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FINALS - BAMS > Medical Emergencies > Flashcards

Medical Emergencies Flashcards

1
Q

What is ABCDE in terms of emergency management?

A

Airway
Breathing
Circulation
Disability
Exposure

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2
Q

How should you check for airway in emergency management?

A

Check for airway obstruction
- See/saw respiration
- Central cyanosis
- Visible blockage
- Diminished and noisy breathing

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3
Q

What is the management for airway obstruction?

A

Airway opening manoeuvres (head tilt, jaw thrust)
Aspiration
Choking manoeuvres
Oropharyngeal airway
Give oxygen 15L/min

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4
Q

How do you check breathing for breathing in an emergency situation?

A

Look for general signs of abnormal breathing
Check rest rate is normal 12-20 breaths min
Check pulse ox if available
Listen to the patients breath, stridor or wheeze

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5
Q

How do you check circulation in an emergency situation?

A

Colour of patient - grey, blue at peripheries
Check for pulse:
- Radial pulse
- Carotid pulse
Check for signs of blood loss

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6
Q

How do you check for disability in an emergency situation?

A

Check for:
- Unconsciousness
- Responsiveness
- Inability to move
- Partial paralysis
- Pupillary response

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7
Q

How do you check for exposure in an emergency situation?

A

Full body exposure necessary for treatment
Maintain patient’s dignity and minimise heat loss.

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8
Q

Outline the emergency management for the following patient:

A - Normal
B - Normal
C - Hypotension, cold clammy skin, pale face
D - Collapse, dizziness
E - Normal

There is also vomiting and diarrhoea.

A

Adrenal crisis

Lie patient flat
Call ambulance stating ‘‘addisonian crisis’’
Administer O2 at 15L/min
Administer emergency hydrocortisone - 100mg IM

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9
Q

Outline the emergency management for the following patient:

A - Wheeze, hoarseness
B - Respiratory distress
C - Hypotension, tachycardia
D - Normal
E - Normal

There is also urticaria, and angiodema.

A

Anaphylactic shock
Call 999, state ‘‘anaphylaxis’’
Elevate legs, administer O2 at 15L/m
Administer adrenaline 1:1000 IM
Repeat adrenaline at 5 minute intervals until stable

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10
Q

Outline the emergency management for the following patient:

A - Expiratory wheeze
B - Respiratory rate 27/m
C - Pulse 112bpm
D - Unable to complete sentences in one breath
E - Normal

A

Severe asthma attack
Follow patient personalised asthma attack plan (PAAP)
2 puffs salbutamol inhaler, repeat as necessary

If no response:
Dial 999 give an SBAR
Give O2 at 15L/min
Continue salbutamol 1/minute, up to 10 times.

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11
Q

Outline the emergency management for the following patient:

A - Expiratory wheeze
B - Respiratory rate <8/m
C - Pulse <50bpm, cyanotic
D - Exhaustion, confused, impaired consciousness
E - Normal

A

Life threatening asthma attack

Dial 999 give an SBAR
Give O2 at 15L/min
Encourage tidal breathing
Continue salbutamol 1/minute, up to 10 times.

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12
Q

Outline the emergency management for the following patient:

A - None
B - None
C - Erratic pulse
D - Light headed, sweating
E - Normal

Heaviness in chess, pain radiating to left arm
Patient history of angina

A

Sit upright, rest patient
Administer 400-800mg GTN spray, 1-2 activations SL
If no response to GTN, follow heart attack protocol

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13
Q

Outline the emergency management for the following patient:

A - None
B - None
C - Erratic pulse
D - Light headed
E - Normal

Heaviness in chess, pain radiating to left arm, nausea
No known history of cardiac issues

A

Call 999, stating ‘heart attack’, give SBAR
Comfortable position for patient
Give 400-800mg GTN
Give 300mg chewable aspirin
Monitor until ambulance arrives, prepare to give BLS

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14
Q

Outline the emergency management for the following patient:

A - Noisy breathing, frothing at mouth
B - Normal
C - Cyanosis
D - Loss of consciousness, rigidity
E - Normal

Patient keeps making jerking movements, lasting less than 5 minutes and not rapidly repeating.

A

Make environment safe
Do not restrain
Give O2 at 15L/min
Note timings of seizure
Follow patients care plan
Recovery position once treatments stop
Call 999 if necessary

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15
Q

Outline the emergency management for the following patient:

A - Noisy breathing, frothing at mouth
B - Normal
C - Cyanosis
D - Loss of consciousness, rigidity
E - Normal

Patient keeps making jerking movements, lasting 5 minutes or more.

