on supra-orbital ridge
  • apply gradual increasing pressure to ilicit a response
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16
Q

Pain LOC assessment

Mandibular Pressure

Central stimulus

A
  • Apply upward pressure at the angle of the mandible
  • gradual increasing pressure for 10 to 20 seconds
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17
Q

Pain LOC assessment

Sternal Rub

Central stimulus

A
  • Clenched fist rubbing up and down sternum
  • extremely painful
  • can result in bruising, residual pain and discomfort
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18
Q

Peripheral Pain Stimulus

A
  • central stimuli should always be used
  • not an indication of brain function
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19
Q

Squeezing nail beds

Peripheral stimulus

A

Squeezing the lanula area of the finger or toenail

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20
Q

Glasgow Coma Scale

A

standardized test used for the assessment of neurological and cognitive functioning
- eye opening response
- verbal response
- motor response

max points 15
min points 3

should discuss with code team

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21
Q

Decerebrate Posturing

A
  • damage to upper brain stem
  • extends limbs at the elbow in response to central pain stimuli
  • adduction of shoulders
  • flexion of wrist, fingers in fist
  • legs extended and feet plantar flexed
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22
Q

Decorticate Posturing

A

Damage to one or more decorticate tracks
- arms are adducted and elbows flexed
- wrist and fingers flexed over chest
- legs stiffly flexed and internally rotated
- feet plantar flexed

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23
Q

Presentation of Neurological Spine Injuries

A
  • numbness (pins and needles)
  • pain
  • paralysis (one or both sides)

min of 3 people to transfer patients from board to xray table

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24
Q

Stroke(CVA)

Hemmoragic or Ischemic

A

Symptoms:
* Severe headache
* Muscle Weakness
* Confusion and dizziness
* Slurred speech (dysphasia) or no speech
* Nausea and vomiting
* Changes in LOC
Appearance:
* Ataxia & stiff neck
* Hemiparesis (one sided loss of strength)
* Eye deviation (one sided)
* facial droop (one sided)
MRT Treatment
- Stop procedure
- Call a code/help
- monitor vital signs
- IV fluids and O2 as requested
- CT imaging for diagnosis

