305 - recognising and supporting actions during first aid and medical emergencies. Flashcards
why are medical emergencies more likely to occur in dental setting?
anxiety in patients
what anxiety may patients have at the dentist?
lower pain threshold - feel pain/discomfort
stress levels raised as believe will feel pain
fear dental treatment, wont eat before and will have low blood sugar = faint
what position is the patient in that leaves the airway vulnerable to potential objects?
supine (flat) position
what is hypertension?
high blood pressure
what are the liver and kidney responsible for?
eliminating waste products and toxins from body
what can uncontrolled diabetes or not taking medication for it lead to?
hypoglycemic attack
how can diabetes affect patients after dental treatment?
poor wound healing
prone to infections
what are the known allergens in the dental setting?
latex
penicillin-based antibiotics
what medications can react with local anaesthetic?
some antidepressants
thyroxine
HRT
contraceptives
what are the signs from a casualty in an emergency?
skin colour: pink, grey, pale?
breathlessness: gasping, struggling to breathe?
suddenness of collapse: fall quickly or slowly?
condition of pulse: fast, slow, weak, absent?
what are the symptoms from a casualty in an emergency?
any pain
location of pain
nausea
drowsiness
difficulty breathing
dizziness
what signs would prompt a rescuer to begin BLS immediately?
unconsciousness
abnormal breathing
what does asystole mean?
heart has stopped beating
what does fibrillating mean?
heart is beating ineffectively
what is hypoxia?
lack of oxygen to the brain
how many breaths per minute shows an increased rate of respiration?
faster than 20 breaths per minute
- check by rise/fall of chest
how many beats per minute for an increased heart rate?
faster than 100 beats per minute
- take the pulse
what systolic reading shows a fall in blood pressure?
systolic reading below 90mmHg
- blood pressure machine
what is the average systolic reading for blood pressure?
120mmHg
what is the DRSABCDE approach?
Danger
Response
Shout for help
Airway
Breathing
Circulation
Disability
Exposure
what is the aim of BLS?
maintain flow of oxygenated blood around body
what is oxygen?
atmospheric gas
what are the 3 vital organs?
heart
brain
lungs
what happens to the body without oxygen?
cells and body cant function = death
how many minutes can the body survive without oxygen before brain damage occurs?
3-4 minutes
how is oxygen provided to lungs during BLS?
rescue breathing
how is oxygen circulated to body tissues during BLS?
external chest compressions
what does unconsciousness in casualty indicate?
unresponsive to stimuli
heart may have stopped beating = cardiac arrest
what does abnormal breathing in a casualty indicate?
possible obstruction in respiratory system
in darker skin tones how do you check if the casualty is lacking oxygen (hypoxia)?
lips
nailbeds
mucous membranes of mouth
what is the log roll technique?
rolling casualty on to back on hard surface
keep head in line with spine
how are compressions given?
30 at rate of 100 per minute
how many cm can the chest be compressed in adults?
4-5cm
after 30 compressions how may rescue breaths are followed?
2
what is the ratio of compressions and rescue breaths?
30:2
how is the airway kept open during rescue breaths?
head tilt
chin tilt
should you pinch the nostrils whilst providing rescue breaths?
YES
how does the AED work?
sending electrical impulse
what will the AED instruct if defibrillation is required?
‘stand clear’ then ‘shock’
what will the AED instruct if casualty has heartbeat and aren’t fibrillating?
‘no shock’
where are AED pads placed on casualty?
one on left side near apex of heart
one on right front side of chest below collarbone
what factors will reduce the effectiveness of defibrillation attempts?
hairy chest
damp skin
breast tissue
poor contact between skin and pads
what is a cardiac arrest in younger casualties usually due to?
lack of oxygen to brain due to airway obstruction
how should a pregnant woman lie during BLS?
slightly on left side with support under right buttock
what signs indicate a functioning circulatory system?
movement
coughing/attempts to breathe
change in skin/lip colour from grey to pink
why is a casualty placed into the recovery position?
so tongue and any fluids can drain out of mouth and not obstruct the airways
how is the casualty placed into the recovery position?
placing casualty onto side and bending limbs so they are supported
after an emergency how is infection control met?
wear full PPE
sharps discarded in sharps container
blood spillages cleaned up using blood spillage kit
non-sharp contaminated into hazardous waste
work surfaces wiped down
what is the correct term for a simple faint?
vasovagal syncope
what is a faint?
signs and symptoms
loss of consciousness due to temporary reduction in oxygenated blood to brain
sign: pale and clammy skin, loss of consciousness
symptoms: dizziness, nausea
how do you treat a casualty who has fainted?
