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patient safety > medical emergencies > Flashcards

medical emergencies Flashcards

1
Q

what are the stages of assessment during a medical emergency?

A

Airway
Breathing
Circulation
Disability
Exposure

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2
Q

what do you do once you have finished your assessment of the patient during a medical emergency?

A

start again- things may have changed
assess if any actions taken have improved/deteriorated/stabilised the patient

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3
Q

describe assessment of the airway

A
  • ask the patient a simple question to see if they are able to respond
  • check for swelling/inflammation
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4
Q

how may a patient with a compromised airway present?

A
  • panicked loom
  • pale
  • sweaty
  • obstruction can cause a snoring noise
  • gurgling noise- fluid in airway
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5
Q

what is the triple airway manouvre?

A

chin lift
jaw thrust
head tilt

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6
Q

describe assessment of breathing during a medical emergency

A
  • check mechanical breathing- see if both sides of the rib cage are moving evenly
  • listen- you cant hear normal breathing
  • check for regulatory breathing
  • to check respiratory rate- pretend you are taking a pulse and place other hand on shoulder to feel rib cage movements
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7
Q

if mechanical breathing is normal but the patient is struggling to breath, what is the problem most likely to be?

A

issue with the lungs themselves

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8
Q

what causes a wheeze?

A

bronchoconstriction- problems with gas exchange

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9
Q

what does it mean if the patient’s tongue goes blue?

A

central synopsis has occured
patient only has 60% oxygen saturation

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10
Q

why should we not always be concerned about a high heart rate?

A

usually just a normal physiological response e.g. a patient having an asthma attack should be tachycardic

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11
Q

when is the only time that brachycardia is not a concern?

A

athletes

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12
Q

what should you do for a pateint with a temperature?

A

give paracetemol
open the window

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13
Q

describe how you check ‘disability’ in a medical emergency

A

pupillary response to light
ask patient to squeeze your hands/lift their feet off the floor
squeeze their shoulder and test response
check if the person is alert and verbal and responsive

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14
Q

what should you always do before turning to the medication in the medical emergency bag during a medical emergency?

A

give the patient oxygen

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15
Q

how long does one tank of oxygen last while giving 15 litres?

A

25 minutes

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16
Q

what is the GDC advice regarding oxygen?

A

give to anyone who is sick

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17
Q

how might a patient suffering from anaphylaxis present?

A

swelling of airway, stridor
increased breathing rate, wheeze
increased heart rate, hypotension
loss of consciousness
rash, swelling

18
Q

why is periorbital swelling a cause of concern for the patient’s breathing?

A

high correlation between that and airway swelling

19
Q

what is the advice surrounding adrenaline in a medical emergency?

A

better to give one inappropriate dose than a late appropriate dose
(if in doubt, give the adrenaline)

20
Q

what should you do if the patient has a pulse <70?

A

give adrenaline

21
Q

what is the best way to give a patient adrenaline?

A

lie them down with legs raised

22
Q

what do you do if the patient shows no repsonse to a dose of adrenaline after 5 minutes?

A

give another dose

23
Q

how should you give adrenaline to a pregnant woman?

A

lie her on her side

24
Q

whereabouts on the thigh should you give intramuscular adrenaline?

A

middle third of the thigh
(anteriolateral part)

25
Q

what are you monitoring after giving adrenaline?

A

the airway
give oxygen
pulse oximetry
ECG
blood pressure

26
Q

what is the dose for IM adrenaline?

A

0.5mg

27
Q

how do you prevent the adrenaline from coming back out of the patient’s leg after it has been injected?

A

after injection, come half way out, remove tension off muscle and then fully remove

28
Q

how might a patient with angina/MI present?

A

still able to speak
increased breathing rate
increased heart rate
still alert
pale, clammy, central chest pain

29
Q

what is the treatment for unstable angina?

A

400ug GTN spray
allows vasodilation
side effects- hypotension, headache
acts as an antiplatelet, analgesiac, anti-inflmmatory and antipyretic
aspirin can also be given

30
Q

what is the treatment for an MI?

A

300mg aspirin
needs to be absrobed into oral mucosa- dont give pt water for at least 10 mins
patient should chew it or it should be crushed into their mouth and placed under tongue

31
Q

what are the benefits of giving a patient aspirin within the first qo minutues of an MI?

A

all measurements improve
shorter hospital stay afterwards

32
Q

how might a patient having an asthma attack present?

A

difficult to complete a sentence
increased breathing rate with a wheeze
increased heart rate

33
Q

what are the 3 categories of asthma attack?

A
  1. mild to moderate
  2. severe/acute
  3. life threatening
34
Q

describe a severe/acute asthma attack

A

increased respiratory rate- 25bpm with wheeze
increased heart rate 120bpm

35
Q

what is the treatment for a patient having a severe/acute asthma attack?

A

10 puffs of salbutamol inhaler with spacer
let the patient then breathe with the spacer for at least 20 seconds

36
Q

what are the signs of a life threatening asthma attack?

A

compromised airway
respiratory rate 8bpm
heart rate 50bpm

37
Q

what class of patient is at risk of hypoglycaemia?

A

type 1 diabetic patients

38
Q

what is the treatment of hypoglycaemia?

A

give glucose
if pateint becomes unresponsive- give glucagon to allow glycongenolysis
side effects- nausea and headache
inject the solution into the powder and gently mix (dont shake or it will turn into a foam)
have sugar on stand for when the patient regains responsiveness

39
Q

what should you do for a patient having a seizure?

A

time the seizure- if repeated or prolonged more than 5 minutes then consider buccal midazolam
10mg

40
Q

what are the side effects and action of midazolam?

A

allows muscle relaxation
slows down nerve signals to the brain
side effects- hypotension, respiratory depression

patient safety (2 decks)

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