medical emergencies Flashcards
emergency
situation in which the condition of a patient or a sudden change in medial status requires immediate action
-ensure open airway, control breathing, take measurement to prevent or treat shock, attend to wounds or fractures, provide emotional support, continually evaluate
emergency equipment
be familiar with location of emergency equipment in each room where you work
-drug box or drug cart
-emergency cart or crash cart
-oxygen
-wall mounted suction
-AED
automatic external defibrilator
AED usually located on top of crash cart
-sometimes on wall
-useful in treating cardiac arrhythmia
-AEDs located in every department and outpatient center
-fully automatic: AED provides shock
-semi automatic: we provide the shock
SHS emergency information
red phones: call 911 only
receptionist desk- equipment
-AED
-nursing skills lab
code blue
code used to expedite the response of the appropriate medial team to participate in resuscitation of any person who has had a cardiopulmonary arrest/failure or who is experiencing a potential life threatening event
-a pediatric code blue will announce for all children 17 years and younger
conditions requiring cold blue
-lack of pulse or ventilation
-acute deterioration of airway, pulmonary, and/or circulatory systems
-acute unresponsiveness
how is cold blue called
in hospital- dial x6363
-tell operator to page code blue
-tell operator your location
-in outpatient centers call 911 only
RT role for code blue
-call for help
-assess vital signs
-get emergency equipment
-get chart to the room’-provide appropriate care while waiting for help
-begin CPR
-be prepared to provide history of events
rapid response team
a team of clinicians who bring critical care exposure to INPATIENT bedside
-response team called instead of code blue when the patient demonstrates signs of deterioration but does not meet criteria of a code blue
-if less serious situation arises call RRT and dial 6363. must be specific if it is a pediatric patient
members of rapid team
team leader, internal medicine resident , coach/ICU RN, respiratory therapist, lab tech, additional is needed
responsibilities of the rapid team
arrive within 5 minutes of the call, assess, stabilize, assist with communication, educate and support, assist with transfer, document and provide feedback
medical emergency
a team of healthcare individuals who will respond to a status change of an individual
-status changes: feeling faint, low blood sugar, fall, chest pain and panic attack
-for anybody
-not for serious conditions that warrant a code blue
-dial 6363 in patient and 911 outpatient
medical emergencies
head injury, shock, anaphylaxis, diabetic coma, respiratory distress and arrest, airway obstruction, cardiac arrest, CVA
head injury
levels of consciousness (LOC)
alert/conscious: least severe injury
semi conscious/serious head injury: patient may need to be gently poked/touched to be alert or loud verbiage
unconscious: unable to be awaken, reacts to painful shock
-comatose: unresponsive to all stimuli
indication of deteriorating consciousness
if patient changes LOC during exam, notify nurse or doctor immediately
-patient start to complain of headache
-lethargic: abnormal drowsiness
-slurred speech
-irritable
-slowing pulse
-slowing respiratory rate
RT response to deteriorating consciousness
stop procedure and get medical assistance, maintain open airway, stay with patient until help arrives, assess vital signs, move patient as little as possible
glasgow coma scale
a way to assess neurological functions
-three areas of functioning: eye open, motor response, verbal response
shock
a failure of the circulatory system to support vital body functions
-hypovolemic
-distributive
-anaphylactic
-neurogenic
-septic
-cariogenic
symptoms of shock
-restlessness
-apprehension/ anxiety
-tachycardia
-decreasing blood pressure
-cold: clammy skin
-pallor
hypovolemic shock
caused by loss of blood or tissue fluid. Heart is unable to pump enough blood to the body
-if bleeding from wound causes shock place pressure on wound site to reduce hemorrhage
distributive shock
results from excessive vasodilation and the impaired distribution of blood flow
-anaphylactic
-neurogenic
-septic
anaphylactic shock
-a type of distributive shock aka vasogenic
-most often caused by an allergy to food, insect bites, or certain medications
-most common encountered in radiology
-can range form mild to severe
-always monitor your patient
neurogenic shock
type of distributive shock that can occur after a spinal cord injury
-body has trouble regulating blood pressure, heart rate and temperature due to nervous system damage
-keeps oxygen from reaching your organs
septic shock
a type of distributive shock
last and most severe type
when an infection in your body causes extremely low blood pressure and organ failure due to sepsis
-frequent
-fast HR, fever, shaking or chills, clammy skin, confusion, hyperventilation, light headed, etc
cardiogenic shock
-when the heart cant supply enough oxygen-rich blood to the body to meet its needs
