Medical Emergencies Flashcards
Most important aspect of dealing with medical emergencies.
Prevention
Primary responsibilities of the dentist.
- PREVENTION
- Preparation
- BLS
- Basic emergency medicine procedures
- Procurement of help/transport
How to prevent medical emergencies:
- Appropriate med hx and physical exam
- Medical consult if needed
- Patient monitoring
If needed, request a statement from the doctor that:
The patient is in optimal condition for the planned procedure.
Monitoring needed for healthy patients being treated with LA alone or with minimal sedation:
- General appearance of patient
- Level of consciousness
- Level of comfort
- Muscle tone
- Color of skin/mucosa
- Respiratory pattern
These are unaffected in minimal sedation.
Ventilation and CV function
These patients have smaller degrees of respiratory and cardiovascular reserve.
Children
When moderate sedation is used, additional monitoring is needed:
- BP
- Pulse Ox
- Ventilation
The arterial oxygen measurement determined by pulse oximetry.
SpO2
This uses the light absorptive characteristics of Hemoglobin AND the pulsating nature of blood flow in the artereis to determine oxygen status.
Pulse Ox
Absorbs infrared light
Oxygenated Hb
Absorbs red light
Deoxygenated Hb
Probe that can be used in small babies on the cheekfrom the inside to outside the mouth.
Ear probes
Can nail polish and hennna impact the reading of a pulse ox?
YES!
Avoid this in order to get an accurate reading on the pulse ox.
Bright lights in the operating room.
A common problem in recovery that can result in an abnormal reading and cause confusion.
Shivering
T/F: Perfusion is needed for a pulse ox reading.
True
Can pulse oximeters detect Hb bound to CO?
No. So they exaggerate the SpO2 reading.
Clinically acceptable level of Sp02?
95-100%
Is pulse ox real time?
No because it’s measuring arterial O2 saturation, which may be different than the amount of oxygen being inhaled into the lungs.
Is capnography real time?
Yes
Measures expired CO2.
Capnography
Capnography monitors this.
Ventilation
Capnography uses what kind of spectrometry?
Infrared
Measures end tidal CO2
Capnography
This is what the capnograph looks like when the patient is not breathing (apnea) or when there’s an obstruction of the airway.
Flat baseline
Instrument for listening to heart and lung sounds.
Precordial stethoscope
Wheezing means what?
Bronchospasm
No breath sounds mean what?
-Complete laryngospasm, bronchospasm, or obstruction.
Pulse ox’s and capnographs give what kind of data?
Quantitative
Stethoscopes give what kind of data?
Qualitative
Respiratory and heart rates go up or down as we get older?
Down
The initial primary goal of BLS is:
Establishing and maintaining an airway.
The final common pathway leading to morbidity and mortality in the majority of severe pediatric medical emergency situations.
Hypoxemia
The primary emergency drug.
Oxygen
You wany what percent oxygen, and for how long?
90% at 10 L/min for 1 hr.
Minimum E cylinder size.
Use this if the patient is not breathing spontaneously.
Positive pressure ventilation.
Delivers the highest concentration of oxygen to a SPONTANEOUSLY breathing patient.
Non-rebreather facemask
% O2 delivered in mouth-to-mouth, and mouth-to-mask:
16
For child rescue breathing, one breath every _______ ?
3-5 seconds
For adult rescue breathing, one breath every _____?
5-6 seconds
Used for positive pressure ventilation.
Bag-valve-mask
Can deliver close to 100% O2?
Bag-valve-mask
Bag-valve-mask is used when the patient is or isn’t breathing?
IS NOT!
