Common Medical emergencies

Question 1

what is ASA 1

Answer 1

normal healthy patient, non-smoking, no or minimal alcohol use

Question 2

what is ASA 2

Answer 2

a patient with mild systematic disease, current smoker, pregnancy, obesity, well controlled DM/HTN, mild lung disease

Question 3

what is ASA 3

Answer 3

a patient with severe systemicc disease. poorly controlled DM/HTN, COPD, undergoing regular dialysis

Question 4

what is ASA 4

Answer 4

a patient with severe systemic disease that is a constant threat to life. Recent MI or TIA

Question 5

what is ASA 5

Answer 5

a moribund patient who is not expected to survive 24 hours without an operation

Question 6

what is ASA 6

Answer 6

a declared brain dead patient whose organs are being removed for donor purposes

Question 7

what are the goals of a physical evaluation

Answer 7

-ability to psychologically tolerate stress
-ability to physically tolerate treatment
- is treatment modification indicated
-is psychosedation indicated
-which sedation technique is indicated
- any contraindications to premedications used

Question 8

what are the signs of anxiety

Answer 8

increase BP and pulse, trembling, diaphoresis, restlessness, hyperventilation, dilated pupils

Question 9

what is stress reduction protocol

Answer 9

oral sedation, intraoperative sedation, effective pain control (local), AM appointment, short appointments, hot and humid weather, post of RX prn, Post op phone call

Question 10

what is syncope

Answer 10

loss of consciousness due to generalized cerebral ischemia and low BP

Question 11

what is orthostatic hypotension

Answer 11

a decrease in systolic or diastolic BP within 3 minutes of standing

Question 12

what is vasovagal syncope

Answer 12

sudden, rapid, drop in HR and BP which leads to fainting

Question 13

what are the early and late manifestations of syncope

Answer 13

early: warmth, loss of color, sweating, nausea, BP at baseline, tachycardia
late: yawning, difficulty breathing, pupil dilation, cold hands and feet, dizziness, loss of consciousness, hypotension and bradycardia

Question 14

what are the symptoms of hyperventilation

Answer 14

rapid shallow breathing, rapid pulse and respirations, confusion, dizziness, cold hands, tightness in chest, carpal-pedal spasms, tingling or numbness of hands or lips

Question 15

how do you manage hyperventilation

Answer 15

-terminate proceudre
-position comfortably ususlly upright
-reassure patient
-no oxygen
-breathe into paper bag or headrest cover
-count to 10 between breaths
-valium 5mg