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Medical Emergencies Dental > Exam 1 > Flashcards

Exam 1 Flashcards

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USMLE® Step 1 flashcards
1
Q

How many medical emergencies occur in a spand of 10 years within a U.S dental office?

A

7 1/2

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2
Q

How many of the medical emergencies are life threatening?

A

1/3

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3
Q

What occurs with increasing age of population?

A

The increase of medical emergencies

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4
Q

What are the most common emergencies ?

A
  • Syncope
  • Mild allergic reaction
  • angina pectoris
  • Orthostatic hypotension
  • Most likely to occur after the administration of a local anesthetic extraction or endodontics
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5
Q

How do you try to prevent medical emergencies within a dental office?

A
  • Thorough medical history
  • Vital signs
  • Preparing for a medical emergency
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6
Q

What are a few conditions that patients may report within medical history that can increase the risk of medical emergencies?

A
  • Heart conditons such as MI, CHF
  • Asthma
  • CVA, Frequent headaches or dizziness
  • Epilepsy
  • Thyroid problems
  • diabetes
  • Corticosteriod use
  • Allergy
  • Bleeding disorder
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7
Q

What are some preparations for a medical emergencies in the dental office?

A
  • Well-equipped medical emergency kit with o2 tank
  • Current CPR training
  • Attendance at CE courses on medical emergencies
  • In office simulated medical emergencies
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8
Q

What does vitals signs document?

A
  • Pulse
  • respiration
  • Blood pressure
  • Tempreature
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9
Q

What is pulse?

A

Speed of heartbeat, its expansion and contraction of artery as blood is forced out of the heart.

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10
Q

Where is pulse taken?

A
  • Carotid neck
  • Radial pulse in wrist
  • Brachial pulse in arm
  • Femoral pulse in groin

Most common site in dental office radial pulse

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11
Q

What are normal pulse rate?

A

Healthy adult= 60-80 BPM
Individuals who excerise: 40-60 BPM

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12
Q

Tachycardia

A

Rapid pulse rate
More than 100 BPM

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13
Q

Why does tachycardia often occurs?

A
  • Fever
  • excersise
  • nervousness
  • excitment
  • medications or stimulant type drugs
  • disease states
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14
Q

Bradycardia

A

Less than 60 BPM

Can cause:
* lightheadedness
* dizziness
* chest pain
* syncope
* circulatory collapse

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15
Q

What do you treat bradycardia with/

A

Treat with atropine to increase heart rate

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16
Q

Irregular pulse means?

A

Arrythmia

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17
Q

Weak pulse (thready)?

A

Decrease stroke volume

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18
Q

Respiration

A
  • normal adult: 12-20
  • Infants and children normal rate are quicker
  • Newborns: 40-50
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19
Q

Tachypnea

A

Abnormally fact more than 20

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20
Q

Bradypnea

A

Slowed rate less than 12
*often seen in syncope

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21
Q

What are abnormal breathing patterns ?

A

Biot-periods of shallow breathing alternating with apnea

Cheyne- Stokes: increased rate and depth alternating with apnea

Kussmaul- increased depth and rate greater than 20

Dyspnea- labored breathing

Stridor- harsh/Crowing ** associated with obstruction**

Wheezing- high pitch sound

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22
Q

Pyrexia/fever

A

Increased temperature

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23
Q

Hypothermia

A

reduced body tempreature

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24
Q

What are causes of Hypothermia ?

A
  • Illness
  • Trauma
  • Malnutrition
  • Medications
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25
Q

Blood Pressure

A

Force exerted against the blood vessel walls

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26
Q

What is systolic and diastolic?

A

120/80 mmHg

Systolic- force of blood against blood vessel wall during ventricular contraction 100-120

Diastolic- force of blood against blood vessel wall during ventricular relaxation 60-80mmHg

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27
Q

What are the 10 most common medical emergencies?

A
  • Syncope
  • Mild allergic reaction
  • Angina pectoris
  • Postural hypotension
  • Sezures
  • asthma attack
  • Epinerphrine reaction
  • Hypoglycemia
  • Cardiac arrest
  • Hyperventilation
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28
Q

What are the 7 medications in a dental emergency kit?

A

Epinephrine (injection)
Diphenhydramine (injection or tabs)
Nitroglycerin (tabs or nitrolingual spray)
Albuterol
Glucose
Asprin (325 mg)
Oxygen

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29
Q

What is the use of the epinephrine?

A

Used for:
* severe allergic reactions
* anaphylaxis
* acute asthmatic episode ( to reduce bronchospasm)

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30
Q

Epinephrine causes?

A

vascocontriction that increases BP, heart rate and force of contaction, bronchial dilation and reduces the release of histamine.

31
Q

Epinephrine can be ineffective if ?

A

Patient is taking beta blocker

32
Q

What are adverse effects of Epinephrine?

A
  • Cardiovascular: Tachyarrhythmias and hypertension
  • Central nervous: Agitation, headache and tremors
  • endocrine system : increase blood glucose
  • Pregnant Female: Can decrease placental blood flow
33
Q

Dose for Epinephrine?

A

Adult: .3mg
Child: .15mg

34
Q

What is the function of Epinephrine?

A

Reduces hypotension, bronchospasm, laryngeal edema, prevents
additional release of histamine and other chemical mediators

35
Q

What should Epi not be used with?

A
  • ischemic heart disease
    or severe hypertension
36
Q

Where should Epi be administered?

A

Thigh

37
Q

What is Diphenhydramie/chlorpheneramine?

