Chapter 16 : Emergency Response Flashcards
a serious, unexpected event that demands immediate attention
Emergency
a group of individuals from multiple disciplines who work together to assess and stabilize a trauma patient
Trauma team
an emergency of huge magnitude that creates an unforeseen, serious, and immediate threat to public health.
Disaster
In the case of a disaster or multiple victims needing attention, the process of identifying the victims, performing initial examinations, and assigning priorities for further care.
Triage
a team that is trained to intervene and assist caregivers before a patient’s condition deteriorates to the point that a conventional code is required.
Rapid Response Team
a progressive and irreversible condition characterized by diminished inspiratory and expiratory capacity of the lungs.
Chronic obstructive pulmonary disease (COPD)
mechanical respirator; device to assist respiration or to provide intensive positive-pressure breathing.
Ventilator
an opening through the neck into the trachea through which an indwelling tube may be inserted to ventilate the patient’s lungs
Tracheostomy
passage of a tube into a body aperture, specifically the insertion of a breathing tube through the mouth or nose into the trachea to ensure a patient’s airway for the delivery of anesthetic gases, oxygen or both.
Intubation
immediately, at once, from the Latin, statim.
STAT
Is a special unit of the hospital equipped to care for person who arrive in the need of immediate care
Emergency Departments (ED)
How can some patients misuse the ED
- seek care for minor illness, rather than having a primary-care provider
- seek narcotics for recreation/abuse
Specialized care facilities usually within a hospital designed to cope with life-threatening injuries
Trauma Units
What are the levels of the trauma units
- Level l
- Level ll
- Level lll
What trauma unit is the most comprehensive, specialized care 24/7
Level l
Stuffed around the clock with physicians, surgeons, and support personnel who are highly trained
Level l
Call someone in since someone’s not always there
Level ll
Smaller community hospitals that usually have an ED physician and radiographer on call at night
Level lll
Can be stabilized within the first hour after the accident
- every minute is precious
- first hour best survival rate
Golden Hour
The role of the radiographer in trauma radiography may be to?
- take radiographs in the ED x-ray room
- operate the CT scanner
- take radiographs with mobile equipment in the trauma bay while the patient is also being tested and treated by other members of the trauma team
What does the radiographer need to do when there are multiple patients that need imaging at the same time
Priorities
- do not be hesitate to call for assistance.
Who is given the highest priority in multiple emergences?
The highest priority is assigned to patients whose vital signs are unstable and whose immediate care depends on the results of the examination, such as those in severe respiratory distress
When there is two cases of apparently equal urgency what do you do?
Start with the patient who can be examined in the shortest amount of time because this decision will result in the shortest total waiting period.
This specific order should be done at once because the patients well-being may be compromised by any delay
an order designated STAT is to be done at once
What are the different types of disaster?
- natural
- manmade
- accidental
What are examples of natural disaster
tornado, earthquake, flood, hurricane
What are examples of accidental disaster
plane crash or train wreck
What are examples of man-made disasters?
terrorist attacks
how does disaster response come to play
- every hospital is required to have a disaster plan
- every member of the healthcare team must know the plan
- Drills (internal and in the community) are routine to practice the response, coordination of care, and roles
Trauma Radiography tips
- Obtain information about patients and their injuries and preorder any imaging examinations.
- Prepare the required radiographic and protective equipment (cassettes, cassette covers, lead aprons, gloves, gowns, markers).
- Assist the trauma team as much as possible in assessing the patient by providing an extra pair of hands or retrieving a warm blanket.
- Introduce yourself to patients and briefly explain what you need to image. Inquire about their mobility and ask for their assistance in positioning them, if possible.
- Provide radiation protection to any personnel required to stay in the room during imaging. Use pertinent gonad shielding on the patient unless it will interfere with the diagnosis.
- Seek assistance from the nurses or physicians in moving and positioning patients so that you do no further harm to them.
- Try to obtain the best images feasible with regard to the patient’s condition. Two radiographs at 90-degree angles are required for all extremities, with the inclusion of at least one joint space for all long-bones.
What is an essential part of disaster response
- set up in a large, central locale
Triage
Color code for fire
Red
Color code for cardiac arrest or cessation of respiration (stopping)
Blue
Color code for hazardous material spill or release
Orange
Color code for combative person
Gray
Color code for weapon or hostage situation
Silver
Color code for infant/child abduction
Amber
Color code for internal/external disaster triage
Yellow
Color code for situation has been resolved
Code clear
-A facilities procedure to call for emergency help
-usually uses a specific communication code
-Important to know the emergency call codes for facility
Emergency’s call systems
- Also known as a code team
- A designated group of healthcaare workers who respond to emergency codes ( cardiac emergency)
Emergency Response Team
The members of the emergency response team consist of
- one or more physican
- several nurses
- a respiratory therapist
- an electrocardiographer
Assisting the emergency response team in a code called in the diagnostic imaging department
- when the code team arrives, allow them to take over immediately
- provide a history of the situation
- stand by to follow their directions
- Record keeping is essentinal:
- time emergency started
- code team arrival time
- time emergency started
Also called “crash carts”
- kept in strategic locations throughout the hospital
- know the location of the nearest cart for imaging department
Emergency Carts
How many times should the emergency cart should be check?
The cart should have a list of contents and should be inspected daily to ensure that emergency supplies are available for instant use and that their dates are within the expiry limits.
What is something important about the emergency cart?
Never borrow equipment or supplies from the emergency set for routine use!
Equipment commonly found on the crash cart
- blood pressure cuff
- bag valve mask
defibrillator - sterile and nonsterile gloves
- hemostat
- cardiac monitor
- tracheostomy tubes
- suction bottle
- needles, syringes
- IV solutions and tubing
- drugs according to institutional protoocol
Patients in the ED are classified as:
-nonurgent
-urgent
-life threatening
What cases are seen first in the ED:
The most acute cases are seen first.
Who decides the order in which patients should receive treatment
ED physician or doctor
trauma is the most common cause of death for individuals
who are younger than the age of 40
What should the the radiographer constantly be doing during imaging procedures for ED patients
Assessing the patient because trauma patients often experience sudden changes in status
Vasoconstrictor(narrowing or constriction of the blood vessels), increases cardiac output, raises blood pressure, aids respiration by relaxing the bronchioles (allergic reactions)
Adrenalin (epinephrine)
Cardiac antidysrhythmic medication (helps treat irregular heartbeat) to a normal rhythmn
Amiodarone
Respiratory/circulatory stimulant; dries up secretions (help reduce saliva and fluid in the respiratory tract during surgery)( help increase breathing )
Atropine
Combats tetany ( low calcium levels in the blood causes spasms of the hands, feet, cramps muscle contractions)
Calcium chloride
Anti-inflammatory ( relieves inflammation swelling, heat, redness, and pain is used to treat certain forms of arthritis
Decadron (dexamethasone)
Treats hyperkalemia ( too much potassium in your blood) symptoms: nausea, vomiting, abdominal pain, chest pain (restores blood glucose and treat low blood sugar levels) using insulin and then not eating a meal it allows for increase of glucose in your blood)
Dextrose 50%
Anticonvulsant (help treat seizures)
Dilantin (phenytoin)
Reverses hypoglycemia (low blood sugar) (help regulate your blood glucose and prevents it from dropping too low
Glucagon
Inhibits blood coagulation ( blood clot bllod chnages froma liquid to a gel) ( this medicine helps treat or prevent blood clots from forming) symptoms: brusing easily
Heparin
Relieves relieves bronchospasm (tightening of the muscles that line the airways in your lungs) causes restricted airflow asthma, emphysema bradycardia (slow heart rate)
Isuprel (isoproterenol)
Increases blood pressure, treats shock (can help treat low blood pressure and heart failure
Levophed (norepinephrine)
Opioid antagonist (helps restore normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose
symptom: very small pupils, inability to speak, limp arms and legs, pale skin
Narcan (naloxone)
Combats acidosis (buildup of acid in the bloodstream symptoms: indigestion
Sodium bicarbonate
Vasodilator, relaxes walls of blood vessels, increases circulation (open your blood vessels allowing blood to flow more easily prevent attacks of chest pain (angina)
Nitrostat (nitroglycerin)
Anti-inflammatory
Solu-Medrol (methylprednisolone)
Diluent (diluent agent)
Sterile water
Tranquilizer, antiseizure agent (treat anxiety, seizures, muscle spasms or twitches)
Valium (diazepam)
Cardiac antidysrhythmic medication, specific to paroxysmal supraventricular tachycardia (PSVT) ( rapid heartbeat) high blood pressure
Verapamil
Anesthetic, cardiac antidysrhythmic medication ( the medicine to prevent pain during surgery and other procedures (local anthestic)
Xylocaine (lidocaine)
Vasoconstrictor (narrowing of the walls of blood vessels( control the amount of water your kidneys reabsorbs
Vasopressin
What is the most common oxygen administration
Nasal cannula
The oxygen should be delivered at a rate of 1 to 6 L/min providing a 24% to 45% oxygen concentration. The oxygen supply can sometimes be warmed and/or humidified.
Nasal cannula
used to provide both oxygen and humidity. It is shaped to conform to the patient’s face and held in place by an elastic strap.
Simple face mask
It delivers oxygen concentrations that vary from 40% to 60%, depending on the fit and the oxygen flow rate.
Simple face mask
has an attached reservoir bag that fills with 100% oxygen and a valve to prevent exhaled gas from being inhaled again.
Nonrebreathing mask
Partial rebreathing masks allow some exhaled air to enter the reservoir bag and can deliver oxygen at 40% to 70% concentrations
Nonrebreathing mask
mask recommended for COPD (chronic obstructive pulmonary disease) a group of lung condition including emphysema and chronic bronchitis
High flow mask
oxygen administration for pediatric patients
Tent
oxygen flow rate for patients with COPD
Should not be higher than 3L/min
Normal oxygen flow rate
1-6L/min
Oxygen flow rate for trauma
May be as high as 10L/min
Used when a patient is unable to clear the mouth and throat of secretions, blood, or vomitus
Suction
Suction checklist
- The pump is working.
- The receptacle is connected to the pump.
- An adequate length of tubing connects the suction catheter to the receptacle.
- An assortment of disposable, flexible suction catheters is on hand for deep tracheobronchial suction by a qualified emergency response provider.
- A rigid pharyngeal catheter device (Yankeur) is available to clean foreign material from the mouth and pharynx.
whenever a patient feels nauseated, is bleeding from the mouth or nose, or is unable to swallow and cope with secretions because of a low level of consciousness.
use suction
if a patient begins to aspirate mucus or vomitus,
turn him or her immediately into the lateral recumbent position, don gloves and protective eyewear, and attempt to clear the airway manually. Remember to stand to one side when clearing an airway, because a sudden, violent expulsion of the obstructing material may spray your face. If a reflex cough does not clear the airway at this point, suction is needed.
