Medical Emergencies Notes Flashcards
what is ABCDE
A - airway
B - breathing
C - circulation
D - disability
E - exposure
airway
causes of airway obstruction = loss of consciousness / infection / inflammation / swelling
recognise via talking / sounds / work to breathe / snoring is most common sign of obstruction
tx = triple manoeuvre / adjuncts
what is the triple manoeuvre
head tilt, jaw thrust, chin lift
breathing
causes = demand / infection / inflammation
recognition = rate / look / listen / feel
tx = posture / O2 / bronchodilators
want breathing to be bilateral & equal, mechanically working i.e. diaphragm down & intercostal muscles up. if mechanical okay then go on to lung tissue; look, listen & feel
wheeze = bronchoconstriction
breathing rate should be 12-16bpm
circulation
causes = arrhythmia / ACS / HF
recognition = pulse check
tx = treat cause / elevate legs
O2 sat = 84 = peripheral cyanosis = blue fingers
O2 sat = 60 = central cyanosis = blue tongue
regular pulse = sinus rhythm
symptomatic & irregular HR = send to A&E
av resting HR = 60-100bpm
disability
cause = drugs / brain injury / hypoglycaemia
recognition = AVPU / GCS
tx = optimise ABC
AVPU = alert / verbal / pain / unresponsive
GCS = glasgow coma scale
exposure
limited in dental setting
look for clinically relevant information
then reassess
anaphylaxis ABCDE
A - swelling, stridor
B - increased rate, wheeze
C - increased rate, hypotension
D - LoC
E - rash, swelling
anaphylaxis guidelines
dx = look for sudden onset of airway +/- breathing +/- circulation problems
call for help
remove trigger if poss & lie pt flat with or without legs elevated
if pregnant lie on side
give IM adrenaline
establish airway give high flow O2, apply monitoring i.e. pulse oximetry, ECG, BP
if no response; repeat IM adrenaline after 5mins, IV fluid bolus
if no improvement in breathing or circulation despite 2 doses of IM adrenaline confirm emergency services have been called & follow refractory anaphylaxis algorithm
giving IM adrenaline
using 1mg/ml adrenaline 1:1000 concentration
adult & child >12yrs = 0.5mg IM 0.5ml
inject at anterolateral aspect of middle 1/3 of thigh using Z traction technique
must inject into DIFFERENT muscle on 2nd inj as adrenaline is a vasoconstrictor so original muscle will have constricted and won’t be able to uptake any more adrenaline
angina / MI ABCDE
A - talking
B - increased
C - increased
D - alert
E - pale, clammy, central crushing chest pain
angina / MI tx
GTN spray under tongue 400mcg/dose for angina
aspirin 300mg crushed or chewed if MI
if MI will not respond to GTN & be a more intense persistent pain
asthma ABCDE
A - difficult to complete sentences
B - increased HR with wheeze
C - increased rate
D - alert
E - tripods
tx of asthma
salbutamol 100mcg per acutation
spacer device when appropriate
cardiac arrest
DRSABC
call 999 ask for ambulance saying pt in cardiac arrest
30 chest compressions 2 rescue breaths continue 30:2 until AED arrives then attach & follow instructions
adult choking
if severe (ineffective cough) and unconscious start CPR
if severe and conscious so 5 back slaps & 5 abdominal thrusts
if mild (effective cough) encourage cough and continue to check for deterioration to ineffective cough or until obstruction relieved
hypoglycaemia ABCDE
A - initially talking
B - initially increased rate
C - initially increased rate
D - initially alert
E - irritable, confused, pale
tx hypoglycaemia
glucose
glucagon injection 1mg IM injection using Z traction technique
seizures / fits ABCDE
A - compromised
B - ?
C - ?
D - unresponsive
E - seizure activity, incontinence
tx of seizure / fit
ensure safe environment
lie on side aim for recovery position
ensure no airway obstruction
if repeated or prolonged 10mg midazolam buccally
syncope ABCDE
A - compromised
B - reduced rate
C - reduced rate & pressure
D - unresponsive
E - pale, clammy
tx syncope
elevate legs
glucose drink when they come round
