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Oral Surgery 1 > Medical Emergencies > Flashcards

Medical Emergencies Flashcards

1
Q

What are the steps of the Basic Life Support (BLS) protocol

A
  1. Assess airway for breathing (5 - 10 seconds)
  2. Call for AED and activate emergency response team
  3. Assess circulation via pulse (5-10 seconds)
  4. AED defibrillation if no pulse
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2
Q

What are the steps to take in an airway obstruction emergency

A
  1. BLS protocol
  2. Recognize obstruction or unconsciousness
  3. position patient for Heimlich or supine for intervention
  4. head tilt/chin lift
  5. ventilate with O2 mask, Ambu bag, IPPBD
  6. reposition head as needed, consider jaw thrust
  7. reventilate with O2 mask, Ambu bag, IPPDB
  8. consider abdominal thrusts
  9. Check for foreign body, use yankauer suction tip
  10. reattempt steps 3-9
  11. consider cricothyrotomy (last resort)
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3
Q

What are the steps to take in a bronchospasm emergency

A
  1. BLS protocol
  2. consider administering bronchodilator (1-2 puffs)
  3. consider subcutaneous Epinephrine (.3 - .5 mg)
  4. consider benadryl (diphenhydramine) 25-50 mg
  5. consider a steroid (decadron 20 mg) IV or sublingual
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4
Q

What are the steps to take in emesis, ingestion, and aspiration emergencies

A
  1. BLS protocol
  2. get tonsil suction tip (yankauer)
  3. turn patient to right side and trendelenburg if possible
  4. check for vomitus and foreign bodies and clear if possible
  5. administer 100% oxygen
  6. auscultate lungs
  7. watch for cyanosis and dyspnea
  8. for ingestion and aspiration get a chest X-ray and consider and abdominal flat plate X-ray
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5
Q

What are the steps to take in a syncope emergency

A
  1. BLS protocol
  2. protect patient from injury
  3. Diagnose etiology (cause)
  4. Place patient in trendelenburg
  5. administer 100% oxygen
  6. consider ammonia inhalant (if patient remains unconsious)
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6
Q

What are the steps to take in angina pectoris for a patient who has been prescribed nitroglycerin

A
  1. BLS protocol
  2. try to keep patient comfortable
  3. nitroglycerin tabs or spray under tongue
  4. administer 100% oxygen
  5. Monitor patients BP, EKG, and with pulse oximeter
  6. if pain continues after 5 minutes administer further nitroglycerin
  7. if pain continues after 5 more minutes administer nitroglycerin, assume MI, contact emergency response teams and prepare to transport
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7
Q

What are the steps to take in angina pectoris for a patient who has NOT been prescribed nitroglycerin

A
  1. BLS protocol
  2. administer nitroglycerin tablet or spray sublingually
  3. activate emergency response teams
  4. reassure and make patient comfortable
  5. provide 100% oxygen
  6. monitor patient BP, EKG, and with pulse oximeter
  7. if no relief after 5 minutes administer more nitroglycerin
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8
Q

What are the steps for a patient who suffers an MI (myocardial infarction)

A
  1. BLS protocol
  2. put patient in comfortable position
  3. administer 100% oxygen
  4. MONA
    • Morhpine (1-4 mg doses every 5-10 minutes)
    • Oxygen (4L per minute)
    • Nitroglycerin (if not already given)
    • Aspirin (160-350 mg chew)
  5. monitor patient BP, EKG, with pulse oximeter
  6. keep patient comfortable and prepare to transport
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9
Q

What are the steps to take in a patient in cardiopulmonary arrest

A
  1. BLS protocol
  2. if shockable rhythm, SHOCK
  3. CPR for 2 min
  4. reevaluate,if shockable rhythm, SHOCK
  5. Consider epinephrine 1mg every 3-5 min
  6. CPR for 2 min
  7. reevaluate, f shockable rhythm,
  8. CPR for 2 min
  9. prepare to transport
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10
Q

What are the steps to take for a patient who undergoes a mild allergic reaction

A

administer benadryl (diphenhydramine) 25-50 mg

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11
Q

What are the steps to take for a patient who undergoes a severe allergic reaction

A
  1. subcutaenous Epinephrine (.3-.5 mg)
  2. Benadryl (diphenhydramine) 25-50 mg
  3. repeat epinephrine after 5-10 minutes
  4. Decadron 20 mg IV
  5. if no resolution BLS protocol
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12
Q

What are the steps to take for a patient who suffers a seizure

A
  1. BLS protocol
  2. Protect the patient from harm (restrain if needed)
  3. consider a benzodiazepine (Valium or Versed)
  4. Provide post-seizure reassurance (embarrassed patients)
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13
Q

What are the steps to take for a hyperventilating patient

A
  1. diagnose and comfortably position the patient
  2. allow patient to breathe into paper bag or O2 mask
  3. BLS protocol if patient becomes unconsious
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14
Q

What are the steps to take for a patient who has a hypoglycemic episode

A
  1. BLS protocol
  2. check patient blood glucose
    (normal fasting - 70-100)
    (two hours post meal - < 180)
  3. if glucose is low and patient is awake administer carbs
  4. if glucose is low and patient is unconscious, administer carb gel or start IV and administer 50% dextrose
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15
Q

What are the signs of a potential oncoming stroke

A

sudden weakness of face, arms, or leg (especially on one side only
sudden confusion
trouble speaking and understanding
trouble seeing in one or both eyes
trouble walking
dizziness
sudden severe headache with no known cause

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16
Q

What are the parts of the stroke assessment FAST

A

Face - have the patient smile and see if half of the face doesn’t respond as well as the other half
Arm - have the patient close their eyes, raise their arms for 10 seconds. see if one arms drift downward when compared to the other arm
Speech- have the patient speak a sentence and see if the speech is slurred, incorrect, or if the patient cant speak
Time - time to activate the emergency response teams

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17
Q

What is the probability of a stroke if the patient exhibits 1, 2, or all 3 of the FAST stroke assessments.

A

1 = 72% probability the patient is having a stroke

all 3 = >85% probability the patient is having a stroke

18
Q

What should be done for a patient with tachycardia

A
  1. BLS protocol (if patient is unconscious)
  2. determine if patient is asymptomatic or symptomatic
  3. administer 100% oxygen
  4. measure vital signs (BP, pulse oximeter, EKG)
  5. identify and address the cause
  6. consider vagal maneuver
19
Q

What should be done for a patient with bradycardia

A
  1. BLS protocol (if patient is unconscious)
  2. determine if the PT. is asymptomatic or symptomatic
  3. administer 100% oxygen
  4. measure vital signs (BP, pulse oximeter, EKG)
  5. identify and address the cause
20
Q

What should be done for a patient with hypertension

A
  1. BLS protocol (if patient is unconscious)
  2. terminate procedure
    3.
21
Q

What should be done for a patient with hypertension

A
  1. BLS protocol (if patient is unconscious)
  2. terminate procedure
  3. administer 100% oxygen
  4. monitor BP, EKG, pulse oximeter
  5. identify and address the etiology
  6. if patient isn’t doing well activate emergency response system
  7. refer to MD for follow up if patient is ok
22
Q

What should be done for a patient with hypotension

A
  1. BLS protocol (if patient is unconscious)
  2. terminate procedure
  3. provide 100% oxygen
  4. place patient in trendelenburg position
  5. monitor patient (EKG, BP, Pulse oximeter)
  6. determine if patient is asymptomatic or symptomatic
  7. identify and address etiology
  8. if symptomatic activate emergency response system
  9. if asymptomatic refer to MD for follow up
23
Q

What are the signs of syncope

A 
patient falls to the ground unconscious
diaphoresis
facial warmth 
palor
nausea
hypotensive?
tachycardia
24
Q

What is the key to treating syncope

A

prevention

25
Q

what is syncope

26
Q

What does an HbA1C of 6 tell you about a patients blood glucose level

A

their average blood glucose level over the last 120 days is about 125 mg/dl

27
Q

What does an HbA1C of 9 tell you about a patient’s blood glucose level

A

their average blood glucose level over the last 120 days is about 215 mg/dl

28
Q

What does an HbA1C of 12 tell you about a patient’s blood glucose level

A

Their average blood glucose level over the past 120 days is about 300 mg/dl

29
Q

What is Naloxone

A

an opiod antagonist that can be used in opiod drug overdoses

30
Q

What should you do if you are performing the BLS protocol and you can’t find a patient’s pulse

A

start CPR
30 compressions (100 per minute pace, Staying alive beat)
Followed by two breaths

31
Q

What signs will a patient exhibit to help you determine if he/she has aspirated or ingested an object

A

if the patient is not coughing or in respiratory distress then it is likely that the object was swallowed
if the patient is coughing or has shortness of breath then it is likely that the object has been aspirated

32
Q

will you auscultate the lungs if you think it is likely that the patient has ingested an object and not aspirated it

A

yes, you auscultate the lungs either way just to have more tools to diagnose

33
Q

What does a patient’s MET (metabolic equivalent level) of <4 indicate

A

<4 = poor MET

the patient can’t do much more than activities of daily living like vacuuming, walking, and writing.

34
Q

What does a patient’s MET score of 4-7 indicate

A

4-7 = moderate MET

the patient can walk, play golf, do cycling, and gardening.

35
Q

What does a patient’s MET score of >7 indicate

A

> 7 = Excellent MET

the patient is able to do strenuous exercise and is in good physical condition.

36
Q

Why is a patient’s rough MET score important to be familiar with

A

a patient with a low MET score is more at risk for problems during dental treatment

37
Q

What does an ASA class 1 physical status indicate

A

A normal healthy patient

38
Q

What does an ASA class 2 physical status indicate

A

A patient with mild systemic disease

39
Q

what does an ASA class 3 physical status indicate

A

A patient with severe systemic disease

40
Q

What does an ASA class 4 physical status indicate

A

a patient with severe systemic disease that is a constant threat to life

41
Q

what does an ASA class 5 physical status indicate

A

A moribound patient who is not expected to survive without the operation

42
Q

What does an ASA class 6 physical status indicate

A

a declared brain-dead patient whose organs are being removed for organ transplant

Oral Surgery 1 (11 decks)

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