Med emergencies Flashcards
Outline the physiology of a faint
syncope occurs when there is inadequate cerebral perfusion w/ oxygenated blood
temp malfunction of autonomic nervous system results in decrease in blood returning to heart .:. lower BP. Brain reacts by further reducing BP and lowering HR.
.:. temp reduction of blood to brain.
Pt feels hot, but becomes cold, clammy, pale, loses consciousness and may vomit.
Vasovagal - emotional/common faint.
but many types of syncope
How is a faint managed in practice?
Stop tx
Assessment ABCDE
lie pt back, raise legs
If any of ABC life threatening phone ambulance
If ABC manageable
monitor, remove restricting clothing and open windows.
Give O2 15L/ min
If no recovery phone 999.
What medicines are in emergency kit? quantities and uses?
Oxygen 15L/min - faints, most med emergencies
Aspirin 300mg - MI / angina
GTN spray 400 micrograms - angina
Adrenaline 500 micrograms 1:1000 conc - anaphylaxis
Midazolam 10mg buccal - >5 min epileptic fit
Salbutamol - 100mg/actuation inhaler - asthma attack
Glucagon - 1mg IM – hypoglycaemia
Pt feels dizzy standing up too fast. What is this called? Physiology?
How to prevent this?
2 risk factors for this
Postural Hypotension
- decrease in systolic of 20mmHg and of diastolic by 10mmHg within 1-3 minutes of standing up after being supine.
Failure of autoregulatory system that mantains blood pressure on standing. Blood pools in legs -> poor venous return -> fall in cardiac output -> decreased BP
Encourage pt to slowly move to sitting upright, then slowly standing upright, taking their time.
To take deep breaths.
Elderly, - low BP, decreased activity
Medication use- antihypertensives, antideppressants and antipsychotics among others.
3 reasons for a pt to fall unconsious?
faint
hypoglycaemic attack
heart attack
anxiety
ABCDE?
Airway - assess w/ talking if conscious, jaw thrust to check for obstruction.
Breathing - check w talking ormuscles moved, sound made, chest moving. measure RR
Circulation - check carotid or radial. check pulse, character, volume, colour, temp
Disability- AVPU
Exposure - any other visible signs symptoms
