Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Human Disease > Medical Emergencies > Flashcards

Medical Emergencies Flashcards

1
Q

What could cause upper airway obstruction at dentist?

A

increased blood and saliva for prolonged periods
LA effect pharyngeal reflexes
dental equipment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the most common causes of upper airway obstruction at dentist?

A
  1. inhalation of foreign object

2. laryngospasm (vocal cord spasm = hard to breath/speak)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What symptoms suggest upper airway obstruction?

A
  • sudden onset
  • coughing & spluttering
  • complaint of difficulty breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Symptom of larynx blocked?

A

can’t breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptom of main bronchus blocked?

A

hard to breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you assess upper airway obstruction?

A

LOOK - colour of pt, ease of breathing, paradoxical chest/abdominal movt (one side rises more / chest moves inwards on inhalation), accessory m. used)
LISTEN - absence of or additional sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the SIGNS of upper airway obstruction?

A
  • paradoxical chest/abdominal movt (one side rises more / accessory m. used) - seesaw movt.
  • accessory mm used
  • central cyanosis - late sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are SIGNS of PARTIAL upper airway obstruction?

A
  • inspiratory stridor (if obstruction at or above larynx)
  • expiratory wheeze (likely if lower airways obstruction)
  • gurgling (suggests liquid / semi-solid foreign material in upper airway)
  • snoring (tongue / palate partially blocks pharynx)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you manage upper airway obstruction?

A
  • head tilt / chin lift or jaw thrust
  • remove visible foreign body
  • airway adjuncts (guedel airway)
  • high flow oxygen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are commonest conditions that affect breathing?

A
  • hyperventilation
  • asthma
  • (angina)
  • (heart failure)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you assess breathing in ABCDE?

A
  • assess Airway first
  • determine if life threatening condition (asthma, angina, heart failure)
  • LOOK - sweating, central cyanosis, use of accessory m., abdominal breathing
  • count respiratory rate
  • LISTEN - stridor, wheeze, gurgling
  • FEEL - air on cheek
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a normal respiratory rate in adults / children?

A 
Adults = 12-20 breaths /min
Children = 20-30 breaths /min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which is worse - an increase of decrease in respiration?

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you manage breathing issues?

A
  • bag & mask
  • pocket mask
  • call 999
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is hyperventilation?

A

Minute ventilation exceeds metabolic demands resulting in haemodynamic changes.
Blowing off too much CO2
Can be acute or chronic
Linked to panic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are symptoms of hyperventilation?

A
  • shortness of breath / wheeze
  • chest pain / palpitations
  • belching / dry mouth
  • dizziness
  • peripheral paresthesia / circumoral numbness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you manage hyperventilation?

A
  • reassure pt
  • paper bag / cupped hands
  • small dose of benzodiazepines eg lorazepam (unlikely at dentist)
  • consider anxiety mgt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give an example of a benzodiazapine given in hyperventilation?

A

lorazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why might giving a benzodizapine be bad if you think pt is hyperventilating?

A

Benzodiazapines depress respiratory system.

Bad if another cause - asthma, angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Asthma - two of more of what symptoms must be present to be diagnosed with asthma?

A

wheeze
breathlessness
chest tightness
cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When are asthmatic symptoms likely to be worse?

A
  • at night / early morning
  • after exercise
  • cold air
  • allergen exposure
  • after taking aspirin, beta blockers
  • history of atopy (hyperallergic)
  • family history of atopy or asthma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why does aspirin make asthma worse?

A
  • aspirin increases leukotrienes (because COX blocked, therefore decrease in prostaglandin / thromboxane pathway, increase in leukotrienes pathway)
  • leukotrienes increase broncial muscle contraction
  • which increases wheezing / shortness of breath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does aspirin work?

A

Membrane phospholipids
I
arachidonic acid
I (COX) I (5-lipoxygenase)
Prostoglandins (inflam) Leukotrienes
Thomboxane (platelet aggregation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is atopy?

A

hyperallergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the risk factors for severe asthma?

A
  • previous near fatel asthma (admitted to hospital)
  • Previous ventilation or respiratory acidosis
  • previous hospitalisation (esp in past year)
  • 3+ classes of asthma medication
  • heavy use of beta2 agonist (asthma not controlled)
  • brittle asthma (don’t respond to treatment, inc inhaled treatments, high dose corticosteroids, long acting beta2 agonists)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What psychological issues are linked to asthma?

A
  • non compliance (treatment)
  • DNA appointments
  • reduced GP contact
  • freq home visits
  • self discharge from hospital
  • psychosis / depression / self harm
  • denial
  • alcohol abuse
  • obesity
  • employment issues
  • income issues
  • social isolation
  • childhood abuse
  • severe domestic / marital / legal stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What could cause acute asthma at dentist?