A

Antihistamine or Intramuscluar histamine blocker

38
Q

What is Diphenhydramie used for?

A

Slow to moderate allergic reactions
When the airway is not compromised

39
Q

What is the difference btween Diphenhydramie/chlorpheneramine?

A

Chlorpheneramine does not cause as much
drowsiness

40
Q

Nitrogylcerin Indications

A

Angina pectoris
Heart attack or heart failure

41
Q

What is Nitrogylcerin?

A

Potent coronary vasodilator: opens up the coronary circulation

42
Q

When not to give nitroglycerine?

A
  • When the pt has viagra or levitra with 24 hrs
  • Cialis within the last 48 hrs
  • PT is on vasodilator ( because adding nitroglycerine will critically decrease BP)
43
Q

How to administer nitroglycerine?

A

Adminster sublingually
* should not administer of Systolic BP is less than 90

44
Q

Nitrogylcerin is given with pain of angina because what happens?

A

because there is a mismatch b/ oxygen demand and oxygen supply in the coronary circulation.

45
Q

What are the risk of nitrogylcerine?

A
  • If Pt is already on vasodilator and adding nitrogylcerin as another vasodilator will critically decrease the blood pressure
46
Q

who are the most importanty people to ask if they are taking nitrogylcerine?

A
  • Patients suffering from pulmonary hypertension
  • on vasodilator or blood pressure management medications
47
Q

How to use nitroglycerin in the forms of spray and tablet?

A

Tablet: Adults-1 tablet placed under the tongue or between the cheek and gum at the first sign of an angina attack,

1 Tablet every 5 mintes as needed for up to 15min.

Spray: spray in mouth, shelf life two yeats

48
Q

How to administer nitroglycerine?

A

Administer sublingually
Administer at five minute intervals- uo to three doses
Should not administer if systolic BP is less than 90 mmHg

49
Q

Oxygen is used to?

A

For all emergencies except for hyperventilation

50
Q

Asprin

A
  • Reduces overal mortality from MI (heart attack)
  • Prevents progression of cardiac ischemia to cardiac injury or tissue death
  • Check medical hx for allergy first
51
Q

When such asprin not be used?

A

Hemorrhagic stroke

52
Q

What is an example of a Bronchodilator

A

Albuterol inhaler

53
Q

Albuterol is used for?

A

Asthma attack or bronchospasm

54
Q

What is the drug effect of Albuterol ?

A

Dilation of bronchioles with minimal cardiobascular effects
Peaks 30-60 min
Duration- 4-6 hours

55
Q

What is the dose of Albuterol?

A

Adult two sprays
Peds: 1

56
Q

Oral Carbohydrate/ glucose symptoms

A
  • appears confused
  • cool, mosit skin
  • may be hungry
  • may seem drunk but not breath odor
  • slurred speech
57
Q

What should gluscose not be used for?

A

Can increase intra cerebral pressure but is critical for hypoglycemia
Stroke can minic hypoglycemia

58
Q

How to treat low blood sugar

A
  • eat/drink 15g carbs
  • wait 15 min
  • check blood
  • less than 70mh/dl repeat steps
59
Q

Naloxone is used for?

A

Opioid overdose

60
Q

How is naloxone used?

A

Spray every 2-3 min into one nostril

61
Q

What is the dose of asprin recommended?

A

162-325mg or 2-4 baby asprin (.81 mg each)

62
Q

What are the factors for choosing a drug?

A

Convenience
Cost
Efficacy
Safety

63
Q

What defines a medical emergency in a dental office?

A

An unexpected event that can include accidental or willful bodily injury, central nervous system stimulation and depression, respiratory and circulatory disturbances as well as allergic reactions.

64
Q

What is the importance of a medical emergency team response?

A
  • having roles to ensure coordinated and efficient response to the situation
  • assigning specific roles helps create a structured and organized approach to managing th emergency.
65
Q

What are the expectations of everyone?

A
  1. identify emergency equipment location
  2. periodically review medical emergency signs/symptoms, procedures, use and administration of emergency drugs
66
Q

What is the GSU communications center phone numbers?

A

Office phone: 3-3333
Personal Cell: 404-413-3333

67
Q

What is the address to GSU and clinic?

A

2101 womack road dunwoody GA 30338
Building: NC
Main clinic: 1200
mini clinic: NC 1240
Lab: NC1375

68
Q

What are the roles of person 1:

A

Assess the nature and severity of the problem
Stay with the Patient
Instruct others
Provide care

69
Q

What are the roles of person 2:

A
  • Check time
  • Assit with Vitals and oxygen
  • Be the second person in two-person CPR for healthcare providers
  • Bring oxygen and the emergency cart, AED and emergency form
  • Prepare drugs
  • Assist as needed
70
Q

What are the roles of person 3

A

Notifies faculty members
Calls campus police in downtown
Record data
assist tem leader
suction if necessary
relieve others in CPR

71
Q

After contacting 3-3333 What should you provide?

A
  • location
  • state of emergency: is the person conscious, is the person bleeding? How much?
72
Q

What type of communication should each person of a medical emergency have?

A

Closed loop

73
Q

All persons invovled in an medical emergency needs to ?

A
  • Record their version of what happen ASAP and ensure all paperwork has been completed.
  • Inform clinic assitant of any supplies used so that they may be replaced
74
Q

Incident Report Forms are for?

A
  • Emergency treatment record
  • Needle stick incident

Medical Emergencies Dental (16 decks)

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