-can cause organs to fail without proper oxygen supply
-most often caused by heart attack or heart failure
-chest pain, trouble breathing, sweats or cold sweats, irregular heartbeat, fainting, etc
prevention/intervention
-prevention: maintaining normal body temperature, keeping patient converted or uncovered; avoid any rough or excessive handling/ be gentile throughout procedures; be aware of patients psychological care
-intervention: if situation is developing- stop the procedure; body temperature; call for assistance; take note of patient vital signs
diabetic crisis
diabetes: condition that happens when your blood sugar glucose is too high. develops when the pancreas doesn’t make enough insulin or any at all
-may be temporary (gestational diabetes)
-normal levels = 70-110 mg
hypoglycemia
excessive insulin is present
-can occur if patient takes normal dose of insulin and does not eat
-intensely hungry, weak and shaky, excessive sweating, confused and irritable and aggressive
insulin shock and insulin reaction
-mild symptoms: tremor, sweating, hunger, tachycardia, irritability
-moderate symptoms: dizziness, headache, numbness of lips or tongue, confusion, cold and clammy skin and blurred vision
-severe symptoms: disorientation, difficulty/ arousing from sleep, impaired motor function, diminishing level of consciousness, seizure, coma
hyperglycemia
excessive sugar in blood and Is the characteristic typically associated with diabetes
-excessive thirst, dry mucosa, rapid and deep breathing, drowsiness and confusion
ketoacidosis
body starts breaking down fat at a rate that is too fast
-liver processes the fat into a fuel called ketones which can cause the blood to be acidic
-ketone bodies in blood stream cause metabolic acidosis or diabetic coma
-most common in type one and can be fatal
respiratory distress and arrest
asthma: condition characterized by difficulty breathing, wheezing; may happen in imaging department
-bronchial swelling on inspiration, collapse on exhalation
-increased mucous production
major emergency: chocking
-chocking occurs when a foreign object becomes logged in the throat or windpipe, blocking the flow of air
-stridor: abnormal breathing sound that resembles wheezing or creaking or whistling sound
-encourage to cough and if that doesnt work then helmich move
heimlich maneuver
-increase intrathoracic enough to propel the lodged object out of the throat
view slide 52
unconscious patient
for unconscious patient, start with CPR in case object became dislodged
check for object in mouth do not do blind finger sweeps
cardiac arrest
-the sudden stoppage of cardiac output that leads to permanent organ damage or death if not treated
cardiac tamponade
blood/fluid fill the space between the sac that encases the heart and the heart muscle
-uses chest tube
cpr
CAB: circulation, airway and breathing
AED
- a portable electronic device that automatically diagnose life threatening cardiac arrhythmia in a patient and treats them through defibrillation allowing the heart to reestablish effective rhythm
-ventricular fibrillation is fluttering that prevents blood flow
-ventricular tachycardia
cerebrovascular accident
stroke or brain attack: onset may be sudden or develop gradually over time
-paralysis, slurred speech, extreme dizziness, loss of vision, complete loss of consciousness
nausea and vomiting
can instruct the patient to breath slowly and deeply through their mouths
-provides patients with emesis basin/bag and moist clothes
-patient should be positioned erect or lateral , if supine, they should roll on their side
epistaxis
nosebleed
-have patient lean forward and pinch nostril
-do not place patient recumbent or tilt head back
-apply moist compress if gentle pressure fails to stop the bleeding
-call help after 15 minutes
vertigo
dizziness
-those who have been not mobile for a period of time can experience vertigo or fainting when standing
-often a precursor to syncope
-should be assisted to a seated or recumbent position
-watch for vertigo when sitting patients up from.a recumbent position
postural hypotension
-a drop in blood pressure due to change in body position, more common in older people
-temporary
-no treatment needed
syncope
-self correcting, temporary state of shock and the result of lack of blood flow to the brain
-assist patient into a recumbent position with feet elevated
-faiting
seizure
mild: brief loss of consciousness, stare into space for a brief time, slight confusion or weak after the episode
severe: involuntary contraction of muscles on one or both sides of the body; could last several minutes; loss of bodily functions; non-convulsive; stare into space
during and after seizure
-do not attempt to restrain patient
-call for help and RRT or medical emergency
-place pillow under head and clear area and lower to floor
-make sure theres an open airway, they could be weak and forgetful and need post-pone procedure
wounds
-hemorrhage, burns, dehiscence
-woulds often are sustained previously or during surgery.
-wear gloves when dealing with wounds
hemorrhage
-bleeding outside of a vessel = most often refers to severe bleeding, not all hemorrhages are serious
-can be internal such as in the brain or external such as on the skin
-wounds need to be observed for signs of hemorrhages
-slide 70
steps for superficial lacerations
-stop the bleeding; apply pressure
-clean the area: apply an antibiotic cream; apply a sterile bandage
steps for deep lacerations
-lacerations is bleeding severely; blood is spurting from the laceration
-clamping the arteries
-hemostat to artery/vein that is profusely bleeding
dehiscence
-patients sutures separate allowing the content to be visible or spill out
-place sterile dressing over site
-place patient in seated position , bending forward to relieve pressure on wound
-do not attempt to place tissues back inside wound
-medical attention sought immediately
burns
1st: superficial
2nd: outermost and second most
3rd: fatty and all layers
-disrupt the protective function of the skin
-very prone to infection
-imperative to maintain sterile precautions
-extremely painful
-never remove clothing from burn if it is stuck to skin
latex allergy
latex comes from the sap of the rubber treat, allergies can build up due to repeated exposure, dermatitis, cramps, hives, etc
-can cause anaphylaxis
treatment/ prevention of agitating allergy
-needs to be treated immediately
-if the patient has latex allergy, remove latex from exam room
-its only non latex gloves
-wash down the room before the patient enters
trauma
a physical injury or wound caused by external force or violence
-sudden, unexpected, dramatic, forceful or violent event
head injuries
a head injury is any trauma that injuries the scalp, skull, or brain
-closed
-open
common accident causes
accidents at home , work, outdoors or while playing sports
-falls
-physical assault
-traffic accidents
-most of these injuries are minor because the skull protects the brain
symptoms associated with head injuries
drowsiness, slurred speech
abnormal behavior
develops a severe headache or stiff neck
loses consciousness
seizures
-visual disturbance
steps to take with mild and severe head injury
mild: observe adults/children after injury for increased symptoms
severe: check persons airway, breathing, circulation; stabilize head/neck, stop any bleeding, apply ice packs to swollen areas
immobilization
cervical collar: limits patient mobility, cannot be removed by radiologic tech, physician must clear the c-spine for removal
spinal injuries
injury that can cause loss of movement below the site of injury
common causes for spinal injury
-bullet or stab wound
-traumatic injury to the face, neck, head, chest, or back
-driving accident
-electric shock
-extreme twisting
-landing on the head
-fall from great height
symptoms of spinal injury
-unusual head position, numbness in the arm or leg, weakness, difficulty walking, paralysis of arms or legs, no bladder control, shock, lack of alertness, stiff neck
steps to take with spinal injury
-never move anyone who has spinal injury
-hold the persons head and neck in the position in which they were found
-do not allow the person to get up and walk unassisted
-dont let them get up to walk around
-check breathing
immobilizations
-cervical collar : places traction on cervical spine, prevents life threatening movement, must remain on and
-backboard/spine board: radiotranslucent
fractures
compound: open fracture when a bone breaks through the skin tissue
closed: closed fracture when the bone causes little or no damage to the surround tissue
traction
-never remove traction apparatus
-never relieve the pull of tractions
splints: used on lower extremities
-exert steady force on limb
-contain radiopaque materials
