Medical Emergencies Flashcards
what is adrenal insufficiency?
after prolonged therapy with corticosteroids
a patient with adrenal insufficiency may become hypotensive under the stress of the dentist
what is adrenal insufficiency?
after prolonged therapy with corticosteroids
a patient with adrenal insufficiency may become hypotensive under the stress of the dentist
management of adrenal insufficiency?
lie flat
give 02
transfer to hospital
what is anaphylaxis?
severe allergic reaction
dentistry - admin of drug/after contact with gloves (latex)
more rapid onset and more profound reaction
signs/symptoms of anaphylaxis?
parasthesia, fluhing, swelling of face
gen itching - esp hands and feet
bronhcospasm, wheeszing, difficulty breathing
rapid weak pulse, fall in bp, pallor, cardiac arrest
treatment of anaphylaxis?
secure airway restore bp by lying flat and raise feet unconscious = recovery position adrenaline 02 hospital
amount of adrenaline?
child
- 5ml adrenaline-repeat at 5 min intervals if necessary
- 15mL
- 3mL
- 5mL
asthma attack, responds to?
2 puffs of beta 2 agonist salbutamol 100mg
if pt unstable how to use inhaler?
use a large volume spacer
what is moderate acute asthma?
able to speak
resp breathes/min
mild acute asthma pulse
adult?
child 2-5?
child 5-12?
peak flow of adult in mod acute asthma?
child 5-12?
> 50% Of predicted best
>50%
arterial stats in mod acute asthma should be?
monitor response for how long?
> 92%
15-30 mins
severe acute asthma?
cant complete sentences in one breath
s.acute resp/min
adult
2-5yrs
5-12yrs
25
>40
>30
s.acute pule
adult
2-5
5-12
> 110
140
125
o2 sats s.acute?
> 92%
what is the peak flow in severe acute asthma?
33-50% of predicted best
what is life threatning acute asthma?
silent chest, feeble resp effot, cyanosis hypotension bradychardia arrythmia exhaustion agitation reduced level of consciousness peak flow less than 33%
treatment of acute asthma?
high flow o2
inhaled short action beta2 via spacer
what is cardiac arrhythmia?
sudden reduction in CO and loss of consciousness
what is the pain of MI similar to?
that of angina
more severe and prolonged
MI signs/symptoms?
progressive onset of severe crushing pain across front of chest - pain may radiate to shoulder and down arm or into neck or jaw
skin becomes pale and clammy
naseua/vomitting are common
pulse - weak, bp may fall
drugs for MI?
o2
sublingual gtn may relieve pain
300 mg aspirin
what to do when pt having epileptic fit?
ensure pt not at risk nothing in mouth 02 dont restrain when conscious = recovery position midazolam if seizure over 5 mins
management of adrenal insufficiency?
lie flat
give 02
transfer to hospital
what is anaphylaxis?
severe allergic reaction
dentistry - admin of drug/after contact with gloves (latex)
more rapid onset and more profound reaction
signs/symptoms of anaphylaxis?
parasthesia, fluhing, swelling of face
gen itching - esp hands and feet
bronhcospasm, wheeszing, difficulty breathing
rapid weak pulse, fall in bp, pallor, cardiac arrest
treatment of anaphylaxis?
secure airway restore bp by lying flat and raise feet unconscious = recovery position adrenaline 02 hospital
amount of adrenaline?
child
- 5ml adrenaline-repeat at 5 min intervals if necessary
- 15mL
- 3mL
- 5mL
asthma attack, responds to?
2 puffs of beta 2 agonist salbutamol 100mg
if pt unstable how to use inhaler?
use a large volume spacer
what is moderate acute asthma?
able to speak
resp breathes/min
mild acute asthma pulse
adult?
child 2-5?
child 5-12?
peak flow of adult in mod acute asthma?
child 5-12?
> 50% Of predicted best
>50%
arterial stats in mod acute asthma should be?
monitor response for how long?
> 92%
15-30 mins
severe acute asthma?
cant complete sentences in one breath
s.acute resp/min
adult
2-5yrs
5-12yrs
25
>40
>30
s.acute pule
adult
2-5
5-12
> 110
140
125
o2 sats s.acute?
> 92%
what is the peak flow in severe acute asthma?
33-50% of predicted best
what is life threatning acute asthma?
silent chest, feeble resp effot, cyanosis hypotension bradychardia arrythmia exhaustion agitation reduced level of consciousness peak flow less than 33%
treatment of acute asthma?
high flow o2
inhaled short action beta2 via spacer
what is cardiac arrhythmia?
sudden reduction in CO and loss of consciousness
what is the pain of MI similar to?
that of angina
more severe and prolonged
MI signs/symptoms?
progressive onset of severe crushing pain across front of chest - pain may radiate to shoulder and down arm or into neck or jaw
skin becomes pale and clammy
naseua/vomitting are common
pulse - weak, bp may fall
drugs for MI?
o2
sublingual gtn may relieve pain
300 mg aspirin
what to do when pt having epileptic fit?
ensure pt not at risk nothing in mouth 02 dont restrain when conscious = recovery position midazolam if seizure over 5 mins
hypoglycaemia signs/symptoms?
shaking/trembling - sweating pins and needles in lip/tongue hunger - palpitation headache - double vision difficulty in concentration speech slurred confusion change of behaviour could be unconscious
give what for a hypoglycaemic attack?
glucose 10-20g by mouth
10g glucose from diet lucozade, coca cola, ribena
if necessary repeat every ten to fifteen mins
if pt unconscious give what?
1M/1mg glucagon
what is syncope?
insufficient blood suppply to brain = loss of consciousness
what is the most common cause of vaso vagal attack?
faint
fainting signs?
pallor/sweating slow pulse nausea/vomitting dilated pupils muscular twitching
tx of faint
lay flat
raise legs
loosen tight clothing round neck
when conscious = sweet tea
other causes of vaso vagal attack?
postural hypotension
stress - hyperventilating - feel faint
give oxygen to what patients?
what does it do?
hypoxaemic patients? increased alveolar tension and decrease work of breathing
oxygen aims to achieve a normal what?
02 saturation
acutely ill patients will have what o2 sat?
94-98%
patients at risk of hypercaphic respiratory failure o2 sats?
88-92%
