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medical emergencies Flashcards

1
Q

Name the types of medical
emergencies that can occur in
dentistry

A

HC (healthcare) 3A 4S

H- hypoglycaemia
C - cardiac emergency
3A
adrenal crisis
anaphylaxis
asthma
4S
epileptic seizure
red flag sepsis
stroke
syncope

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2
Q

What does SBARD stand for?

A

Situation, background, assessment, recommendation,

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3
Q

How do we assess the level of
consciousness? (disability)

A

ACVPU:
Alert
Confused
Responds to verbal stimulus
Responds to painful stimulus
Unresponsive

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4
Q

Chain of survival

A

Early Access, Early CPR, Early Defibrillation, Early Advanced Care

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5
Q

The chain of prevention

A

MR CER
Monitoring
Recognition
Call for help
Education
Response

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6
Q

Adrenal crisis signs and symptoms (3)

A
  • Collapse, pallor, cold and clammy skin
  • Hypotension and dizziness
  • Vomiting and diarrhoea
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7
Q

adrenal crisis management

A
  • airway breathing circulation disability exposure
  • call 999, state “Addisonian crisis”, SBAR
  • lie flat, administer oxygen 15l/min
  • Patient’s hydrocortisone emergency IM kit at hand
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8
Q

What are the signs and symptoms of anaphylaxis?

A
  • sudden onset
  • urticaria and/or angioedema, flushing, pallor
  • respiratory distress, stridor, wheeze and/or hoarseness, hypotension, and tachycardia
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9
Q

Management of anaphylactic shock

A

ABCDE
call 999, state anaphylaxis, SBAR
lie flat, elevate legs (if breathing not impaired), administer oxygen
15l/m
Administer adrenaline 500 micrograms IM
- Repeat adrenaline at 5 mins intervals until an adequate response

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10
Q

What is the first step in the management of anaphylactic shock?

A

Call 999 and state anaphylaxis using SBAR

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11
Q

What position should a patient be placed in during anaphylactic
shock management?

A

Lie flat and elevate legs if breathing is not impaired

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12
Q

What is the recommended oxygen flow rate for a patient in anaphylactic shock?

A

Administer oxygen at 15 liters per minute

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13
Q

What is the initial dose of adrenaline for anaphylactic shock?

A

Administer 500 micrograms IM for >12yrs old and adults
Paeds dose
< 6 yrs - 150 micrograms
6-12 yrs - 300 micrograms

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14
Q

How often can adrenaline be repeated in the management of
anaphylactic shock?

A

Repeat adrenaline at 5-minute intervals until an adequate response.

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15
Q

paediatric doses for adrenaline in anaphylaxis

A

< 6 yrs - 150 micrograms
6-12 yrs - 300 micrograms
>12 yrs - 500 micrograms

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16
Q

asthma signs and symptoms

A

breathlessness and expiratory wheeze
severe: inability to complete sentences in one breath, RR> 25/min,
pulse >110/min
Life-threatening: cyanosis or RR <8/min, pulse <50/min, exhaustion, confusion, decreased level of consciousness

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17
Q

What are common breathing related signs and symptoms of asthma?

A

Breathlessness and expiratory wheeze

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18
Q

What indicates severe asthma?

A

Inability to complete sentences in one breath, RR > 25/min, pulse
> 110/min

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19
Q

What are life-threatening signs of asthma?

A

Cyanosis or RR < 8/min, pulse < 50/min, exhaustion, confusion,
decreased level of consciousness

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20
Q

Asthma Management

A

Airway Breathing Circulation Disability Exposure
Sit upright; if available, follow patient’s personalised asthma action plan (PAAP) 2 puffs (100 micrograms/puff) ž2 bronchodilator
inhaler e.g. salbutamol; repeat
doses may be necessary (early use of spacer device) Unsatisfactory/no response or if severe/ life threatening: Call 999, SBAR
While awaiting ambulance: oxygen 15 litres/min; B2 bronchodilator
via spacer given one puff at a time, inhaled separately using
tidal breathing, according to response, give another puff every 60
seconds up to a maximum of 10 puffs

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21
Q

What position should a patient with asthma be in during an asthma
attack?

A

Sit upright

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22
Q

What is the recommended initial treatment for asthma using a
bronchodilator?

A

2 puffs (100 micrograms/puff) of a B2 bronchodilator inhaler, e.g.,
salbutamol

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23
Q

What should be done if a patient with asthma shows unsatisfactory response to initial treatment?

A

Call 999 and use SBAR

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24
Q

What is the recommended oxygen flow rate while awaiting an
ambulance for a severe asthma attack?

