Midterm Review Flashcards
What is the most common medical emergency in dental offices?
Syncope
* (50 percent of medical emergencies are in the dental office are from syncope)*
What are the second,third, and fourth most common medical emergencies?
(Each one of these makes up 8 percent of medical emergencies in the dental office)
2nd-Mild Allergic Reactions
3rd-Angina Pectoris
4th-Othrostatic Hypotension
When are medical emergencies in a dentall office most likely to occur?
(After what procedures. There are 3 of them)
Most likely to occur after the administration of anesthetics, extractions, or endodontics.
What are three things you can do to help prevent medical emergencies in the dental office?
- Thorough medical history
- Vital signs
- Prepare for med. emergencies as an entire dental office team.
What is ASA I classification?
NORMAL:
Can walk up 2 flights of stairs or walk 2 city blocks W/OUT shortness of breath.
What is ASA II classification?
MILD SYSTEMIC DISEASE:
Can walk up 1 flight of stairs or walk 2 city blocks, but may have shortness of breath upon completion.
EXAMPLES:
- Controlled type 2 Diabetes
- Controlled Epilepsy
- Controlled Hypertension
- Asthma
- Allergies
- Pregnancy
What is ASA III classification?
SEVER SYSTEMIC DISEASE:
(limits activity, but is NOT incapacitating)
Can walk up 1 flight of stairs or walk 1 city block, but may stop due to shortness of breath
EXAMPLES:
- Stable Angina
- MI (longer than 6 mo./ no signs or symptoms)
- Controlled type 1 Diabetes
- Controlled Heart Failure
- BP > 160/95
- Morbid Obesity
What is ASA IV classification?
SEVER SYSTEMIC DISEASE:
(it is incapacitating and a constant threat to life)
Unable to walk up a flight of stairs or 1 city block and they may have shortness of breath or distress at rest.
EXAMPLES:
- MI (within 6 mo.)
- Unstable Angina
- BP >180/110
- Coronary Heart Failure (CHF)
- Uncontrolled Diabetes
- Uncontrolled Epilepsy
- Uncontrolled Thyroid
What is ASA V classification?
Moribund patient not expected to survive 24 hrs.
What are some examples of diseases that an ASA I type of patient would have?
None
This type of patient is healthy
What are some examples of diseases that an ASA II type of patient would have?
- Controlled type 2 Diabetes
- Controlled Epilepsy
- Controlled Hypertension
- Asthma
- Allergies
- Pregnancy
What are some examples of diseases that an ASA III type of patient would have?
- Stable Angina
- MI (longer thatn 6 mo. ago/ no signs or symptoms)
- Controlled type 1 Diabets
- Controlled Heart Failure
- BP > 160/95
- Morbid Obesity
What are some examples of diseases that an ASA IV type of patient would have?
- Unstable Angina
- MI (within 6 mo.)
- BP > 180/110
- Coronary Heart Failure (CHF)
- Uncontrolled Diabetes
- Uncontrolled Epilepsy
- Uncontrolled Thyroid
Tue/ Flase
An ASA V type of patient is expected to live for the next 48 hrs.
FALSE
not expected to survive 24 hrs.
Oxygen is used for all medical emergencies EXCEPT…?
Hyperventilation
When would you use a nasal cannula?
for what kind of pt
A conscious patient suffering from COPD, MI, or CVA
What color is the oxygen tank in a dental office?
Green
True/ False:
An oxygen tank has a Cylinder, Regulator, and a Flow meter.
TRUE
True/ False:
The Cylinder on oxygen tanks are all the same size.
FALSE
They have different sizes but size E is the recommended for dental offices
What size cylinder is recommended for the oxygen tank in dental offices?
Size E
How much oxygen is inside of dental office oxygen tanks?
how much time
30 minutes worth of oxygen
When would you use a non-rebreathing mask?
When a patient is unconscious suffering from an Asthma attack or Angina pectoris.
When do you use a Bag mask?
During respiratory arrest and the patient needs complete oxygen delivery.
What 7 medications are emergency kit essentials?