A

Make environment safe
Do not restrain
Give O2 at 15L/min
Note timings of seizure
Follow patients care plan
Recovery position once treatments stop
Call 999 if necessary

10mg Midazolam oral gel given buccally

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16
Q

Outline the emergency management for the following patient:

A - Normal
B - Normal
C - Normal
D - Confused
E - Normal

MH - Diabetes
Patient is tired, sweating, and trembling

A

Hypoglycaemia

Offer 15-20g quick acting carbohydrate
Monitor for response

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17
Q

Outline the emergency management for the following patient:

A - Normal
B - Normal
C - Normal
D - Unconscious
E - Normal

MH - Diabetes
Pallor, sweating

A

Call 999, state ‘hypoglycaemia’, give SBAR
Sit in recovery position
Give 1mg IM glucagon
Wait for consciousness to return, then offer oral carbohydrate
Monitor whilst waiting for ambulance

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18
Q

Outline the emergency management for the following patient:

A - Normal
B - Respiratory rate 28/min, SPO2 90%
C - Heart rate 145bpm
D - Normal
E - Normal

MH - Has a suspected periapical abscess

A

Red flag sepsis
Call 999, state ‘red flag sepsis’, give SBAR
Give O2 15/L min
Monitor until ambulance arrives

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19
Q

What are the signs to consider when checking for red flag sepsis?

A

Presume infection, patient looks unwell, family member worried, or the situation is worsening.

AND one of:

  • Systolic BP less than 90mmHg
  • Heart rate >130bpm
  • O2 required to maintain sats above 92%
  • Non-blanching rash, mottled, ashen, cyanotic
  • Not passed urine in 18 hours
  • Recent chemotherapy (within 6 weeks)
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20
Q

Outline the emergency management for the following patient:

A - Normal
B - Normal
C - Slow pulse, low bp
D - Unconscious
E - Normal

Patient was sweating profusely before loss of consciousness.

A

Syncope
Lie flat, elevate legs, loosen clothing
Consider oxygen
Once consciousness returns give glucose/sweet tea
Monitor signs of life and check for dif. diagnosis

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21
Q

Outline the emergency management for the following patient:

A - Normal
B - Normal
C - Normal
D - Speech problems, arm weakness
E - Normal

Face is drooping to one side.

A

Stroke
Call 999, state ‘Stroke, give SBAR
Administer O2 15L/min

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22
Q

what do you do once you have reached the end of ABCDE

A

go over it again and see if they have improved/gotten worse/stabilised

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23
Q

what are the causes of airway obstruction

A

loss of consciousness infection/inflammation/swelling snoring

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24
Q

what is the triple manoeuvre

A

head tilt, chin life, jaw thrust

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25
Q

what would a patient gurgling mean

A

that water is in the airway

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26
Q

what kind of airway problem is snoring

A

upper

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27
Q

what kind of problem is wheezing

A

expiratory problem

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28
Q

at what stage of oxygen saturation does a person have peripheral cyanosis

A

84

29
Q

how do you treat breathing problems

A

posture/oxygen/bronchodilators

30
Q

what are the causes of circulation problems

A

arrhythmia/ACS/HF

31
Q

at what systolic level does blood pressure change from strong to weak

A

100

32
Q

when does the pulse disappear at the wrist

A

70

33
Q

what kind of problem is a tachyarrhythmia

A

conduction problems

34
Q

what is the cause of disability

A

drugs/brain injury/hypoglycaemia

35
Q

how do you judge disability

A

ACVPU/GCS

36
Q

what does ACVPU stand for

A

alert new confusion verbal response pressure response unresponsive

37
Q

how do you score a 3 on GCS

A

if you have positive CVPU

38
Q

what happens if you score a 3 on GCS

A

need to be seen by medic in an hour

39
Q

how do you treatment disability

A

optimise ABC

40
Q

what are the medical emergencies seen in dental practices

A

anaphylaxis angina/MIasthma cardiac arrest choking hypoglycaemia seizure/fits syncope

41
Q

when would you use oxygen

A

on anyone you think is sick/has one of the medical emergencies

42
Q

how long do the oxygen cannisters last

A

30mins

43
Q

what kind of mask is used for oxygen

A

non-breathing mask

44
Q

what would ABCDE look like for someone with anaphylaxis

A

A - swelling/stridor B - increased resp rate, wheeze C - increased heart rate, hypotension D - loss of consciousness E - rash, swelling

45
Q

when would it be appropriate to give adrenaline?

