Chapter 8 Flashcards
What is an Emergency?
Any situation in which the condition of a patient or a sudden change in medical status necessitates immediate attention and action
Types of Emergency
Pulmonary Embolus Shock Diabetic Reactions Seizure CVA Syncope
Fainting also called
Syncope
Dizziness also called
Vertigo
Emergency Cart is also called
“Crash Cart”
Medical Imaging Professional’s Role
Preserve life
Avoid further harm to the patient
Obtain appropriate medical assistance as quickly as possible
Must be able to recognize emergency situation and initiate emergency measures
What does AED stand for?
automatic external defibrillator
What is Glasgow Coma Scale?
Address three (3) areas of neurological functioning 1. Eyes open 2. Motor response 3. Verbal response Total of 15 pts possible
A failure of the circulatory system to support vital body functions
Body’s reaction to illness, trauma or to severe physiologic or emotional stress
Shock
Shock is caused by
Loss in body fluid, cardiac failure, decrease blood vessel tone, or an obstruction in blood flow to vital organs
4 Classes of Shock
Neurogenic Shock
Hypovolemic Shock
Cardiogenic Shock
Vasogenic Shock
Caused by spinal anesthesia or damage to the upper spinal cord
Spinal cord injury, severe pain, neurologic damage
Blood vessels become relaxed and dilated
Pooling of blood in venous system
Neurogenic Shock
Caused by loss of blood or tissue fluid
Hemorrhage, burns, prolonged vomiting, diarrhea or medications, GI bleeding, bleeding after surgery
Insufficient amount of fluid & heart unable to pump enough to body
Hypovolemic Shock
Caused by a variety of cardiac disorders
Failure of heart to pump an adequate amount of blood to organs
7% of patient die from heart attack – most common cause is cardiogenic shock
Cardiogenic Shock
Caused by sepsis, deep anesthesia, or anaphylaxis
Peripheral vascular dilation produced by factors such as toxins that directly affect blood vessels
Vasogenic Shock
Most common type of shock encountered in radiology dept is?
Anaphylactic Shock
Anaphylactic Shock is also a
Vasogenic shock
Anaphylactic Shock may occur
with contrast media administration
Meticulous history/questionnaire form
Signs & symptoms of Anaphylactic shock
must be monitored as routine procedure with contrast studies
Alert physician when signs occur (sneezing/itching……call nurse)
Mild/Moderate/Severe reactions
Localized itching Injection site Urticaria (hives) Nasal congestion Sneezing, coughing Swelling – eyes, face Tearing of eyes Flushed, feeling of warmth (common site effect) Nausea & vomiting
Mild Reaction
PE is
Occlusion of a pulmonary arteries by a thrombus
Blood clot forms and becomes lodged in the pulmonary artery
Decreased BP
Weak, thready pulse (rapid or shallow)
Bronchospasm, laryngeal edema, severe dyspnea, cyanosis
Dysphasia, abdominal cramping, vomiting, and diarrhea
Seizures, respiratory & cardiac arrest
Severe Reaction
Anaphylactic Shock Reaction
Stop the procedure & injection Do not remove IV access Notify the radiologist and nursing staff Obtain crash cart Place patient in a Semi-Fowler’s position or in a sitting position to facilitate breathing Document reaction (important)
PE stands for
Pulmonary Embolus
PE is
Occlusion of a pulmonary arteries by a thrombus
Blood clot forms and becomes lodged in the pulmonary artery
Originates in the lower extremity and travels to the lungs (DVT)
PE originates
in the lower extremity and travels to the lungs (DVT)
PE caused by
Trauma, surgical procedures (orthopedic & abdominal), pregnancy, CHF, prolonged immobility (airplane or long car rides)
Swelling in lower extremities, pain, sudden onset
PE result in
50,000 deaths each year
A group of metabolic diseases which result from a disorder of carbohydrate metabolism
Diabetes Mellitus
Diabetes Mellitus is caused from
insufficient production of insulin or inadequate utilization of insulin
Diabetes Mellitus results in
abnormal amount of glucose in the blood or hyperglycemia
How many types of Diabetes?
