Medical emergencies part 1

Question 1

What conditions increase the likelihood of a medical emergency occurring?

Answer 1

Ischaemic heart disease
Diabetes
Asthma
Allergies
Polypharmacy

Question 2

What are the principles of emergency management?

Answer 2

ABCDE

Question 3

What may cause an upper airway obstruction?

Answer 3

Blood/ saliva/ vomit in mouth
LA may decrease pharyngeal reflexes
Foreign body aspiration
Laryngospasm

Question 4

What are the signs of upper airway obstruction?

Answer 4

Sudden onset, coughing, spluttering, difficulty breathing, chest movement

Question 5

What are the signs of partial obstruction?

Answer 5

expiratory wheeze (lower obstruction)
gurgling (liquid in upper airway)
snoring (pharynx partially occluded by tongue / palate)

Question 6

What conditions may present with breathing difficulties?

Answer 6

Hyperventilation
Asthma
Angina
Heart failure

Question 7

What are the signs of respiratory distress?

Answer 7

Sweating, central cyanosis, using accessory muscles to breathe, increased respiratory rate, additional sounds - gurgling, stridor, wheeze

Question 8

What is hyperventilation?

Answer 8

Minute ventilation exceeds metabolic demands resulting in haemodynamic changes
Acute or chronic, association with panic disorder

Question 9

What are the symptoms of hyperventilation?

Answer 9

SOB, wheeze, chest pain, belching, dry mouth, dizziness, paraesthesia, circumoral numbness

Question 10

What is asthma?

Answer 10

Presence of more than one of the following: wheeze, breathlessness, chest tightness, cough
Symptoms worse at night, and often in response to exercise, allergens, cold weather

Question 11

How do psychosocial issues affect healthcare?

Answer 11

Non compliance with treatment, failure to attend appointments, self discharge, self harm, drug abuse, obesity, social isolation, employment problems

Question 12

What precipitates asthma in the dental practise?

Answer 12

LA with vasoconstrictors may cause bronchospasm
Sedatives/GA may cause asthma attack
Penicillin allergies
NSAIDS, beta blockers and aspirin should be avoided

Question 13

What are the signs and symptoms of an asthma attack?

Answer 13

MILD - wheeze, chest tightness, increase RR, tachycardia
MODERATE - further increase in same symptoms
SEVERE - inability to complete one sentence in one breath, RR >25/min, tachycardia >110/min, bradycardia >50/min
LIFE THREATENING - cyanosis, RR