BLS and medical emergencies Flashcards
What is an atherosclerosis?
potentially serious condition where arteries become clogged with fatty substances called plaques or atheroma
What is myocardial infarction?
death of heart muscle
What is the common word for cerebral infarction?
stroke
What does infarction mean?
tissue death
What is an example of periphery infarction?
gangrene of legs
What is a type of gut infarction which is often fatal?
mesenteric infarction
What is hypercholesterolaemia?
high cholesterol
Blood pressure is stated as what?
systolic/diastolic
What is a systolic movement?
heart pumping
What is a diastolic movement?
heart relaxing
Where does the heartbeat originate?
sinoatrial node
What is an arrhythmia?
abnormal cardiac rhythm
What is atrial fibrillation and what is it an example of?
abnormal electrical impulses suddenly start firing in the atria causing highly irregular pulse rate
type of arrhythmia
What is a tachyarrhythmia ?
irregular cardiac rhythm - too fast
What is Bradyarrhythmia?
irregular cardiac rhythm - too slow
What is asystole?
complete absence of electrical activity in the heart
What are pacemakers often placed to compensate for?
Bradyarrhythmia
Adrenaline in LA should be used with caution in patients with what heart condition?
Arrhythmia and heart failure
What is SVT and is it normally serious?
Supraventricular tachycardia is a condition where your heart suddenly beats much faster than normal. Many patients know how to self terminate but can be more dangerous if people have other heart conditions
What is the most common type of arrhythmia?
atrial fibrillation
What is atrial fibrillation?
abnormal electrical impulses suddenly start firing in the atria which causes you to have a highly irregular pulse rate
What are the most dangerous cardiac arrhythmias?
ventricular fibrillation and ventricular tachycardia
What do you call an arrhythmia where the heart rate is too slow?
Bradyarrhythmia
What do you call an arrhythmia where the heart rate is too high?
Tachyarrhythmia
What is the treatment for ventricular fibrillation?
start CPR, rapid defibrillation, phone 999
Where on the body will you most often find a pacemaker?
left upper chest wall, below the clavicle
What does ICD stand for?
implantable cardioverter defibrillator
What is peripheral vascular disease?
atherosclerosis affecting peripheral vessels
What is an abdominal aortic aneurysm?
swelling of aorta due to damage to vessel wall from atherosclerosis
What is the number 1 cause of mortality in the Western World?
Ischaemic heart disease
What is ischaemic heart disease also known as and what are its symptoms?
stable angina
due to narrowing of coronary arteries by atherosclerosis
What are two anti-platelet drugs used to treat stable angina?
clopidogrel, aspirin
What are two types of acute coronary syndrome?
1) unstable angina (myocardial ischaemia)
2) myocardial infarction
In the management of acute coronary syndrome, what are the stages involved?
call 999
sit patient up
give high flow oxygen
give GTN spray - 2 sprays sublingually up to 3 doses 5mins apart
give 300mg aspirin
What is the most common symptom in people with peripheral vascular disease?
intermittent claudication, pain in calves while walking
There is a UK screening programme for abdominal aortic aneurysm, what demographic does it target?
men over 65
Where can angina pain be felt?
centre of chest
indigestion
back pain
jaw pain
arm pain
In a person having angina, what is the dose of GTN spray and how is it administered?
2 puffs GTN sublingually, 5 mins apart up to 3 doses
What is the emergency dental treatment of a person having a myocardial infarction?
999
sit up
oxygen
GTN
Aspirin
Where is the aortic valve?
LHS - between ventricle and aorta
Where is the mitral valve?
LHS - between atrium and ventricle
Where is the tricuspid valve?
RHS - between atrium and ventricle
Where is the pulmonary valve?
RHS - between ventricle and pulmonary artery
What is the most common cause of valvular heart disease?
ageing
Everyone with a valve replacement needs lifelong anticoagulation - T or F?
false - all mechanical valves require lifelong anticoagulation. Biological do not (eg. porcine valves) do not.
What is the target INR for a person with a mechanical valve replacement?
Range 2.5-4 depending on patient and valve factors
A person with an atrial septal defect should get antibiotic prophylaxis prior to dental treatment - T or F?
false
What are three causes of heart failure?
dilated cardiomyopathy
ischaemic heart disease
atrial fibrillation
What medicines are commonly prescribed in heart failure with reduced ejection fraction?
loop diuretics - mainstay of symptom control treatment
angiotensin converting enzyme (ACE) inhibitors - always
beta blockers - always if tolerated
Postural hypotension is common in people with heart disease - T or F?
true due to many medications that reduce BP
People with heart failure may experience orthopnoea and may not be able to lie flat - T of F?
true
What is orthopnoea?
shortness of breath that occurs while lying flat and is relieved by sitting or standing
What is a normal heart rate?
between 60 and 100bpm
What is a normal blood pressure?
90/60 mm Hg to 120/80 mm Hg
What is a normal breathing rate?
12 to 18 breaths per minute
What is a normal body temperature?
roughly 37 degrees C
What is a normal INR level?
1.1 or below is considered normal
What is the INR level?
measures the time for the blood to clot
What is an effective therapeutic INR level for people taking warfarin?
2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin for certain disorders.
What is a normal oxygen saturation?
95-100%
What does ABCDE stand for?
Airways
Breathing
Circulation
Disability
Exposure
What does the AVPCU scale stand for?
Alert
Verbal
Pain
Confusion (new)
Unresponsive
What is the emergency treatment of a seizure over 5 mins or repeated seizures?
high flow oxygen
midazolam oromucosal solution 10mg buccally
999 if needed
What does FAST stand for relating to cerebral infarction?
Face
Arms
Speech
Time
What is a pneumothorax?
when lung lining punctures and air escapes into pleural space
How do you treat asthma in the dental setting?
ABCDE approach
give salbutamol inhaler - 2 puffs with spacer
phone 999
high flow oxygen
salbutamol 5mg nebuliser or 2-10 puffs via spacer
repeat salbutamol every 10 mins
What are the markers of acute severe asthma?
1) PEFR 33-50% predicted
2) resp rate over 25/min
3) HR >110bpm
4) inability to complete sentences in one breath
What dose of Salbutamol inhaler should be given in an acute asthma attack in your dental surgery?
initially 2 puffs via metered dose inhaler
if no response - call 999, oxygen flow, salbutamol 5mg nebulised or 2-10 puffs via MDI
How would you manage acute breathlessness in a person with COPD in your surgery?
ABCDE
salbutamol 2 puffs via spacer
oxygen to maintain sats at 88-92%
may need to hospitalise
How is COPD different to asthma?
irreversible airway obstruction
chronic cough common
persistent and progressive breathlessness
aetiology is usually inhalation of toxins - smoking, air pollution
What inhalers are used in COPD?
SABA, LABA, LAMA, ICS
What does HbA1c measure?
measures the amount of blood sugar (glucose) attached to your hemoglobin
What is a normal HbA1c level?
> 48mmol/mol
What is arthritis?
inflammation of joints
What is arthrosis?
non-inflammation joint disease
What is arthralgia?
joint pain