unconscious = lay flat and elevate legs to restore blood to brain
conscious = sit casualty with head down and fresh air
what do you give to a casualty who has fainted once they are conscious?
glucogel/dextrose tablet for blood sugar
slow-release carbohydrates and a drink
what is asthma?
signs and symptoms
hypersensitivity condition affecting the respiratory airways
signs: breathless with wheezing, cyanosis (blue lips), restless
symptoms: difficulty breathing, sensation of suffocating/drowning
how do you treat a casualty having an asthma attack?
salbutamol inhaler
oxygen
999 if doesn’t make rapid recovery
what is an anaphylaxis?
signs and symptoms
severe allergic reaction
signs: rapid facial swelling, rash, gasping, collapse
symptoms: sudden onset breathing difficulties, tingling of extremities
how do you treat a casualty having an anaphylaxis?
999
administer intramuscular adrenaline
oxygen
BLS if necessary
what is an epileptic fit?
signs and symptoms
brief disruption of normal electrical activity within brain
petit mal -mild fit
grand mal - major fit
signs: loss of unconsciousness, seizures
symptoms: altered mood before seizure, dazed and sleepy on recovery
how do you treat a casualty having an epileptic fit?
protect from injury but dont move
allow recovery
if no recovery within 5 mins call 999
midazolam buccal gel
what is hypoglycaemia and diabetic coma?
signs and symptoms
low blood sugar in prediagnosed diabetes who haven’t followed insulin regime correctly or not eaten at correct times
signs: trembling, cold and clammy, irritable, drowsy, slurred speech
symptoms: confusion, disorientated, blurred or double vision
how do you treat a casualty who has hypoglycaemia?
conscious: glucogel tube orally
unconscious: intramuscular glucagon
oxygen
999 if no recovery
what is angina?
signs and symptoms
chest pain by not enough blood reaching heart
signs: congested facial expression, casualty clutching chest or left arm, irregular pulse, shallow breathing
symptoms: crushing chest pain travel to left arm or jaw, nausea
how do you treat a casualty who has angina?
administer GTN spray under tongue
oxygen
casualty sat upright
999 if no recovery or consciousness is lost (cardiac arrest)
BLS if necessary
what is a myocardial infarction?
signs and symptoms
heart attack - supply of blood to heart is blocked usually by blood clot
signs: sudden clutching of chest, grey appearance, possible collapse
symptoms: sudden crushing chest pain not relieved by GTN spray
how do you treat a casualty having a myocardial infarction?
999
aspirin tablet
oxygen
BLS if necessary
what is choking?
signs and symptoms
partial or full blockage of respiratory tract causing lack of blood oxygenation
signs: sudden coughing/wheezing, laboured breathing, inability speaking, blue lips
symptoms: aware of respiratory obstruction, breathing difficulties, dizziness
what is the treatment for an adult casualty choking?
support and lean forward encourage cough
5 back slaps
5 abdominal thrusts if obstruction still present
unconscious = open airway for BLS
999
treatment for child casualty choking?
cough to expel obstruction
unsuccessful = 5 back slaps and recheck mouth
unsuccessful = 5 chest thrusts recheck mouth
if unsuccessful send for help and repeat back slaps
unsuccessful = 5 abdominal thrusts
continue cycle until obstruction cleared
treatment for baby casualty choking?
check mouth for obvious obstruction and remove it
baby face down along arm and 5 back slaps using fingers only
turn baby face up and remove obstruction
unsuccessful: 5 sharp chest compressions
call for help and continue cycle until obstruction cleared
what is a stroke?
signs and symptoms
cerebral infarction = blood vessel supplying brain is blocked by clot
cerebral haemorrhage = blood vessel supplying brain begins to leak or ruptures in skull pressing on brain
signs: sudden weakness of face or limbs on one side of body, loss of balance and difficulty speaking
symptoms: sudden numbness of face or limbs, sudden headache, confusion and dizziness
what is the treatment for a casualty having a stroke?
need to react fast as chance of survival and disability worsens with time
Facial weakness: signs of drooping
Arm weakness: can both arms be raised equally
Speech problems: speak clearly, understand commands
Test all 3 signs quickly, any deficit call 999
what is adrenal crisis?
signs and symptoms
adrenal insufficiency - disorder of adrenal glands
signs: low blood pressure, fast heart rate, pale, vomiting
symptoms: nausea, abdominal pain, lethargic and weak
what is the treatment for a casualty having adrenal crisis?
999
lay casualty supine
oxygen
prepare for BLS if necessary