A
  • LA with vasoconstrictors (sulphites in vasoconstrictors = bronchospasm)
  • GA / sedatives (avoid - can cause asthma / respiratory failure)
  • avoid penicillin as many asthmatics are allergic
  • NSAIDS
  • aspirin, barbituates, beta-blockers, cyanoacrylates, mefanamic acid, morphine, pancuronium, suxamethonium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What drugs should be avoided at dentist for asthmatic?

A
  • LA with vasoconstrictors (sulphites in vasoconstrictors = bronchospasm)
  • GA / sedatives (avoid - can cause asthma / respiratory failure)
  • avoid penicillin as many asthmatics are allergic
  • NSAIDS
  • aspirin, barbituates, beta-blockers, cyanoacrylates, mefanamic acid, morphine, pancuronium, suxamethonium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are symptoms / signs of MILD asthma?

A
  • increase wheeze
  • complaints of chest tightness
  • increased respiratory rate
  • tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are symptoms / signs of MODERATE asthma?

A
  • same as mild, but increased symptoms
  • and increased freq of attacks
  • no symptoms of severe
  • wheeze
  • complaints of chest tightness
  • increased respiratory rate
  • tachycardia
31
Q

What are symptoms / signs of SEVERE asthma?

A
  • inability to complete sentences in one breath
  • respiratory rate >25 breaths/min
  • tachycardia >110 beats/min (normal = 70)
  • use of accessory muscles
32
Q

What are symptoms / signs of LIFE THREATENING asthma?

A
  • cyanosis

- respiratory rate

33
Q

How do you manage asthma?

A
  • ABCDE
  • high flow O2 (10-15L/min)
  • salbutamol - 4-6 puffs in spacing device. Repeat every 10mins
  • nebuliser - with salbutamol
  • 999 if severe
34
Q

What drug goes in nebuliser?

A

salbutamol

35
Q

How many puffs of which drug should be put into spacing device during asthma attack?

A

4-6 puffs salbutamol

36
Q

What emergencies affect cardiovascular system at the dentist?

A

Syncope - most common
Heart disease - angina, MI
Anaphylaxis

37
Q

What is the most common cardiovascular issue in the dental surgery?

A

syncope

38
Q

What forms part of the cardiovascular examination in an emergency?

A

Look at colour of hands - blue, pink, pale, mottled?
Assess temp of pt peripheries
Capillary refill time - should be

39
Q

Signs and symptoms of syncope?

A
  • pale, sweaty, clammy
  • light headedness
  • slow pulse rate (may be rapid)
  • low BP
  • (loss of consciousness)
40
Q

What do you do if pt fainted?

A
  • reassure pt
  • lie back, legs raised
  • Oxygen 10-15L/min
  • loosen tight clothing
  • monitoring breathing and circulation
41
Q

What is recovery rate for a faint?

A

Fast.

If not a quick recovery, could be another cause (eg MI)

42
Q

What are SYMPTOMS of acute chest pain?

A
  • central crushing chest pain (not always)
  • may radiate to left arm, neck, back, epigastrium (pain may only be in jaw, arm, epigastrium)
  • nausea, vomiting
  • sweating
  • difficulty breathing / shortness of breath
43
Q

What is the sign of an inferior heart attack?

A

Slow pulse

44
Q

What is management for angina?

A
  • reassure pt
  • oxygen
  • Nitrate - GTN (nitroglycerin)- spray / tablets under tongue
  • 999 if prolonged
45
Q

What is management for MI?

A

MONASH!

  • Monitor pt
  • Oxygen
  • Nitrate (GTN)
  • Aspirin (300mg PO)
  • Help - 999
46
Q

What dose of aspirin should be given in MI?

A

300mg PO

47
Q

What is anaphylaxis?

A

Hypersensitivity reactions

  • mild symptoms - urticaria, pruritis (itching)
  • severe symptoms - hypotension, airway compromise

Acute, life threatening, IgE antibody-antigen mediated hypersensitivity reaction

Life threatening airway +/- breathing +/- circulation problems
Linked to skin and mucosal changes

48
Q

What is pruritis?

A

itching

49
Q

What % of pop is affected by anaphylaxis?

A

up to 15%

50
Q

Common causes of anaphylaxis?

A

Food - shellfish, nuts, milk products, eggs, nitrates/nitrites (eg bacon, processed meat, some veg)
Drugs - penicillins, muscle relaxants, NSAIDS, opiates
Latex
Radiographic contrast media
Additives in medicines (inc topical drugs)

51
Q

What acronym covers symptoms of anaphylaxis? What are the symptoms of each letter?

