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Dentistry Human Disease > Medical Emergency > Flashcards

Medical Emergency Flashcards

1
Q

What does AED stand for?

A

Automated external defibrillation (or defibrillator)

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2
Q

In treatment of anaphylaxis, what is the dose of intramuscular adrenaline for a child aged 10 years?

A

300 micrograms IM (0.3ml)

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3
Q

In treatment of adult anaphylaxis, what is the dose of intramuscular adrenaline?

A

500 micrograms IM (0.5ml)

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4
Q

If a patient has stridor, what medical emergency are you immediately considering?

A

Anaphylaxis

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5
Q

What is the acceptable level of SPO2 for an adult?

A

95% and above

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6
Q

What are the four factors to be checked when assessing someone’s circulation?

A
  1. Manual pulse
  2. Blood pressure
  3. Capillary refill
  4. Colour
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7
Q

How would you manually record peripheral pulse?

A

This is your radial pulse, you would press down on the wrist in line with thumbline.

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8
Q

How would you manually record central pulse?

A

This is your carotid pulse, where your carotid artery sits in the neck

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9
Q

If someone has passed out and you check their pupils with a pen torch, what would pinpricked pupils suggest has happened?

A

Indication that patient has taken opiates such as morphine or heroin

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10
Q

If someone has passed out and you check their pupils with a pen torch, what would large saucer like pupils suggest has happened?

A

Patient has taken amphetamines or a concoction of other drugs

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11
Q

If there is a difference in size of pupils in each eye, why is this very concerning?

A

It would indicate a change in pressure on one part of the brain

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12
Q

What does SBAR stand for and when is it used?

A

S- situation
B- background
A- assessment
R- recommendation

Used when phoning for an ambulance or handing patient over to the ambulance crew

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13
Q

What does NEWS stand for and why is it used?

A

N- national
E- early
W- warning
S- score

Used in hospital - more in depth ABCDE check

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14
Q

A NEWS score of 7 or more indicates what?

A

High escalation required, urgent or emergency response required

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15
Q

A patient complains that they have recently experienced decreased hearing in their right ear.

What cranial nerve is suspected to be damaged?

A

Vestibulocochlear nerve (VIII)

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16
Q

A patient complains of right-sided face paralysis.

What cranial nerve is suspected to be damaged?

A

Facial nerve (VII)

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17
Q

A patient complains that they can no longer blink with their right eye.

What cranial nerve is suspected to be damaged?

A

Trigeminal nerve (V)

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18
Q

A patient presents with drooping of their upper eyelid (ptosis).

What cranial nerve is suspected to be damaged?

A

Occulomotor nerve (CN III)

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19
Q

A patient presents with pupil unresponsiveness to light.

What cranial nerve is suspected to be damaged?

A

Optic nerve (CN II)

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20
Q

What test would you use for CN I?

A

Ask patient if they can smell a certain substance

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21
Q

What test would you use for CN II?

A
  • Ask patient to read something
  • ask patient to look straight and try to identify someone else’s fingers in peripheral vision
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22
Q

How would you test CN III?

A

Ask patient to follow moving finger with eyes whilst keeping their head still

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23
Q

How would you test CN V?

A

Use cotton wool roll to test facial sensation in all three segments.

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24
Q

How would you test CN VII?

A

Ask patient to show different facial expressions

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25
Q

What is meant by cyanosis?

A

When your skin, lips or nails turn blue due to a lack of oxygen in your blood

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26
Q

In an epileptic seizure, what would signal a patient is in the tonic phase?

A

Rigidity and cyanosis

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27
Q

In an epileptic seizure, what would signal a patient is in the clonic phase?

A
  • jerking movements of limbs
  • tongue may be bitten
  • frothing at mouth
  • incontinence
28
Q

What position should epileptic patients be put in once clonic phase has stooped in seizure?

A

Recovery position

29
Q

What checks should be made when a patient has an epileptic seizure?

A

Check:
- slow heart rate (this can cause seizure)
- blood glucose levels (hypoglycaemia can cause seizure)

30
Q

What medication and dosage should be administered to an adult patient experiencing an epileptic seizure and how?

A

Midazolam 10mg via buccal route

31
Q

What medication and dosage should be administered to a child 1-5 years old experiencing an epileptic seizure?

A

5mg midazolam

32
Q

What medication and dosage should be administered to a child 5-10 years old experiencing an epileptic seizure?

A

7.5mg midazolam

33
Q

What medication and dosage should be administered to a child >10 years old experiencing an epileptic seizure?

A

10mg midazolam

34
Q

What are symptoms of a hypoglycaemic attack?

A
  • shaking/trembling
  • slurred speech
  • vagueness
  • sweating
  • double vision
  • confusion
  • unconsciousness
35
Q

What are the options for treatment of hypoglycaemic attack?

A

Depending on the circumstances and state of patient:
- 10-20g glucose
- 4x glucose tablets
- buccal glucose gel
- glucagon 1mg IM

36
Q

What are the ABCDE signs of anaphylaxis?

A

A- stridor, wheezing
B- increased RR, decreased SPO2, rapid breaths
C- drastically lowered BP, increased CRT, tachycardia, bounding pulse
D- A (with impending sense of doom)
E- flushing, urticarial rash, angiodema of lips, nose and tongue., stomach cramps, vomiting etc.

37
Q

What are the 5 management steps for anaphylaxis?

A
  1. Phone 999 and state anaphylaxis
  2. Remove the source (if known)
  3. Lay patient in supine position to restore BP
  4. Administer 1:1000 adrenaline IM. 0.5mg.
  5. O2 delivery 15 l/min via non-rebreather mask
38
Q

What is the dosage of adrenaline to be administered IM in anaphylaxis management for children 6 months-5 years old?

A

0.15mg

39
Q

What is the dosage of adrenaline to be administered IM in anaphylaxis management for children 6-11 years old?

A

0.3mg

40
Q

What is the dosage of adrenaline to be administered IM in anaphylaxis management for children 12-17 years old?

A

0.5mg

41
Q

Why is adrenaline used to manage anaphylaxis?

A

Because it is a vasoconstrictor, this means that it squeezes the peripheral vessels to ensure that blood and fluid is forced back towards the heart.

42
Q

Give ABCDE signs and symptoms of an acute severe asthma attack.

A

A- wheezing on expiration
B- increased RR. Decreased SpO2, paid shallow breaths
C- increased HR, hypertension, pallor
D- ACVPU: alert but anxious, blood glucose N/A
E- pale, distressed, use of accessory muscles for breathing, inability to complete sentences in one breath.

43
Q

Give ABCDE signs and symptoms of a life threatening asthma attack.

A

A- severe wheezing on expiration
B- decreased RR. Severely Decreased SpO2, laboured breaths
C- decreased HR, cyanosis in lips/nose
D- ACVPU: confused due to hypoxia
E- grey/blue in colour, exhausted, sleepy

44
Q

What is the management of an asthma attack for an adult?

A
  • 15 litres/min O2 non rebreather mask
  • administer patients own bronchodilator (2 puffs)
  • administer salbutamol through large volume spacer (4 puffs)
  • call 999 if no improvement after 5 minutes
  • reassure patient
  • sit patient upright and lean forward to open accessory muscles and aid with breathing
45
Q

Give ABCDE signs and symptoms for an epileptic tonic-clonic seizure.

A

A-difficult to assess but often patent
B- increased RR but hard to assess, decreased SpO2, pauses in breathing (apnoea)
C- increased HR, hypertension
D- ACVPU: unresponsive, blood glucose N/A
E- convulsions, flushed complexion, rigidity, urinary incontinence, frothing and mouth

46
Q

What are the signs and symptoms of an absence seizure?

A
  • blank stare
  • zoning out
  • usually short lasting
47
Q

What is the management of a tonic-clonic seizure (adult)?

A
  • move objects that may harm patient during seizure
  • do not attempt to restrain it put anything in their mouth
  • time the seizure, if >5 mins then classes as status epilepticus. Administer 10mg midazolam buccaly and phone for ambulance.
  • administer O2 15 litres through non-rebreather mask
48
Q

What dosage of midazolam is given to a child 6-11 months of age having a tonic-clonic seizure?

A

2.5mg

49
Q

What dosage of midazolam is given to a child 1-4 years of age having a tonic-clonic seizure?

A

5mg

50
Q

What dosage of midazolam is given to a child 5-9 years of age having a tonic-clonic seizure?

A

7.5mg

51
Q

What dosage of midazolam is given to a child 10-17 of age having a tonic-clonic seizure?

A

10mg

52
Q

Give ABCDE signs and symptoms of hypoglycaemic attack.

A

A- patent
B- increased RR, decreased SpO2
C- tachycardia, hypertension, pallor, clammy
D- ACVPU: confused, blood glucose <4mmols
E- slurred speech,shaking, aggressive, appears drunk

53
Q

What is the management of hypoglycaemic attack?

A
  • O2 15 litres if patient allows
  • if conscious = 10-20g oral glucose (repeat every 10-15 mins)
  • if unconscious = 1mg glucagon IM, CALL 999
  • if patient regains consciousness, give more oral glucose.
54
Q

Give the ABCDE signs and symptoms of angina and MI.

A

A- patent, but potential for some wheezing sounds
B- increased RR, decreased SpO2, rapid
C- HR can increase or decrease, BP can increase or decrease, CRT increases, pallor.
D- ACVPU: A but anxious, blood glucose N/A
E- clammy, grey in colour, sweaty, nauseous, potential evidence of cyanosis

55
Q

What is the management of angina attack/ MI?

A
  • O2 15 litres/min
  • administer 2 puffs of GTN spray (400 micro grams) sublingually (repeat after 3 mins)
  • if symptoms alleviate this was ANGINA ATTACK
  • if pain remains CALL 999, administer 300mg aspirin tablet
  • this is likely MI
56
Q

Give the ABCDE signs and symptoms of anaphylaxis.

A

A- stridor, wheezing
B- increased RR, decreased SpO2, rapid shallow breaths
C- drastically decreased BP, tachycardia, increased CRT, bounding pulse
D- ACVPU: A but with impending sense of doom
E- flushing, urticarial rash, angiodema, stomach cramps, urinary incontinence, bowel incontinence, vomiting, nausea

57
Q

What is the management of anaphylaxis (adult)?

A
  • phone 999
  • remove source of infection if known
  • lie patient supine to restore BP
  • administer 1:1000 adrenaline IM 0.5mg (1mg/1ml) in anterolateral thigh
  • 15 litres O2 through non-rebreather mask
  • repeat every 5 mins till ambulance arrives
58
Q

What is the dose of adrenaline for management of anaphylaxis in a 6month-5 year old child?

A

0.15mg

59
Q

What is the dose of adrenaline for management of anaphylaxis in a 6-11 year old child?

A

0.3mg

60
Q

What is the dose of adrenaline for management of anaphylaxis in a 12 + year old child?

A

0.5mg

61
Q

What are the 4 main features of tonic stage of seizure?

A
  1. Back arched
  2. Incontinence
  3. Stiff body
  4. Epileptic cry
62
Q

What are the 3 features of the clonic stage of siezures?

A
  1. Jerking
  2. Frothing saliva
  3. Blinking eyes
63
Q

What is normal respiratory rate?

A

12-20 breaths per minute

64
Q

What is the acceptable limit for an adults BP?

A

120/70

65
Q

What is considered a low BP?

A

90/60

66
Q

What is considred a high BP?

A

140/90

Dentistry Human Disease (29 decks)

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