Medical Emergencies Part II Flashcards
This should not be used in CONSCIOUS PATIENTS because they tend to induce gagging and vomiting.
Oropharyngeal or nasopharyngeal airway (intubation).
Suctions without damaging the surrounding tissues.
Yankauer suction
Versed is AKA what?
Midazolam
Reversal agent for Versed
Flkumazenil
The most common method to deliver emergency drugs.
Intramuscular (IM)
Insert the needle at what angle for intramuscular injections.
90 degrees with the BEVEL UP!
Landmark for deltoid IM injection.
2 fingerbreaths below the acromion process
Landmarks for vastus lateralis injection.
1) Greater Trochanter
2) Lateral femoral condyle
Second moat important emergency drug after oxygen.
Epi
This emergency drug is only administered if the patient is experiencing a life-threatening medical emergency.
Epi
Epi treats:
- Severe allergic reaction
- Severe asthma attack
- Cardiac arrest
Epi’s affect on HR and BP.
Increases
Epi’s affect on bronchial smooth muscle
Relaxes it.
Epi has anti-histaminic action.
True.
1:1000 epi has ? mg/ml.
1
1:10,000 epi has ? mg/ml?
0.10
EpiPens should only be injected here.
Vastus Lateralis
EpiPen dose
0.3 mg/dose
EpiPen Jr dose
0.15 mg
Pediatric dose of epi.
.01 mg/kg up tp 0.3 mg/dose.
Starting at how many pounds are you considered an adult?
66 lbs.
Dose of epi for a 65 lb person.
.01 mg/kg
Adult dose of epi ?
0.3 mg/dose
How often can you give epi?
Every 5 mins until help arrives.
No maximum on how many times you can give epi.
This drug is a beta 2 adrenergic receptor agonist, thus causing bronchodilation.
Albuterol
Dosage of albuterol
2 puffs
Side effects of albuterol.
Tachycardia
Anxiety
Side effects of epi.
- HTN
- Tachycardia
- Cardiac arrythmias
- Chest pain
- Anxiety
- Headache
Relaxes vascular smooth muscle to cause vasodilation.
Nitroglycerin
Nitroglycerin is used for what?
Angina pectoris
Myocardial infarction
Dosage of Nitroglycerin
1 spray or tablet, 0.4 mg, every 5 minutes.
When do you stop giving Nitroglycerin?
1) When chest pain subsides.
2) When systolic BP is below 100 mm Hg
Aspirin dose.
325 mg
Use of aspirin
Suspected MI
How is Aspirin taken
Chewed
Side effect of Aspirin
Upset stomach
Diphenhydramine AKA
Benadryl
Diphenhydramine MOA
H1 receptor antagonist.
Blocks Histamine from binding to its receptor.
Use of Diphenhydramine
1) Allergic reactions of slower onset or less severity than anaphylaxis.
2) Adjunct to epi in severe allergic reactions.
Dosage of diphenhydramine.
1-2 mg/kg INTRAMUSCULARLY up to 50 mg.
What is Midazolam used for?
Grand mal seizures
sedative
MIdazolam pediatric dose for sustained grand mal seizure.
0.15 mg/kg to a maximum of 10 mg for the initial dose.
This form of glucose is only effective in raising blood glucose when swallowed.
Glucose pastes
Used for adrenal insufficiency and adjunct in allergy management.
Corticosteroids (like methylprednisolone)
What do you do if a patient doesn’t have a pulse?
30 chest compressions at 100 per minute.
Give 2 breaths after 30 compressions.
30 compressions
2 breaths
If there are two rescuers for a child, how many compressions do you do?
15
How do you position someone who has lost consciousness?
Lay flat on their back, with the feet slightly raised above the level of the heart.
Diphenhydramine child dose
10-25 mg
Diphenhydramine adult dose
25-50 mg
Drug delivery of epi
0.01 mg/kg INTRAMUSCULARLY
What do you do for local anesthetic toxicity?
Supplemental oxygen
Metallic taste and tinnitus are a sign of what?
LA toxicity.
Preferred way to administer flumazenil.
IV
AKA “passing out.”
Syncope
What is syncope usually triggered by?
Anxiety
Signs of pre-syncope.
1) Light-headedness
2) May lose normal skin color in the face and lips
Appropriate in any emergency involving a decrease in brain perfusion.
Administering O2
Positioning of someone with pre-syncope.
Lay flat on back with legs above heart level to allow blood flow to the brain.
Name the medical eergency:
- Decrease in HR and BP
- Decreased blood flow to the brain, and loss of consciousness
- Breathing becomes irregular, pupils dilate, and convulsive movements may be noted.
- Muscles relax and airway may become obstructed.
Syncope
Drug of choice to increase HR.
ATROPINE
What type of hypersensitivity reaction is immediate?
Type I
Common triggers of allergic reactions in pediatric dentistry.
- Penicillins
- Ester-type LA’s for their topical anesthetic effect
- Sulfide antioxidants in LA’s
An anaphylactic reaction is cause by the release of this.
Histamine
This causes constriction of bronchial smooth muscle that produces respiratory distress.
Anaphylaxis
Principle recognizable sign of an allergic reaction.
Wheezing, which indicates bronchoconstriction.
What do you give if it’s a SEVERE ALLERGIC REACTION?
Epinephrine
(0.01 mg/kg to max initial dose of 0.3 mg).
Epinephrine physiologically counteracts the effects of what?
Histamine
This causes BRONCHODILATION and RAISES BP.
EPINEPHRINE
This should always be administered in an allergic reaction.
OXYGEN
Pediatric dose of Benadryl
1 mg/kg
Phases of grand mal seizures:
Prodromal
Aura
Ictal (Convulsive)
Postictal
Grand mal phase where there are subtle changes that maoy occur over minutes to hours.
Not usually clinically evident to the DDS or patient.
Prodromal
Phase of grand mal seizures where:
- Neurologic experience that the patient goes thru right before the seizure.
- May involve a taste, smell, hallucination, motor activity, etc.
- Often the same for the patient.
Aura
Tonic-clonic phase
Convulsive
As chest wall musculature contracts, air is expelled through the larynx, producing vocalization called ……
Epileptic cry
Rigid skeletal muscle contraction
Tonic
Jerky movements begin.
Clonic
This phase lasts 1-3 mins.
Clonic
Phase where muscles relax and movement stops.
Postictal
Phase where there’s a lot of CNS depression, may lead to respiratory depression.
Postictal
A seizure lasting more than 5 minutes, or having more than one seizure in a 5 minute period.
Status Epilepticus.
Single seizures are usually what?
Self-limiting.
Drug for status epilepticus.
Midazolam
Epi for asthma is administered how often?
Every 15 mins