A

FAST
Face - rash, swelling, urticaria, erythema, rhinitis (runny nose), conjunctivitis, red/pale face

Airway - hard to breath, swallow, speak, tongue swelling, hoarse voice, bronchospasm (leads to wheeze), upper airway oedema (leads to stridor)

Stomach - pain, nausea, vomiting, diarrhoea

Total body - rash, swelling, weakness, pallor/cyanosis, sense of doom, loss of consciousness, hypotension

52
Q

What are the facial symptoms of anaphylaxis?

A

rash, swelling, urticaria, erythema, rhinitis (runny nose), conjunctivitis, red/pale face

53
Q

What are the airway symptoms of anaphylaxis?

A

hard to breath, swallow, speak, tongue swelling, hoarse voice, bronchospasm (leads to wheeze), upper airway oedema (leads to stridor)

54
Q

What are the stomach symptoms of anaphylaxis?

A

pain, nausea, vomiting, diarrhoea

55
Q

What are the total body symptoms of anaphylaxis?

A

rash, swelling, weakness, pallor/cyanosis, sense of doom, loss of consciousness, hypotension

56
Q

How do you manage anaphylaxis?

A
  • ABCDE
    Airway - ensure patent, give oxygen
    Breathing - assess respiratory rate, consider salbutamol in spacer device
    Circulation - lie pt flat, check pulse and BP

Adrenaline

  • epi-pen - 0.3mL or 1:1000 (300mcg)
  • IM - 0.5mL of 1:1000 (500mcg)
  • repeat after 5 mins (or 10 / 15 mins)

Disability - assess conscious level
Exposure - extent of rash

MUST go to hospital

57
Q

What are the signs of hypoglycaemia?

A
  • sweating, clammy, trembling
  • rapid heartbeat
  • poor concentration
  • slurred speech, can’t complete sentences
  • aggression
  • fitting
  • loss of consciousness
58
Q

How do you confirm a diagnose of hypoglycaemia?

A

automated blood glucose measurement device

aka glucometer

59
Q

What is a normal blood glucose level?

A

4-7mmol/L before food

60
Q

What blood glucose level suggests hypoglycaemia?

A
61
Q

How do you treat hypoglycaemia?

A
  • oral glucose - drink, tablets, glucose gel
  • can’t swallow - buccal glucose gel
  • IM glucagon (glycogen to glucose in liver)
62
Q

How long will recovery after glucagon IM given in hypoglycaemia?

A

10mins

63
Q

What glucagon dose should be given in hypoglycaemia?

A

Adults
- 1mg (IM)

Children 8yrs+ / 25kg+
- 1mg (IM)

Children

64
Q

What is epilepsy?

A
  • common, chronic neurological disorder
  • recurrent seizures due to abnormal neuronal activity in brain
  • can be unprovoked, flashing lights, hyperventilation
  • mild = disorientation
  • moderate = collapse
  • severe = consulsions
65
Q

What are the types of epileptic seizure?

A

Simple partial seizure
- hallucination, confusion, disorientation

Complex partial seizure
- may become unconscious

Tonic-clonic seizure
- unconscious, then convulsions

66
Q

What is a Simple partial seizure?

A

hallucination, confusion, disorientation

67
Q

What is a complex partial seizure?

A

may become unconscious

68
Q

What is a tonic-clonic seizure?

A

unconscious, then convulsions

69
Q

What are signs / symptoms of tonic-clonic seizure?

A
  • may see aura before seizure
  • tonic phase - brief cry before loss of consciousness, rigid extended body
  • clonic phase - widespread jerking movt

May also have
- tongue biting, incontinence, cyanosis

70
Q

What is speed of recovery post-epileptic fit?

A

Slow.

pt may be confused.

71
Q

How do you manage epileptic fit?

A

ABCDE

  • circulation - may be hypotensive
  • disability - check glucose (pt with hypoglycaemia may have a fit)

MOVE

  • Monitor - reassess ABCDE
  • Oxygen
  • Verify help coming - prepare doc for transfer
  • Emergency action - recovery position, away from sources of injury
72
Q

What do you do in self-terminating seizure?

A
  • recovery position
  • if know epileptic, check they are accompanied
  • may not want to go to hospital
73
Q

What do you do in a prolonged seizure?

A
  • ensure good airway
  • consider buccal or intranasal midazolam
  • 999 (may not need if it happens a lot)
74
Q

What drug might you give in prolonged seizure and what are dose levels?

A

Midazolam
1-5yrs = 5mg
5-10yrs = 7.5mg
10yrs+ = 10mg

NB only give if confident

Human Disease (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions