Lecture 5 Part 1 Exam 2 Flashcards
What size O2 tank is recommended for a dental office?
Size E- 30 mintinues of oxygen
What are the parts of a O2 tank?
Regulator
Flow meter
Oxygen outlet
Cylinder
Reducing valve
What is syncope?
sudden, transient loss of consciousness and then quick recovery
Syncope is often associated with?
other underlying condition, stressful condition
Who is more susceptible for syncope?
Common medical problems affecting all ages, children, pregnant mothers and elderly
What are the signs of syncope in children?
- Missed meal
- Heat
- Dehydration
- Crying
- Exertional activity
What are the signs of syncope in elderly?
Postural changes
Defecation
Coughing
orthostatic hypotension
Medications
Disease: CHD,HF, diabetes, renal insufficeny,COPD
What is the most common medical emergency in the dental office and when does it occur?
- Syncope
- Occurs during administration of local anesthetics
What are the different types of syncope?
- Cardiac Synscope- inadequate cardac output
- Noncardiac syncope-seizures, orthostatic hypotension,stitualtional occurence, hyperventilation, Metabolic disease
- Neurocardiac syncope-vasodepressors
What is neurocardiac snycope?
Maybe more on test
- Activation of the autonomic nervous system
- fight or flight response
- Releases catecholemines, epinephrine and norepinephrine
- Blood can pool in extremities with no movement
What is the etiologies of cardiac syncope
on test
Arrhythmic
Obstructive
What is the etiologies of Noncardiac syncope
on test
Seizures
Orthostatic Hypotension
Situational occurrences
Hyperventilation
Metabolic disease
What is the etiologies of Neurocardiac/Vasodepressor syncope
on test
- Noxious stimuli
- Activation of the sympathetic division of the autonomic nervous system
What is the signs and sympotoms of presyncope?
- Pallor
- Pupil dilation
- Diaphoresis
- Excitation of piloerector muscles
- Weakness, dizziness, vertigo
- Nausea
- Yawning or sighing
- Visions changes
- Increased BP
- Shortness of breath
- Heart palpitations
- Chest pain
- Slow onset
What are the vision changes in presyncope?
Darkening
Blurring
Seeing Spots
What are the signs and symptoms of syncipe ?
Unconsciousness
Weak
Slow pulse
What is the treatment of syncope?
- Remove objects from oral cavity
- Position Supine with feet elevated
- open airway
- assess circualtion
- loosen tight clothing
- o2
- VS
- Do not use ammonia inhalant
- call EMS
What is shock?
condition produced when the cardio-vascular pulmonary system fails to deliver enough oxygenated blood to body tissues to support metabolic needs
What are the stages of shock ?
Initial
Compensatory
Progressive
Refractory
Describe the first stage of shock
- Cells deprived of oxygen
- Inhibits ability to produce energy
- Cells not functioning properly
- Impacts body systems
Describe the second stage of shock
Compensatory- body performs physiological adaptations in an attempt to overcome shock
* increased respiration
* increased BP
* Reduced blood supply to peripheral organs
Describe the third stage of shock
Progressive- compensatory mechanisms begin to fail.
* If the problem causing shock is not treated, condition will worsen
* vital organs compromised and not functioning appropriately
Describe the fourth stage of shock
Refractory - failur of vital organs
* Irreversible
* Cell death and brain damage have occured
* Death will occur in a few hours
What are the types of shock ?
- Hypovolemic shock
- Cardiogenic
- Distributive: anaphylactic, septic, neurogenic
- Obstructive
What is Hypovolemic Shock?
**Most common Form **
- Caused by inadequate venous return
What is the cause of hypovolemic shock?
Hemorrhage or dehydration (vomiting or diarrhea)
Hypovolemic Shock initial symptoms are?
Increased heart rate
Rapid, thready pulse
Cool skin
Reduced urine output
Confusion
What is the treatment of hypovolemic shock?
Arrest cause of hemorrhage or dehydration
supine position
contact ems
CABS of CPR
Monitor Vitals signs
Administer oxygen
Needs IV fluids to restore blood volume
What is Cardiogenic shock
- Reductuon in perfusion due to decreased cardiac output
What is the etiologies of cardiogenic shock?
MI
Cardiac arrhythmias
Cardiac dysfunction
What are the signs and symptoms of cardiogenic shock?
- Reduction in BP with systolic below 90
- Fast, weak pulse
- Cold, clammy skin
- Cynanosis
- Nonspecific chest pain
- shortness of breath
- Reduced urine output and confusion
What is the treatment for Cardiogenic shock ?
Similar to heart attack
- supine positon
- contact ems
- CABS of CPR
- Monitor VS
- Oxygen
- Needs IV fluids
- Cardiac medications needed
What is distributive shock?
vasogenic shock: Anaphylactic, Septic and neurogenic
What is anaphylatic shock ?
Sudden, massive vasodilation and circulatory collapse after exposure to allergen
What is septic shock?
- vasodilatory shock
- bacteria invade bloodstream
What are the signs of septic shock?
Fever
Increase cardiac output
tissue edema
Pink warm skin
restlessness
tachycardia
thirst
eventual respiratory failure
What can septic shock cause
Microthrombi formation- small bloodclots
What is Neurogenic Shock?
- Loss of sympathetic nerve
- Because of emotional trauma, disease, drug or traumatic injury to brain or spinal cord
Loss of sympathetic nerve activity causes?
Peripheral dialtion leading to reduction of venous, which decreases cardiac output with low blood pressure
What are the signs and symptoms of neurogenic shock?
- Hypotension
- Bradycardia
- Brain and Kidneys at risk of failure
What are the treatment for neurogenic shock?
Positon supine
Contact EMS
CABs of CPR
Monitor vital signs
Administer o2
needs drug therapy
What is obstructive Shock?
Results from indirect heart pump failure
leads to decrease cardiac function and reduce circulation
What are the causes of Obstructive shock
- Arterial stenosis
- Pulmonary embolism
- Cardiac tamponade
What are the signs of obstructive shock?
Hypotension- low BP
Dyspnea- shortness of breath
What is the treatment of Obstructive shock
Position supine
contact ems
CABS of CPR
Monitor vital signs
Oxygen
Needs IV Fluids
Surgical intervention
What is hyperventilation?
Rapid, deep breathin
Respiration: 22 and 40 respirations
Hyperventilation is more common in who?
Females age 30-40
When is hyperventilations most commonly occured?
High altitude
Pregnant
Takes CNS stimulants
Asprin toxicity
Extremely anxious
What are the signs and symptoms of Hyperventilation?
Abnormal prolonged rapid and deep respirations
Decrease in carbon dioxide
Impairment vision
seizures
twitching muscles (tetany)
Numbness of extremities
What does progressive hyperventilation cause?
Hypocalcemia
What does hyperventilation mimic?
Pulmonary embolism
What is the treatment for Hyperventilation?
Place PT in the positon of their choice
Loosen tight clothing in neck region
Work with patient to control rate of respirations
Monitor vital signs
Can give benzodiazepine/lorazepam
What should you not do when a patient is experiencing hyperventilation ?
Do not use a paper bag, due to cardiac arrest
Oxygen should not be administered