A

A - swelling B - peripheral cyanosis C - absence of radial pulse

46
Q

how would you position an anaphylactic patient

A

lying down with legs in air

47
Q

where do you administer adrenaline

A

into the thigh

48
Q

what treatment do you give for anaphylaxis

A

adrenaline 1:1000 0.5mgintramuscular injection

49
Q

how do you administer adrenaline

A

pull muscle to side, go straight through skin into muscle, aspirate, inject into muscle, come halfway out, let go of skin and then pull out all the way

50
Q

what does adrenaline do

A

allow vasoconstriction, bronchodilation, and increased myocardial contractility

51
Q

what are the side effects of adrenaline

A

anxiety, arrhythmias, hypertension

52
Q

what does the ABCDE look like for angina/MI

A

A - talkingB - increased respiratory rate C - increased heart rate D - alert E - pale, clammy, central chest pain

53
Q

what are the side effects of GTN spray

A

hypotension headaches

54
Q

how do you treat MI

A

aspirin 300mg crushed or chewed

55
Q

what is the effect of aspirin

A

antiplatelet, analgesic, anti-inflammatory and antipyretic

56
Q

what are the side effects of aspirin

A

GI bleeding, ulcers

57
Q

why should patients not drink water for at least 10mins after taking aspirin

A

it filters it into the stomach so it is not absorbed in the same way

58
Q

what is the salbutamol inhaler dose

A

100mcg

59
Q

what is the effect of salbutamol

A

bronchodilator

60
Q

what are the side effects of salbutamol

A

headaches, anxiety, nervous, dry mouth

61
Q

how do you administer adrenaline

A

pull muscle to side, go straight through skin into muscle, aspirate, inject into muscle, come halfway out, let go of skin and then pull out all the way

62
Q

What is the mechanism for adrenaline when used as an emergency drug for anaphylaxis?

A

Main effects of anaphylaxis are reduced blood pressure, narrowing of airway, and swelling.

Alpha receptor agonism mediates peripheral vasoconstriction and reduces tissue oedema

Beta receptor agonism mediates bronchodilation, positive inotropic effects, and suppresses inflammatory mediator release

63
Q

What emergency drug should be given for anaphylaxis?

A

Adrenaline 1:1000 (500 micrograms), intramuscularly via epipen.

64
Q

What is the mechanism of action for aspirin in emergency managment of heart attacks?

A

Heart attack occurs due to blockage in coronary artery.

Aspirin inhibits COX enzymes to reduce thromoxane production. This then reduces the ability of platelets to aggregate and increase the size of the clot.

Dispersable route should be used as it is more rapidly absorbed than oral route.

65
Q

What is the mechanism by which GTN works to manage angina in an emergency situation?

A

Nitrates cause relaxing smooth muscle and consequent dilation of peripheral arteries and veins.

The result is a decreased cardiac load, mitigating the effect of heart disease. Does not work in MI, as blockage is too severe.

66
Q

What is the mechanism of salbutimol for asthma attacks?

A

Short acting B2 agonist (SABA), which increases cAMP production which reduces Ca within smooth muscle cells.

This causes the smooth muscle within the trachea to dilate, leading to a wider and more relaxed airway (bronchodialation).

67
Q

How does fast acting glucose work in a person experiencing hypoglycaemia?

A

Fast acting glucose is in a ready to use form, meaning it doesn’t need to be digested to be used.

It can be rapidly uptake to increase blood sugar levels in a person experience hypoglycaemia.

68
Q

What effect does injectable glucagon have in someone experiencing hypoglycaemia?

A

Glucagon raises blood sugar through activation of hepatic glucagon receptors, stimulating glycogenolysis and the release of glucose.

If the person is unconscious, then this can be an effective way of managing hypoglycaemia.

69
Q

What effect does midazolam have when given to a patient experiencing a fit?

A

Midazolam is a GABA-A agonist, which enhances the effectiveness of GABA receptors.

GABA is a neurotransmitter that blocks messages between the cells, so when its activity is enhanced, it produce sedation and muscle relaxation.

FINALS - BAMS (3 decks)

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