A

15 litres/min

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25
How should a B2 bronchodilator be administered via a spacer during an asthma attack?
One puff at a time, inhaled separately using tidal breathing
26
What is the maximum number of puffs of B2 bronchodilator that can be given in one session?
10 puffs
27
signs and symptoms of cardiac emergencies
Symptoms can vary but commonly: 1) Chest pain or discomfort that suddenly occurs and doesn't go away, It may feel like pressure, squeezing or heaviness in your chest 2) Pain that may spread to your left or right arm or may spread to your neck, jaw, back or stomach 3) Feeling sick sweaty, Iight-headed or short of breath NB: Heart attacks in women commonly missed
28
What is a common symptom of a cardiac emergency?
Chest pain or discomfort that suddenly occurs and doesn't go away, often described as pressure, squeezing, or heaviness
29
Where can pain from a cardiac emergency spread? h
Pain may spread to the left or right arm, neck, jaw, back, or stomach
30
What are some additional symptoms of cardiac emergencies?
Feeling sick, sweaty, light-headed, or short of breath.
31
What is a notable issue regarding heart attacks in women?
Heart attacks in women are commonly missed
32
management of cardiac emergency
Call 999, state "heart attack" SBAR Comfortable position (usually sitting up) GTN spray 400-600mcg (typically 1-2 activations) sub lingual Dispersible aspirin 300 mg to chew unless there is clear evidence of allergy to it) NB Known angina sit down, rest, GTN, no relief after a few minutes relief after a few minutes repeat GTN. STill no relief - heart attack protocol: call 999, SBAR & aspirin
33
What should you do first in a cardiac emergency?
Call 999 and state 'heart attack' using SBAR.
34
What is the recommended position for a patient experiencing a cardiac emergency?
Comfortable position, usually sitting up.
35
What is the dosage for GTN spray in a cardiac emergency?
400-600 mcg, typically 1-2 activations sublingually
36
What is the recommended dosage of dispersible aspirin for a cardiac emergency?
300 mg to chew, unless there is clear evidence of allergy
37
What should a known angina patient do if they experience chest pain?
Sit down, rest, and use GTN spray.
38
What should a known angina patient do if there is no relief after a few minutes?
Repeat GTN spray
39
What is the protocol if a known angina patient still has no relief after repeating GTN?
Call 999, use SBAR, and administer aspirin.
40
epileptic seizures signs and symptoms
Sudden collapse & loss of consciousness Figidity & cyanosis; Jerking movements of limits Noisy breathing Tongue may be bitten; Frothing at mouth Incontinence may occur
41
What is a sign of an epileptic seizure related to consciousness?
Sudden collapse & loss of consciousness
42
What is a physical sign of an epileptic seizure involving muscle tone?
Rigidity & cyanosis
43
What type of movement is commonly associated with epileptic seizures?
Jerking movements of limbs
44
What is a respiratory symptom that may occur during an epileptic seizure?
Noisy breathing
45
What may happen to the tongue during an epileptic seizure?
Tongue may be bitten
46
What is a possible symptom related to saliva during an epileptic seizure?
Frothing at mouth
47
What is a potential urinary symptom that may occur during an epileptic seizure?
Incontinence may occur
48
epileptic seizure management
DRSABCD remove dangerous objects do not touch during seizure Administer oxygen 15l/m & note time of seizure once seizure over, place in recovery position if asleep, ensure airway is open check pulse seek medical help
49
What does the acronym ABCDE stand for in seizure management?
Airway, Breathing, Circulation, Disability, Exposure
50
What should you do to ensure a safe environment during an epileptic seizure?
Prevent injury, do not put anything into the mouth, do not restrain
51
What is the recommended oxygen administration for a patient experiencing a seizure?
15 litres/min
52
What should you note during an epileptic seizure?
The timings of the seizure
53
What position should a patient be placed in once jerking movements of a seizure cease?
Recovery position
54
What should you do if a seizure lasts 5 minutes or more or rapidly repeating seizures?
Call 999 and follow SBAR protocol Administer midazolam oromucosal solution (adults 10mg) via buccal route
55
What is the adult dose of midazolam oromucosal solution for prolonged seizures?
10mg via the buccal route (unlicensed in adults)
56
What is the paediatric dose of midazolam oromucosal solution for children aged 1-4; 5-9 and 10-18 years old?
aged 1-4: 5mg aged 5-9: 7.5mg aged 10-18: 10 mg This is only given if there are prolonged convulsive seizures or repeated rapidly
57
hypoglycemia signs and symptoms (face, body and behaviour)
The face: general facial appearance: sweating and pallor Brain: tiredness/ lethargy; unconsciousness Eye: blurred vision Mouth: slurred speech and vagueness Behaviour: confusion/ aggression stroppy/ moody Body: Shaking/ trembling
