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Human Disease Y3 > Medical Emergencies > Flashcards

Medical Emergencies Flashcards

1
Q

what are the principles of emergency management ?

A 
check responsiveness,
airway and oxygen,
breathing,
circulation,
disability,
exposure
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2
Q

why are dental patients at risk of upper airways obstruction ?

A

blood or saliva in the mouth for long periods of time,
LA may diminish normal protective pharyngeal reflexes,
dental equipment in mouth for long periods

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3
Q

what are the commonest problems for dental patients regarding compromised airways ?

A

foreign body aspiration and laryngospasm

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4
Q

what are the signs of an upper airway obstruction ?

A

paradoxical chest and abdominal movements,
use of accessory muscles of respiration,
central cyanosis - late sign

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5
Q

what are the signs of partial airway obstruction ?

A

inspiratory stridor - obstruction at or above the larynx,
expiratory wheeze - lower airway obstruction,
gurgling,
snoring

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6
Q

what is the management for airway obstruction ?

A

head tilt, chin lift, jaw thrust
remove visible foreign body
airway adjuncts
high flow oxygen

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7
Q

what medical conditions present with breathing problems ?

A

hyperventilation, asthma, angina, heart failure

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8
Q

what are the signs of respiratory distress ?

A

sweating, central cyanosis, use of accessory muscles of respiration, abdominal breathing

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9
Q

what is the normal respiratory rate for adults ?

A

12-20 breaths per min

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10
Q

what is the normal respiratory rate for children ?

A

20-30 breaths per minute

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11
Q

what is the management for inadequate breathing ?

A

bag and mask/pocket mask,

ambulance

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12
Q

what is hyperventilation ?

A

minute ventilation exceeds metabolic demands resulting in haemodynamic changes

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13
Q

what are the symptoms of hyperventilation ?

A 
shortness of breath/wheeze,
chest pain/palpitations,
belching,
dry mouth,
dizziness,
paraesthesia/circumoral numbness
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14
Q

what is the management for hyperventilation ?

A

encourage re-breathing of CO2 through paper bag

small dose of benzodiazepines e.g. lorazepam

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15
Q

what is asthma ?

A

more than one of wheeze, breathlessness, chest tightness, cough

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16
Q

when is asthma worse ?

A

at night/early hours
exercise
allergens

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17
Q

what are the risk factors for severe asthma ?

A 
previous hospitalisation,
repeated ED attendances,
require more than 3 medications, 
heavy use of beta 2 agonist,
brittle asthma
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18
Q

what are the potential precipitants of acute asthma in the dental setting ?

A

sulphites in vasoconstrictors may case bronchospasm,
sedatives and general anaesthetics,
penicillin allergy

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19
Q

what drugs may precipitate and asthma attack ?

A

NSAIDs, aspirin, barbiturates, beta blockers, cyanoacrylates, mefanamic acid, morphine, pancuronium, suxamethonium

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20
Q

what are the symptoms of severe asthma ?

A

inability to complete sentences in one breath,
RR > 25 per min
tachycardia > 110
use of accessory muscles

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21
Q

what are the symptoms of life threatening asthma ?

A

cyanosis,

RR

22
Q

what is the management for an asthma attack ?

A

ABCDE assessment,
high flow oxygen 10-15L/min,
Salbutamol through spacer or nebuliser every 10 mins,
ambulance

23
Q

what emergencies affecting the cardiovascular system might occur in dental surgery ?

A

syncope, angina, MI, anaphylaxis

24
Q

what are the features of a cardiovascular examination ?

A

colour of hands - blue, pink, pale, mottled
temperature of peripheries,
capillary refill time should be less than 2 seconds
pulse - weak and thread indicates hypotension

25
Q

what are the signs and symptoms of syncope ?

A

light headedness, pale, clammy, sweaty, slow pulse rate, low blood pressure, loss of consciousness

26
Q

how do you manage a faint ?

A

reassure, raise legs, 10L/min oxygen, looses tight clothing, monitor breathing and circulation

27
Q

what are the symptoms of acute chest pain ?

A

central crushing chest pain,
pain radiates to left arm, neck, through back or into epigastrium,
associated with nausea, sweating, vomiting or difficulty breathing

28
Q

what is a sign of an inferior heart attack ?

A

slow pulse

29
Q

how do you manage angina ?

A

reassure, give oxygen, GTN, ambulance of episode is prolonged

30
Q

how do you manage MI ?

A

monitor, give oxygen, nitrate, aspirin 300mg PO, summon help

31
Q

what is anaphylaxis ?

A

an acute, life threatening IgE antibody-antigen-mediated hypersensitivity reaction
characterized by rapidly developing airway, breathing and circulation problems associated with skin and mucosal changes

32
Q

what are the common precipitants to anaphylaxis ?

A

drugs - penicillin, muscle relaxants, NSAID’s, opiates
foods - shellfish, nuts, milk, eggs, nitrates, nitrites
latex,
radiographic contrast media,
additives in medicines and topical drugs

33
Q

what symptoms of anaphylaxis are associated with the face ?

A

urticaria, erythema, rhinitis, conjunctivitis, facial oedema, facial flushing

34
Q

what symptoms of anaphylaxis are associated with the airway ?

A

tongue swelling, hoarse voice, bronchospasm leading to wheeze, upper airways oedema leading to stridor

35
Q

what symptoms of anaphylaxis are associated with the stomach ?

A

nausea, abdominal pain, vomiting, diarrhea

36
Q

what symptoms of anaphylaxis are associated with the entire body ?

A

rash, hypotension, pallor or cyanosis, feeling of impending doom, loss of consciousness

37
Q

how do you manage anaphylaxis ?

A

ensure airway is patent, give oxygen, assess respiratory rate, salbutamol through spacer, lay patient flat, check pulse and blood pressure, give adrenaline IM 500 mcg (0.5mL of 1:1000) or epipen 0.3mL of 1:1000, repeat after 5 mins, hospital

38
Q

what are the signs of hypoglycemia ?

A

sweating, clamminess, trembling, poor concentration, slurred speech, aggression, fitting, loss of consciousness

39
Q

how do you confirm a diagnosis of hypoglycaemia ?

A

automated blood glucose measurement device, blood glucose

40
Q

how do you manage hypoglycaemia ?

A

if patient conscious and able to swallow, give oral glucose, if patient unconscious give buccal glucose gel or IM glucagon

41
Q

what is the recovery time for hypoglycaemia if glucagon is given ?

A

10 mins

42
Q

what is the glucagon dose for adults ?

A

1mg

43
Q

what is the glucagon dose for children over 8 or above 25kg ?

A

1mg

44
Q

what is the glucagon dose for children under 8 or 25Kg ?

A

0.5 mg

45
Q

what is epilepsy ?

A

chronic neurological disorder,

characterized by recurrent siezures due to abnormal neuronal activity in the brain

46
Q

what are the types of seizure ?

A

simple partial seizure
complex partial seizure
tonic clonic seizure

47
Q

what is a simple partial seizure ?

A

hallucinating, confused, disorientated

48
Q

what is a complex partial seizure ?

A

patient may become unconscious

49
Q

what is a tonic clonic seizure ?

A

patient is unconscious and convulses

50
Q

what are the signs and symptoms of a tonic clonic seizure ?

A

pre seizure aura,
tonic phase - brief cry precedes loss of consciousness with ridged extended body,
clonic phase - widespread jerking movements,
tongue biting, incontinence, cyanosis,
slow recovery

51
Q

how do you manage a seizure ?

A 
ensure airway open and protected,
breathing,
beware of hypotension,
check glucose, 
high flow oxygen,
recovery position,
buccal or intranasal midazolam, 
ambulance
52
Q

what is the dosage of midazolam ?

A

1-5 years 5mg,
5-10 years 7.5mg,
>10 years 10mg

Human Disease Y3 (24 decks)

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