Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pain and Anxiety > L9 Medical Emergencies > Flashcards

L9 Medical Emergencies Flashcards

1
Q

What are the most common causes of medical emergencies

A
  1. Stress & anxiety
  2. Extreme age
  3. Improper pt assessment
  4. Longer dental appt
  5. Unhealthy, unfriendly enviornment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Other risk factors for med emergencies?

A
  1. OSA
  2. Obesity
  3. Higher mallampati score
  4. Increased drug administration
  5. Multipharma pt’s
  6. Addict patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When do most medical emergencies happen?

A 
55% LA 
39% extraction
27% pupal extirpation 
22% ensuing dental tx
2% in the waiting room
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you have to be concerned about that is stress related?

A 
Syncope
Acute angina
Acute asthma
Stroke
Seizures 
HV (hyperventilation) syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Non stress related

A 
Allergy
Hypoglycemia
Drug overdosage & LA toxicity
Postural hypotension
Airway obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PABCD of BLS

What does BLS stand for?

A

Positioning
Airway
Breathing
Circulation

Definitive tx: diagnosis, drugs, defibrillation

Basic life saving = dentist certification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

General emergency drugs that are INJECTABLE for dental office

A
  1. epi
  2. histamine-blocker
  3. antihypoglycemic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Use of epi in office

A

1: 1000 IM
1: 10 000 IV

Anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Histamine-blocker aka benadryl emergency injection

A

Non life threatening allergy - rash, hives, itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antihypoglycemic emergency injection

A

50% dextrose in water

glucagon 1mg/IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Non-injectable & inhalational drugs

A
  1. O2 - almost all emergency
  2. Glucose - hypoglycemia
  3. Nitroglycerin - acute angina
  4. Salbutamol (2 puffs) - acute asthma
  5. Aspirin (chewable) - chest pain, suspected MI
  6. Aromatic ammonia - respiratory stimulant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Parental (non oral) drugs

A
  1. Analgesic - ex morphine, fentanyl
  2. Anticonvulsant - diazepam, midazolam
  3. Antihistamine - Benadryl
  4. Antihypoglycemic - dextrose + glucagon
  5. Corticosteroid - methylprednisolone
  6. Narcotic antagonist - Naloxone
  7. Benzo antagonist - flumazenil
  8. Vasopressor - epi
  9. Vagolytic - atropine, glycopyrolate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vasovagal Syncope

A

Syncope is a sudden loss of consciousness due to transient brain schema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of patients do vasovagal responses occur in?

A

Otherwise healthy people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes the vasovagal response?

A

Psychic, smelling, hearing, panic, anxiety, acute pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the mechanism of vagal responses?

A

Vagal stimulation –> slow HR –> decreased CO –> decreased BP and brain schema –> transient LOC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Max dose for LA with and without epi

A

500 –> 5 um/ml in blood

300 mg

18
Q

How to prevent systemic toxicity from LA’s?

A
  1. Slow injection
  2. Aspirate
  3. Small divided doses
  4. Ask about symptoms
  5. Know your max doses
19
Q

How you manage systemic toxicity from LA’s?

A
  1. Stop injecting
  2. Call for help - start lipid emulsion therapy?
  3. Airway mgmt - give 100% oxygen, avoiding HV
  4. Treat seizure - valium?
  5. Treat hypotension and bradycardia
  6. Pulseless - start CPR
20
Q

Manifestations of sedative and GA overdose

A
  1. Medullary depression
  2. Reduced RR and HR
  3. Lower O2 sat, higher CO2 sat
  4. Cyanosis
  5. Heart and resp failure
21
Q

Management of sedative and GA overdose

A
  1. Stop injecting drug
  2. Call for help, call 911
  3. O2, fluids, vasopressor
  4. Reversal drug
  5. Consider admission
22
Q

What if patient hasn’t woken up after from fainting after 5 mins? they are breathing

A
  1. Administer O2
  2. Crush ammonia ampoule under nose
  3. Monitor vitals
  4. Assess pt - good and awake
  5. Get pt escorted home
  6. Plan for anxiety control measures for future dental care
23
Q

What if patient hasn’t woken up after from fainting after 5 mins? they are not breathing

A
  1. Start BLS
  2. Call for help, call EMS
  3. Consider possible non vasovagal syncope - hypoglycemia, seizure etc.
24
Q

What are skin manifestations of allergic rx?

