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BDS3 BAMS Patient Safety > Medical Emergencies > Flashcards

Medical Emergencies Flashcards

1
Q

Pneumonic used for medical emergency assessment and what does it stand for.

A

ABCDE
Airway, breathing, circulation, disability, exposure.

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2
Q

What are three causes of airway obstruction ?

A

Choking.
Loss of consciousness.
Infection, inflammation or swelling.

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3
Q

Patient has lost patent airway. What is the first thing you should do to assess airway if appropriate ?

A

Triple manoeuvre - head tilt, jaw thrust, chin lift - will relieve airway blockage.
Can place oro-pharyngeal airway (measure from lips to angle of mandible) to maintain patent airway.

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4
Q

Patient has choked and has airway obstruction. What do you do ?

A

5 back slaps, Heimlich manoeuvre and repeat.
If patient is lying down, start chest compressions.

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5
Q

What is normal respiratory rate and oxygen saturation ?

A

12-15 breaths per minute and >94%.

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6
Q

At between 60-84% oxygen saturation, how will the patient appear ?

A

Lips and finger begin to go blue.

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7
Q

With oxygen saturation <60% oxygen saturation, patient will ?

A

Begin to centrally cyanose and tongue will begin to go blue.

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8
Q

What can be the cause of reduced respiratory rate ?

A

Trauma, neurological deficit, demand, infection, inflammation.

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9
Q

Why will a patient struggling to breath naturally go into tripod position ?

A

Optimal position to open intercostal muscles and accessory muscles and ease breathing.

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10
Q

What is the best way to assess patient breathing ?

A

Listen - should be silent, any noise is problem.
Rate - hand on chest and shoulder, normal is 12-15 breaths per minute.

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11
Q

What is the best way to assess patient circulation ?

A

Take brachial pulse, normal is between 60-100bpm, changes can be normal.

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12
Q

At what heart rate does perfusion of organs stop ?

A

<45bpm.

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13
Q

What position should the patient be in if circulatory problem has been diagnosed ?

A

Lie back and elevate legs.

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14
Q

What can cause neurological disability ?

A

Drugs, brain injury, hypoglycaemia, seizure.

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15
Q

What scoring scale is used to assess patient disability ?

A

ACVPU/GCS.
Alert, new confusion, verbal, pressure (in trapezius), unconciousness.

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16
Q

How many litres of oxygen should be selected for every medical emergency in dental setting ?

A

15l.

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17
Q

A patient is in anaphylaxis. What will be seen to do with their airway ?

A

Swelling and stridor due to bronchoconstriction.

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18
Q

A patient is in anaphylaxis. What will be seen to do with their breathing ?

A

Increased rate and wheeze.

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19
Q

A patient is in anaphylaxis. What will be seen to do with their circulation ?

A

Increased HR and decreased BP.

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20
Q

A patient is in anaphylaxis. What will be seen to do with their disability ?

A

Loss of consciousness.

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21
Q

A patient is in anaphylaxis. What will be seen to do with their exposure ?

A

Rash and swelling.

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22
Q

What treatment is given for anaphylaxis ?

A

Adrenaline 1:1000 0.5mg for single dose IM emergency injection.
Two doses will be found in medical emergency dental bag (1mg in 1ml).

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23
Q

What does adrenaline do for anaphylaxis ?

A

Bronchodilator.
Peripheral vasoconstrictor - helping BP.
Central vasodilator - more blood to brain and reduction of swelling.
Improve myocardial function.

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24
Q

When should a second dose of adrenaline be given where there is no improvement in patient ?

A

After 5 mins.

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25
What is the most appropriate position for a patient in anaphylaxis ?
Lie down, legs raised.
26
A patient is suffering angina/MI. What will be seen to do with their airway ?
Should be talking and no constriction/blockage.
27
A patient is suffering angina/MI. What will be seen to do with their breathing ?
Increased rate.
28
A patient is suffering angina/MI. What will be seen to do with their circulation ?
Increased HR - usually more to do with anxiety (no significant physiological reason).
29
A patient is suffering angina/MI. What will be seen to do with their disability ?
Should be alert.
30
A patient is suffering angina/MI. What will be seen to do with their exposure ?
Pale, clammy, central crushing chest pain radiating down right arm and jaw or sometimes back pain (more common in women).
31
What treatment options is there for angina/MI in dental emergency setting ?
GTN spray - 400micrograms per dose, 2x puffs. Aspirin - 300mg crushed or chewed.
32
How does GTN spray help angina/MI ?
Analgesic for symptomatic relief. Vasodilator which relives heart (venous circulation dilation, reducing pressure).
33
How does aspirin help angina/MI ?
Anti-platelet primary effect - slows platelet aggregation and slows thrombus formation. Mild analgesic too.
34
Patient has suffering central crushing chest pain. It has not relieved since treatment. When should you suspect MI ?
After 5 mins.
35
A patient is suffering asthma attack. What will be seen to do with their airway ?
Difficult to complete sentences but still able to talk.
36
A patient is suffering asthma attack. What will be seen to do with their breathing ?
Increased rate with wheeze due to bronchoconstriction.
37
A patient is suffering asthma attack. What will be seen to do with their circulation ?
Increased HR.
38
A patient is suffering asthma attack. What will be seen to do with their disability ?
Alert.
39
A patient is suffering asthma attack. What will be seen to do with their exposure ?
Tripod position, anxious, cyanotic.
40
What is the definition of a mild to moderate asthma attack ?
Chest tightness, normal HR and normal RR.
41
What is the definition of severe asthma attack ?
Respiratory rate >25 breaths per minute. Heart rate of >115bpm. Audible wheeze with stethoscope.
42
What is the definition of life threatening asthma attack ?
Heart rate of <40bpm. Respiratory rate of <8 breaths per minute.
43
What treatment should be given to patient suffering mild to moderate asthma attack ?
2x puffs of salbutamol inhaler 100 micrograms per actuation and ask patient to hold breath for 10 seconds, can be repeated as required.
44
What treatment should be given to patient suffering severe or life-threatening asthma attack ?
10x puffs into spacer and breathe for no longer than 20 seconds, remove spacer and continue with oxygen. Can be repeated every 3-5mins. No improvement, medical emergency 999. Patient has now lost ability to hold breath for 10 seconds.
45
How does a salbutamol inhaler help an asthma attack ?
Bronchodilator - improves gas exchange.
46
What patient is most likely to suffer hypoglycaemic attack ?
Type 1 diabetes - as they are insulin dependent. If not, inflammatory or infective reason to cause i.e. sepsis.
47
A patient is suffering hypoglycaemic attack. What will be seen to do with their airway ?
Should be initially talking if still conscious.
48
A patient is suffering hypoglycaemic attack. What will be seen to do with their breathing ?
Increased RR initially if still conscious.
49
A patient is suffering hypoglycaemic attack. What will be seen to do with their circulation ?
Increased HR initially if still conscious.
50
A patient is suffering hypoglycaemic attack. What will be seen to do with their disability ?
Initially alert and loss of consciousness as blood sugar begins to drop further.
51
A patient is suffering hypoglycaemic attack. What will be seen to do with their exposure ?
Irritable, confused, pale.
52
What treatment can be given to patient suffering hypoglycaemic attack ?
Glucose gel or tablets. Glucagon (1milligram IM injection) - comes as fluid and powder and needs mixed.
53
Following glucagon injection, what should always be given to patient ?
Glucose gel or tablet - to regain normal blood sugar level.
54
A patient is suffering seizure. What will be seen to do with their airway ?
Compromised.
55
A patient is suffering seizure. What will be seen to do with their breathing ?
Can be various different presentations and very difficult to assess.
56
A patient is suffering seizure. What will be seen to do with their circulation ?
Can be various different presentations and very difficult to assess.
57
A patient is suffering seizure. What will be seen to do with their disability ?
Unresponsive - not always unconscious.
58
A patient is suffering seizure. What will be seen to do with their exposure ?
Convulsions, seizure activity, incontinence.
59
What treatment is available in dental setting if patient is suffering seizure ?
Midazolam (benzodiazepine) 100mg via buccal mucosa.
60
When should treatment be initiated in patient having seizure ?
If seizure lasting longer than 5 mins or repeated seizures.
61
A patient is suffering syncope. What will be seen to do with their airway ?
Compromised.
62
A patient is suffering syncope. What will be seen to do with their breathing ?
Reduced rate.
63
A patient is suffering syncope. What will be seen to do with their circulation ?
Reduced rate and pressure.
64
A patient is suffering syncope. What will be seen to do with their disability ?
Unresponsive.
65
A patient is suffering syncope. What will be seen to do with their exposure ?
Pale and clammy.

BDS3 BAMS Patient Safety (4 decks)

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