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25
Orthostatic Hypotension | Blood can’t get to brain as quickly as it needs to Common in elderly
Symptoms: * Lightheaded when sitting or standing * Temporary cerebral hypoxia Appearance: * Blood pooled in extremities after one position for long time MRT Treatment - Assist the patient to the sitting position - Let them sit for a minute before getting up
26
Vasovagal Syncope | Fainting, Insufficient blood to the brain Caused by stress, fatigue
Symptoms * Dizziness and nausea * Hypotension * Bradycardia * Appearance * Looking pale * Cold clammy skin MRT Treatment - Lie patient down and elevate legs - Get them orange juice
27
Asthma
Symptoms * Labored, noisy breathing * Wheezing * Neck vein distention * Diaphoresis (sweating) * Anxiety * Cyanosis of lips and nail beds (blue) * Bronchospasm-contraction of the smooth muscles in the bronchii and narrowing the lumen MRT Treatment Sit patient up Puffer/nebulizer In severe cases: epinephrine, corticosteroids or intubation
28
Obstruction of Airway (Foreign Body)
* Labored, noisy breathing * Wheezing * Neck vein distention * Diaphoresis (sweating) * Cyanosis of lips and nail beds (blue)
29
Respiratory Arrest
Symptoms * No chest movements * Loss of consciousness * Weak or faint pulse MRT Treatment - place patient supine - initiate code - grab crash cart - Start CPR if no pulse
30
31
Angina (Pectoris) | Ischemia of myocardium due to lack of blood flow to the heart ## Footnote Stable
* Chest pain/pressure * Diaphoresis * Pallor * Nausea * Symptoms of indigestion * Occurs with over exertion, **pain doesn’t change or worsen** | Indicator of impending heart attack
32
Angina Pectoris | Ischemia of myocardium due to lack of blood flow to the heart ## Footnote Unstable
* Occurs at rest or exertion, **pain worsens in frequency and severity ** * Chest pain/pressure * Diaphoresis * Pallor * Nausea * Symptoms of indigestion
33
Myocardial Infarction | Heart Attack
Chest pain/pressure Diaphoresis Pallor Nausea Symptoms of indigestion
34
Cardiac Arrest
* Loss of consciousness, pulse and BP * Dilation of the pupils in seconds * Possible seizures MRT Treatment - Use AED
35
Hypovolemic Shock
Symptoms: * Excessive thirst * Cold extremities and clammy skin * Cyanosis of lips, nails tongue and soft palate * Elevated HR * Decreased BP 15% of intravascular fluid loss
36
Cardiogenic Shock
* Cardiogenic ShockChest pain * Respiratory distress * Cyanosis * **Rapid changes in LOC** * Irregular pulse * Decreasing BP * Decreasing urinary output * Cool, Clammy skin
37
Stage 1 of Shock | Compensatory Stage
Blood shunted from other organs to heart and brain - cold and clammy skin - nausea and dizziness - increased SOB - BP drops, pulse rate increases
38
Stage 2 of shock | Progressive Stage
- arterial pressure drops - Vasoconstriction reduces arterial blood flow to organs. - All body systems are inadequately perfused, causing ischemia and necrosis. - Acute renal, liver, GI and hematologic failure. - Tachycardia (as rapid as 150 beats/minute) - Change in mental status
39
Stage 3 of shock | Irreversible stage
* Irreparable damage to organs, and recovery is unlikely. * Low BP * Renal and liver failure * Release of necrotic tissue toxins and overwhelming lactic acidosis
40
Distributive Shock
Characterized by the blood vessel’s inability to constrict (loss of vasal tone) and the resultant inability to return blood to the heart * Blood pools in the peripheral blood vessels and results in: * Decreased venous return to heart * Decreased blood pressure * Decreased tissue perfusion
41
Neurogenic Shock | Distributive
- spinal cord injury, severe pain, diabetic shock
42
Septic Shock | Distributive Shock
- Systemic Infection - High mortality rate
43
Anaphylactic Shock | Distributive Shock
Most commonly caused by contrast media reaction - Releases histamine, causing vasodilation and peripheral pooling of blood. - Accompanied by contraction of the smooth muscles, particularly of the respiratory tract. - Combined response produces shock, respiratory failure and death within minutes.
44
Mild Anaphylaxis
* Nasal congestion, sneezing, coughing * Periorbital (around the eyes) swelling * Itching of eyes, nose, injection site * Tightness in chest, mouth or throat
45
Moderate Anaphylaxis
* Symptoms of Mild systemic reaction+ * Flushing, feeling of warmth, urticaria * Bronchospasm and edema of airways or larynx * Dyspnea (difficulty swallowing), cough, wheezing
46
Severe Anaphylaxis
- All previous moderate and mild reactions + * Decreased BP and weak pulse * Rapid progression of bronchospasm, laryngeal edema, severe dyspnea, cyanosis * Seizure, respiratory and cardiac arrest MRT Treatment * Stop the infusion of contrast * Stay with the patient, call for help * Notify Radiologist * Sit patient up if they are having breathing issues * For moderate to severe reactions, may use EpiPen * Call a code
47
Type 1 Diabetes | Insulin Dependent
- Younger than 30 years of age (born with it) - Sudden onset - Autoimmune process destroys insulin producing pancreatic beta cells. - Insulin needs to be injected to control blood glucose levels and prevent diabetic ketoacidosis (DKA).
48
Type 2 Diabetes
- Most common - Older than 40 - Gradual onset - Impaired sensitivity to or decreased production of insulin - Controlled by weight loss, dietary control and exercise - Medications to prevent hyperglycemia - May develop hyperosmolar hyperglycemic nonketotic syndrome (HHNS)
49
Type 3 (Gestational) Diabetes
* Later months of pregnancy (non-diabetic women) * Hormones secreted by placenta prevent the action of insulin * Often treated with diet, insulin if needed * Typically resolved following birth of child
50
Diabetic Ketoacidosis | Cells do not get the glucose they need for energy and burn fat
* Vomiting * Pronounced thirst, excessive urination and abdominal pain * Fruity odor on breath
51
Hyperosmolar Hyperglycemic Nonketotic Syndrome
- Results from uncontrolled DM. * More common with Type 2. * Often associated with an illness or infection. * In HHNS, your body tries to rid itself of the excess blood sugar by passing it into your urine, resulting in hyperosmolality if fluid is not replaced. * Can lead to life-threatening dehydration as fluid is pulled into bloodstream from other organs. * May lead to seizures, coma, death.
52
Hyperglycemic Event | Patient has taken insulin but no food (prep for GI study)
- Sudden onset of weakness, sweating, tremors - Eventually loss of consciousness/syncope MRT Treatment - give patient candy or juice - if unconscious can be given glucagon parenterally
53
Aphasia
Inability to speak
54
Bradycardia
(Abnormally) decreased heart rate
55
Bronchospasm
Contraction of smooth muscles in the wall of the bronchi and bronchioles, causing narrowing of the lumen and difficulty breathing
56
Diaphoresis
Excessive sweating
57
Dys**phasia**
Slurred speech
58
Dyspnea
Difficulty breathing
59
Dys**phagia**
Difficulty swallowing (think ‘esophagus’)
60
Edema
Swelling (caused by fluid collection)
61
Hemiparesis
Paralysis affecting one side of the body.
61
Hyperglycemia
Abnormally high blood glucose level
61
Hypoglycemia
Abnormally low blood glucose level
62
Polydipsia
Increased thirst
63
Polyphagia
Increased hunger
64
Polyuria
Increased urination
65
SOB
Shortness of breath
66
Syncope
Fainting
67
Tachycardia
(Abnormally) increased heart rate
68
Tachypnea
Rapid, shallow breathing
69
Vasodilation
Dilation of blood vessels

Patient Management (7 decks)

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