A
  1. Urticaria
  2. Angioedema
  3. Pruritus
  4. Erythema
  5. Rashes
25
Q

What are the respiratory manifestations of an allergic rx?

A
  1. Wheezing

2. Dyspnoea (laboured breathing)

26
Q

Management of an allergic reaction?

A
  1. Stop administration of all drugs presently in use
  2. Call for help
  3. Administer epinephrine (0.3 – 0.5 mg SC/ IM) (if respiratory signs)
  4. Give oxygen (6 L/Min) by face mask or nasally
  5. Monitor vital signs frequently
  6. Establish IV access
  7. Administer antihistamine, Benadryl 50 mg
  8. Consult patient’s physician or emergency room physician
  9. Observe in office at least 1 hr
  10. Prescribe antihistamine 25-50 mg tabs 4-6 h.
27
Q

Manifestations of anaphylaxis?

A 
Malaise
Wheezing
Moderate to severe dyspnea
Stridor
Cyanosis
Tachycardia
Hypotension
Dysrhythmias
Cardiac arrest
28
Q

What are 4 possible causes of chest pain?

A
  1. Cardiac - angina, MI
  2. GI - esophagitis, ulcer, heart burn, hernia
  3. Skeletomucle - spasm
  4. Psychological - hyperventilation
29
Q

What relieves angina?

A
  1. nitroglycerine
  2. Oxygen
  3. rest
30
Q

What are common causes of chest pain?

A
  1. exertion
  2. Large meal
  3. anxiety
31
Q

Management of chest pain in dental chair

A
  1. Stop dental tx
  2. Put patient in semi-reclined position
  3. Give nitroglycerin
  4. Give aspirin
  5. Give oxygen
  6. check pulse and BP

If relieved: assume angina

  1. slowly taper oxygen
  2. Modify dental tx to prevent recurrence
  3. hospital referral

If not relived: assume MI

  1. give morphine for pain
  2. call EMS
32
Q

MGMT of basic asthma attack

A
  1. Terminate all dental treatment
  2. Position patient in fully sitting posture
  3. Administer bronchodilator by spray (Salbutamole, isoproterenol, epinephrine)
  4. Administer oxygen
  5. monitor vital signs
33
Q

Symptoms of hyperventilation

A 
Anxiety
Tetany
Hyperpnea
Light headedness
Tingling extremities
Circumoral numbness
34
Q

Mgmt of hyperventilation

A
  1. Terminate all dental treatment and remove foreign bodies from mouth
  2. Position patient in chair in almost fully upright position
  3. Attempt to verbally calm patient
  4. Have patient breathe CO2 enriched air, such as in and out of a small bag
  5. if symptoms persist, administer diazepam 10 mg IM (midazolam 5 gm IM)
  6. Monitor vital signs
  7. Use anxiety control/ Sedation in future
35
Q

What are mild symptoms of hypoglycemia?

A

Nausea
Hunger
Weakness

36
Q

What are moderate symptoms of hypoglycemia?

A 
Tachycardia
Perspiration
Pallor
Anxiety
Behavioural changes - confusion, uncooperative
37
Q

What are severe symptoms of hypoglycemia?

A

Unconsciousness
Seizure
Hypotension

38
Q

Symptoms of pt in seizure

A

Rigid
Cyanosis
Cheek/tongue biting
Loss of consciousness

39
Q

Symptoms post seizure

A

Guilt
Desire to sleep
Confused, disoriented

40
Q

Tx of conscious pt in seizure

A 
1, protect from harm
2. suction airway if need be
3. monitor vitals
4. give oxygen
5. call dr
6 observe for 1 hour
7. escort home
41
Q

Tx of unconscious pt in seizure

A
  1. call for help
  2. protect from harm
  3. place on side and suction airway
  4. monitor vitals
  5. start BLS
  6. oxygen if needed
  7. Transport ot emerg

Pain and Anxiety (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions