Chapter 20 Flashcards
What is an emergency?
Condition of patient of sudden change in medical status that requires immediate action: technologist must recognize when assistance is warrented or needed
Priorities for working with patients in medical emergencies:
- Ensure an open airway (A)
- Control bleeding (B)
- Prevent Shock (C)
- Attend wounds and fractures
- Provide emotional support
- Continually re-evaluate and follow up
What do crash carts contain?
Drugs and equipment to handle life threatening situations
How are drawers ordered on crash cart?
ABC order
What drugs are on crash cart?
Atropine - respiratory stimulant/bradycardia
Benadryl - allergic reactions
Cordarone - heart arrhythmias
Dilantin - seizures/anti-convulsant
Lasix - edema
Xylocaine - local anethetic
Intropin - shock
Epinephrine - cardiac arrest and anaphylaxis
What are non-drug items on crash cart?
Backboard - CPR
Flashlight
Levine tubing - NG tube
Jelco cannulas - IV tube
Cut down tray - PICC lines
Connectors - connect tubing
Surgical lubricant - place NG tube
Levels of consciousness
- Least severe - alert and conscious; can full respont to stimuli and questions
- More serious - drowsy; can be roused with loud voice or gentle contract
- More serious - unconscious and only reacts to painful stimuli
- Most serious - comatose or unresponsive to all stimuli
Signs of deteriorating head injury
- Irritability
- Lethargy
- Slowing pulse rate
- Slowing respiratory rate
How should Rad Tech respond to deteriorating head injuries
Stop the procedure
Maintain open airway
Minimal movement
Get assistance
Mointor vital signs
What is shock?
Indicates the failure of the circulatory system to support vital body functions
Types of shock?
Hypovolemic
Cardiogenic
Neurogenic
Vasogenic
What is Hypovolemic shock?
Loss of blood/tissue fluid
What is Cardiogenic shock?
Caused by cardiac arrest issues
What is Neurogenic shock?
Spinal anethesia or damage to upper spinal cord; CNS is damaged
What is Vasogenic?
Most common - caused by infection, anesthesia, or anaphylaxis
What kind of shock do X-ray techs encounter?
Hypovolemic or vasogenic
When does Anaphylaxis usually occur?
After a contrast media injection
How to prevent shock?
Prevent sudden changes in body temp
What factors contibute to shock?
Pain
Anxiety
Stress
What two aspects do you need to pay attention to when caring for the patient?
Physical and
Psychological care
Signs and symptoms a patient might be going into shock:
Anxiety
Tachycardia
Decreased blood pressure
Cold and clammy skin
Pallor - pale skin
Severe contrast reactions can result in:
Cardiac arrest or death
Symptoms of a mild contrast reaction:
Localized itching
Uticaria - hives
Nausea or vomitting
What is generalized itching and hives an indicative of?
Systemic reaction - more serious reaction
First thing administered to patient in the event of a reaction?
Benedryl or epinephrine
More serious contrast reactions might include:
Laryngeal edema
Shock
Cardiac arrest
What is insulin?
Hormone that helps regulate carbohyrdate and fat metabolism in the body
What is hypoglycemia and what are the symptoms?
Excessive insulin/low blood sugar; weak, shaky, sweat, confused, irritable
What is hyperglycemia?What are symptoms?
Excessive sugar/low insulin; thirst, urination, dry mucosa, rapid and deep breaths, drowsy and confused
What can happen if patient is hypoglycemic?
Can go into insulin shock; needs carbs, ask patient to sit or lie down
What can happen if patient is hyperglycemic?
Needs insulin - can go into a diabetic coma
What is happening when “wheezing” occurs?
Loss of elasticity of bronchi
What should the tech do in case of an asthma attack?
Stop the procedure
Set the patient upright
Allow patient to use asthma meds
How to assess for choking?
Can you breath
Red face, clutches throat
Encouraged to cough
How to perform Heimlich if pregnant?
Stand in back
Arms around patient
Thumb side of fist placed about center of sternum
Chest thrusts - not abdominal
Signs and symptoms of cardiac arrest
Sharp chest pain
Pain down the left arm
Pallor
SOB, palpatations, anxious
Warning signs of CVA?
Slurred or loss of speech
Paralysis
Dizziness and loss of vision
What should a technologist do if patient is experiencing CVA?
Signs and symptoms reported to nurse/physican
Do not stand/move
CPR may be required
Who is more likely to have CVA?
Adults over 75
Nausea/vomitting is what type of response?
Psychological and physiological
How should patient breathe if nauseaus?
Slowly and deeply through their mouths
If patient is going to vomit, how should they be positioned? And what should be provided?
In a position where they don’t aspirate - side/erect
Turn head
Provide emesis basin
What is epistaxis?
Nose bleed
What to do in case of a nose bleed?
Do not put patient in recumbent position
Lean them foward
Put digital pressure on nostril
Don’t tilt head back
Apply moist compress
Seek medical attention after 15 minutes
What is vertigo?
Dizziness
Another word for syncope?
Fainting
What to do if patient is experiencing vertigo?
Put them in a seated or recumbent position
What is syncope?
Self-correcting mechanism to get blood flow back to the brain
What is a temporary form of shock?
Syncope
What to do if patient faints?
Get in recumbent position with feet elevated, loosen any tight clothing, moist cool towel to forehead
What is orthostatic hypotension?
Dizziness or vertigo from sitting/standing too quickly
What happens during a mild seizure?
Brief loss of consciousness or may stare into space.
May be slightly confused and weak
What happens during a severe seizure?
Involunatry contractions of muscles on 1 or both sides
Lasts one to several minutes
What should tech do if patient has a seizure?
Do not restrain, but prevent injury
Do not stick fingers in their mouth
Move to floor
After seizure, make sure airway is open
What is an aura?
Physical or mental warning of seizure
What is dehiscence?
When sutures separate allowing contents to spill our of cavity
What to do in the event of dehiscence?
Do not try to put contents back in
Place sterile dressing over
Put patient in seated/slightly forward position
Get help
What is eviseration?
Loss of organs from a body cavity
Medicaton used to decrease anxiety during MRI
Xanax
Valium
Versed
