Communication and medical emergency

Question 1

what does SBAR stand for?

Answer 1

Situation
Background
Assessment
Recommendations

Question 2

adrenal insufficiency management… 3 things

Answer 2

1. lay flat
2. give oxygen
3. transfer to hospital

Question 3

who is at risk of adrenal insufficiency?

Answer 3

patients who have been on long term corticosteroid therapy

Question 4

what do you say in situation? 4 things

Answer 4

• who you are
• where you’re calling from
• identify patient
• reason for calling other healthcare professional

Question 5

what do you say in background? 3 things

Answer 5

• the patients reasons for attending dental appointment
• significant PMH, drug, social, family
• history of progression of concern during your care

Question 6

what do you say in assessment?

Answer 6

• what you think is happening
• how urgently you think they need to be seen
• vital signs

Question 7

what do you say in recommendations?

Answer 7

• explain what you need from other healthcare professional
• make suggestions
• clarify expectations

Question 8

which patients would you give adrenaline to?

Answer 8

those in anaphylactic shock

Question 9

for an adult, what is the mL of adrenaline?

Answer 9

0.5mL (500mg)

Question 10

for a child

Answer 10

0.15mL (150mg)

Question 11

for a child between 6-12 what mL of adrenaline would you give?

Answer 11

0.3mL (300mg)

Question 12

define anaphylaxis

Answer 12

a severe allergic reactions following exposure to an allergen ( commonly a drug in the dental environment )

Question 13

what are 8 signs and symptoms of anaphylaxis?

Answer 13

• parasthesia (pins and needles)
• flushing and swelling of the face
• itching (esp feet and hands)
• bronchospasm and laryngospasm
• rapid, weak pulse
• fall in blood pressure
• pallor
• cardiac arrest

Question 14

what are the 4 steps of management in a patient who is in anaphylaxis?

Answer 14

1. lay flat and raise feet (put in recovery position if unconscious)
2. administer adrenaline
3. administer oxygen
4. transport to hospital

Question 15

how is adrenaline administered?

Answer 15

intramuscularly

Question 16

how often can you repeat the dose of adrenaline?

Answer 16

every 5 mins if not working

Question 17

how many puffs of a short acting beta2 agonist does it take for most asthma sufferers to respond with?

Answer 17

2

Question 18

what are the 3 types of asthma attack?

Answer 18

• moderate acute asthma
• severe acute asthma
• life threatening asthma

Question 19

what is the easiest way to distinguish between the 3?

Answer 19

moderate = able to talk
severe = unable to complete sentences in one breath
life threatening = silent chest

Question 20

how many breaths per minute is worrying?

Answer 20

around 25/min

Question 21

how long would you monitor a patient who had moderate acute asthma attack?

Answer 21

15-30 mins

Question 22

true or false : you must always send someone who has had an angina attack to hospital?

Answer 22

false. they may have their own GTN sray or isosorbide denigrate tablets and make a full recovery

Question 23

what is the difference between angina attack and myocardial infarction symptoms?

Answer 23

they are much the same except MI symptoms more severe

Question 24

what are the 6 signs and symptoms of a myocardial infarction

Answer 24

• progressive onset of central crushing chest pain
• may radiate down one arm, shoulder, neck or jaw
• skin is pale and clammy
• nausea and vomiting
• breathlessness
• weak pulse and drop in blood pressure

Question 25

steps in managing someone who’s having an MI

Answer 25

• call ambulance
• allow patient to get into a comfortable position
• oxygen
• sublingual GTN for pain relief
• reasssure
• asprin 300mg (single dose)

Question 26

what advice should you give to an epileptic patient before attending a dental treatment?

Answer 26

to continue on the same dose of anti-convulsant