4 types
Type I: gestational diabetes
Type II: associated with other conditions
Hypoglycemia
Excessive insulin (sugar) is present (low blood sugar) Characteristic of diabetes
Hypoglycemia occurs
If patient takes normal dose of insulin and does not eat (exam prep)
Example: inpatient comes to radiology after taking insulin but before eating breakfast
Hypoglycemia Rapid onset of symptoms:
Intense hunger, weakness, shaky, sweat excessively, confused or irritable
Need a quick form of carbohydrate or take a glucose tablet
Diabetic Ketoacidosis
Insufficient insulin causes liver to produce more glucose resulting in hyperglycemia
Kidneys then excrete glucose with water & electrolytes resulting in polyuria, dehydration & electrolyte imbalance
Hyperglycemia develops
Gradually over a period of hours/days
Excessive thirst & urination, dry mucosa, rapid and deep breathing, drowsiness & confusion
Insulin required – leads to diabetic coma if left untreated
Diabetic Ketoacidosis may result from
a patient being detained within the imaging department and missing their insulin medication
Without insulin
Cells cannot use the sugar in the blood and the cells need energy to survive.
Body switches to a back up mechanism.
Affects patients with Type 1 diabetes
Diabetic Ketoacidosis Symptoms
Tachycardia Headache Blurred or double vision Extreme thirst Sweet odor to the breath
Responsibility for Diabetic Ketoacidosis
Stop the procedure and notify nursing staff/radiologist
Do not leave the patient unattended
Cerebral Vascular Accident (CVA) also called
“Stroke or Brain Attack”
What is CVA?
Due to occlusion or rupture of the blood supply to the brain
CVA range from
Mild attacks to severe
Life-threatening situations
CVA symptoms are
Paralysis on one or both sides Slurred or no speech Extreme dizziness Loss of vision Severe headache Temporary loss of consciousness
Generalized brain function disturbance and are accompanied by changes in LOC
Seizures
Seizures Symptoms
A symptom of an underlying condition
Little or no warning and lasting only seconds to several minutes
Seizures caused by
Infectious disease Extreme stress Head trauma Brain tumors Vascular disease Congenital malformation Odors and flashing lights – seizure prone patients
Generalized Seizures
Affects both sides of brain
Different types: Tonic-clonic or Grand mal seizure; absence or petit mal seizure
Generalized Seizures Symptoms
Utter a sharp cry as air is rapidly exhaled
Muscles become rigid and eyes open wide
Jerky body movements & rapid, irregular respirations
Vomit or froth
Urinary or fecal incontinence
Falls into a deep sleep after seizure
Patients who have reoccurring seizures due to brain disorder
Epilepsy
Affects one side of brain
Focal or Partial Seizure: Complex
Symptoms of Focal or Partial Seizure: Complex
Remain motionless or experience emotional outburst of fear, crying, or anger
Facial grimacing, lip smacking, swallowing movements, or panting
Confusion for several minutes after episode with no memory of incident (affects memory)
Condition of Focal or Partial Seizure: Complex
Finger or hand may shake Speak unintelligibly (? Dizzy Sense strange odors, tastes, or sounds Does not lose consciousness Does not affect memory (Can have both general and simple)
How to deal with Seizures pt?
Call for assistance
Protect patient’s privacy
Place pillow under patient’s head
Do not restrain the patient
Do not attempt to insert a hard object into the patient’s mouth
Prevent patient from falling; if patient knows of pending seizure (aura) assist to floor
Turn patient to a Sim’s position (pane procedure)
What cause Syncope?
Transient loss of consciousness
Due to insufficient blood supply to the brain
Syncope Reaction
Watch for orthostatic hypotension
Assist patient to a recumbent position with feet elevated
Loosen any tight clothing
Patient falling
Do NOT try to keep them up
Place knees behind patient with arms around waist & assist to floor
History of outbursts or history of growing confusion/disorientation
Agitated/Confused Patient
Increasing agitation
Rapid pacing back and forth
Animated and increasing noisy conversation with someone who is not present
Illogical thought processes
Refusal to cooperative
Dealing with Agitated/Confused Patient
Consult with the patient’s nurse
Request assistance (don’t handle yourself)
Leave a door open and a clear path to leave room if necessary
Approach from the side, not face to face
Do not touch patient before asking permission
Use simple (not specific), concise statements to explain purpose & procedure
Do not become involved in conversation
Quarrelsome & reluctant to cooperate
Intoxicated Patient
Neglect all rules for safety
Risk of falling from stretcher or imaging table
Keep communication simple, direct & non-judgemental
Do not leave the patient alone
Observe the patient at all times
Ask for assistance if necessary
If refuses, stop procedure
Moderate Reaction
Tachycardia/Bradycardia Hypotension/Hypertension Bronchospasm, wheezing Constriction of the air passageways Dyspnea Laryngeal edema Acute inflammation causing obstruction to air flow
Vertigo is a precursor (sign) to
Syncope
