MEDICAL EMERGENCIES Flashcards
List the key equipment for use in medical emergencies in the dental setting
- 02 cylinder
- non rebreather mask
- AED
- Bag valve mask (BVM)
- Oropharyngeal airway (OPA)s
- Emergency drugs for common medical emergencies
- Spacer device (adult and paeds)
- Glucose device
what sizes of OPAs are available in the medical emergency trolley?
2 (green)
3 (yellow)
4 (red)
List the contents of the drug box?
glucose gel
adrenaline
midazolam
glyceril trinitrate spray
dispersible aspirin
salbutamol inhaler
glucagon
what is the concentration of adrenaline in the drug box?
1 in 1000
1mg in 1ml
what is the concentration of midazolam in the drug box?
10mg in 2ml
what is the concentration of glyceril trinitrate spray in the drug box?
400mcg per metered dose
what strength of aspirin is in the drug box?
300mg tablets
what concentration of salbutamol inhaler is in the drug box?
100mcg per metered dose
what concentration of glucagon is in the drug box?
1mg, powder and solvent
list the drug box extras?
1ml syringe
2ml syringe
blunt filter needle
green sharp injector needle
liquid antihistamine (chlorphenamine)
IV cannulas
mucosal atomisation device
list the common medical emergencies?
vasovagal syncope
asthma attack
anaphylaxis
hypoglycaemia
epileptic seizure
stroke
SEPSIS
angina attack
myocardial infarction
cardiac arrest
choking
list ABCDE signs and symptoms of hypoglycaemia?
A - patent
B - increased RR, possible decreased sp02
C - tachycardia, may have hypertension, pallor, clammy
D - alert/ confused, blood glucose <4mmols
E - slurred speech, shaking, aggressive, appears drunk
hypoglycaemia management?
02 15l/min through non rebreather (if pt allows)
pt conscious: 10-20g oral glucose and repeat every 10-15 mins if required (use glucose monitor)
pt unconscious: 1mg glucagon IM, 02 and call 999
when pt regains consciousness - more oral glucose to replenish reserves
what type of pts may have difficulty regaining consciousness after a hypoglycaemic attack?
pts with low glucose reserves: eating disorders, IVDU, alcohol abusers
signs and symptoms of an absence siezure?
- blank stare
- zoning out
- usually short lasting
ABCDE signs and symptoms of epilepsy?
A - difficult to assess but often patent
B - increased RR, decreased sp02, pauses in breathing (apnoea)
C - increased HR, hypertension
D - Unresponsive, blood glucose N/A
E - convulsions, flushed complexion, rigidity, urinary incontinence, frothing of mouth
management of epilepsy tonic clonic seizure?
if pt recovers naturally, reassure them or consider recovery position if necessary
time the seizure, if over 5 mins this is “status epilepticus” - 10mg midazolam buccally and phone 999
move objects that may harm pt during seizure
do not attempt to restrain pt or put anything in their mouth
if no response to the drug after 10 mins, emergency services should be updated
02 15l/min through non re-breather
continuously monitor until help arrives
what symptoms of a seizure imply it is serious and 999 must be called?
it lasts more than 5 mins
occur intermittently
ABCDE signs and symptoms of angina and myocardial infraction?
crushing central chest pain, radiating to left arm, neck and jaw
A - usually patient
B - increased RR, decreased sp02, rapid shallow breathing
C - tachycardia with weak pulse, hypotension, increased CRT, pallor
D - alert but distressed
E - clammy, grey in colour, sweaty, nauseous, potential cyanosis
what is the management for angina and MI?
02 15l/min
2 puffs GTN (400ug) sublingually - repeat after 3 mins if pain remains
(if symptoms alleviate = angina)
if pain remains or worsens phone 999 and give 300mg dispersible aspirin (chewed and swallowed asap)
monitor and reassure until ambulance arrives
if pt becomes unresponsive, follow BLS sequence
signs and symptoms of a stroke?
think FAST:
F: face fallen on 1 side, unable to smile, unable to raise both eyebrows
A: unable to raise both arms and keep them there, unable to squeeze with equal strength in both hands
S: speech slurred, or words muddles
T: time to call 999
pt may have fast onset and severe headache, may feel nauseous and confused
stroke management?
02 15l/min
phone 999 immediately
if pt unconscious monitor airway
be prepared to follow BLS
what are signs and symptoms of sepsis?
sweaty skin
disorientation
shivering
high heart rate
extreme pain
short of breath
sepsis management?
phone 999 - say you have a pt with suspected SEPSIS
get pt to nearest A+E asap
reassurance and high flow 02 in the meantime
continuously monitor pt for further signs of deterioration
what is SBAR?
a handover:
situation
background
assessment
recommendation