58
hypoglycaemia management
Airway Breathing Circulation Disability Exposure Offer 15-20g of quick acting carbs e.g. 4-5 Glucotabs or 1.5-2 tubes of glucogel Impaired consciousness/unable to swallow safely or unconscious: Call 999, SBAR, recovery position, glucagon 1mg IM Once consciousness returns, offer oral carbohydrate If able, measure blood sugar to help confirm correct diagnosis Paediatric dose of glucagon: < 8 years of age or < 25kg: 0.5mg IM
59
What is the recommended dose of quick acting carbs for hypoglycaemia?
15-20g, e.g. 4-5 Glucotabs or 1.5-2 tubes of glucogel
60
What should you do if a patient with hypoglycaemia has impaired consciousness or is unconscious?
Call 999, use SBAR, place in recovery position, administer glucagon 1mg IM
61
What should you offer a patient once consciousness returns after hypoglycaemia?
Oral carbohydrate
62
What should you do if able after a hypoglycaemia episode?
Measure blood sugar to help confirm correct diagnosis
63
What is the paediatric dose of glucagon for children under 8 years of age or under 25kg?
0.5mg IM
64
red flag sepsis signs and symptoms (8)
In the context of presumed infection, if patient looks very unwell, family or carer is very concerned, there is ongoing deterioration or if physiology abnormal for this patient (check HR, SpO2 & BP): is ONE red flag present: - New deterioration in GCS/ AVPU - Systolic B.P less than 90 mmHg (or > 40 mmHg < normal) - Heart rate >130 per minute - Respiratory rate 25 per minute - Needs oxygen to keep SpO2 92% (88% in COPD) - Non-blanching rash or mottled/ashen/ cyanotic - Not passed urine in last 18 hours - Recent chemotherapy (within last 6 weeks) NB Refer to age-appropriate GDP Sepsis Decision Tool for guidance in children s 12 years of age
65
What is a red flag in sepsis management related to GCS?
New deterioration in GCS/AVPU
66
What systolic blood pressure indicates a red flag in sepsis management?
Systolic B.P less than or equal to 90 mmHg (or >40 mmHg < normal)
67
What heart rate indicates a red flag in sepsis management?
Heart rate >130 per minute.
68
What respiratory rate indicates a red flag in sepsis management?
Respiratory rate >25 per minute.
69
What oxygen saturation level indicates a red flag in sepsis management?
Needs oxygen to keep SpO2 92% (88% in COPD).
70
What skin condition indicates a red flag in sepsis management?
Non-blanching rash or mottled/ashen/cyanotic skin
71
What urinary condition indicates a red flag in sepsis management?
Not passed urine in the last 18 hours.
72
What recent medical history indicates a red flag in sepsis management?
Recent chemotherapy (within the last 6 weeks).
73
What tool should be referred to for sepsis guidance in children under 12 years of age? Age-appropriate GDP Sepsis Decision Tool.
Age-appropriate GDP Sepsis Decision Tool.
74
red flag sepsis management
Airway Breathing Circulation Disability Exposure Call 999, state 'Red Flag Sepsis!, SBAR Oxygen 15 litres/min Ensure paramedics pre-alert as 'Red Flag Sepsis NB Refer to age-appropriate GDP Sepsis Decision Tool for guidance in children d 12 years of age
75
What should you do when you suspect red flag sepsis?
Call 999 and state 'Red Flag Sepsis!, SBAR
76
What is the recommended oxygen flow rate for a patient with red flag sepsis?
15 liters/min
77
What should you ensure when calling paramedics for a red flag sepsis case?
Pre-alert them as 'Red Flag Sepsis'
78
Where can you find guidance for managing sepsis in children aged 12 years or younger?
Refer to the age-appropriate GDP Sepsis Decision Tool
79
stroke signs and symptoms (4)
FAST Face drooping Arm weakness Speech difficulty Time to call 999
80
Stroke management (4)
Airway Breathing Circulation Disability Exposure Act FAST & call 999, SBAR Administer oxygen 15 litres/min Nil by mouth; appropriate position
81
syncope signs and symptoms (8)
Feels faint/dizzy/light headed Collapse & loss of consciousness Pallor, sweating, slow pulse, low BP Nausea/vomiting
82
syncope management (6)
Airway Breathing Circulation Disability - - Exposure Lie flat, elevate legs & and loosen tight clothing - oxygen not usually necessary - Once consciousness returns, offer glucose in water or sweet tea - Slow recovery: consider alternative diagnosis; unresponsive: check signs of life
83
What position should a patient be placed in during syncope management?
Lie flat and elevate legs
84
Is oxygen usually necessary in syncope management?
No, oxygen is not usually necessary
85
What should be offered once consciousness returns after a syncopal episode?
Glucose in water or sweet tea
86
What should be considered if recovery from syncope is slow?
Consider alternative diagnosis
87
What should be checked if a patient is unresponsive after a syncopal episode?
Check signs of life

BDS5 (5 decks)

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