(DACA GONE) *D- Diphenhydramine A- Albuterol *C- Chlorypheneramine A- Aspirin
G- Glucogon O- Oral Carbohydrate N- Nitroglycerine E- Epinephrine ****( the ones with * are similar and you can have one or the other inside of the emergency kit you don't NEED to have both)****
What is Epinephrine used for and what is the dosage given to adults and children?
Use: Anaphylaxis and Severe Asthma Attack
Dosage:
-ADULT = 0.3mg of 1:1000 given intramuscularly and intralingually through injections.
-CHILD = 0.3mg of 1:2000
(Rapid onset Long duration)
When should you NOT use Epinephrine?
When a patient has Ischemic heart disease or severe Hypertension.
What does Epinephrine reduce?
- Hypotension
- Bronchospasm
- Laryngeal Edema
- Additional release of histamine and other chemical mediators.
When would you use Nitroglycerine and what does it do to the coronary blood vessels?
- Use it for patients with Angina Pectoris, MI, or CHF.
- This dilates the coronary blood vessels.
True/ False:
Nitroglycerine has a slow onset
FALSE
it has a rapid onset
What are 2 ways Nitroglycerine is administered?
Tablet and spray
True/ False:
The Nitroglycerine tablet is placed sublingually.
TRUE
How would you administer Nitoglycerine?
dose
Every 5 minutes up to 3 doses.
When should you NOT give a patient Nitroglycerine?
When systolic BP < 90mmHg
What is the shelf life for the Nitoglycerine spray?
About 2 years
What is the shelf life for the Nitroglycerine tablets after they have been exposed to light or air?
12 weeks
When would you use Diphenhydramine or Chlorpheneramine?
For patients with moderate allergic reaction with respiratory symptoms(mild non-life threatening allergic reactions).
True/ False:
Diphenhydramine/ Cholrpheneramine is an oral histamine.
FALSE
It is an oral histamine Blocker
What is the dosage given for oral Diphenhydramine/Chlorpheneramine?
(Adult)
Diphenhydramine = 25-50 mg Chlorpheneramine = 10 mg
What is the dosage given for an intramuscular histamine blocker (Diphenhydramine/ Chlorpheneramine)?
(Adult)
Diphenhydramine = 25-50 mg Chlorpheneramine = 10-20 mg
What is the histamine blocker dosage for a child (Diphenhydramine/ Chlorpheneramine)?
1mg/kg of body weight for both diphenhydramine or chlorpheneramine.
(Not to exceed adult dosage)
Which histamine blocker causes LESS drowsiness, Diphenhydramine or Chlorpheneramine?
Chlorpheneramine
What Albuterol used for?
Asthma attacks or Bronchospasm
How is Albuterol administered?
Inhaler
What does Albuterol do to the body?
Dilates the bronchioles with minimal cardiovascular effects.
Does Albuterol have a fast or slow onset?
Quick!
30-60 min.
True/ False:
Albuterol has a long duration of action of 4 to 6 hours.
TRUE
What is the adult and child dose of Albuterol?
Adult = 2 sprays Child = 1 spray
Can the dosage for Albuterol be repeated if necessary?
Yes
True/ False:
Aspirin reduces overall mortality from MI.
TRUE
What does Aspirin help prevent?
The progression of cardiac ischemia to cardiac injury or cardiac tissue death.
What is the recommended dose for Aspirin?
162-325 mg
OR
2-4 baby Aspirin
What is an Oral Carbohydrate used for?
For patients with Hypoglycemia
True/ False:
An Oral Carbohydrate is a drug.
FALSE
Do Oral Carbohydrate pastes or tablets require refrigeration?
(Yes or No)
NO
Would Glucagon be used on a conscious or unconscious patient?
UNconscious
What kind of patient would need Glucagon?
A hypoglycemic patient
True/ False:
The adult dose for Glucagon is 1 mg and the child dose is 0.5 mg.
TRUE
What are the vital signs for the average healthy adult?
pulse rate, respirations,temp, and BP
Pulse Rate = 60-80 beats per minute(BPM)
Respirations = 12-20 respirations per minute
Temp. = 98.6 F (+/- 1 degree)
BP = 120/80
What is Tachycardia?
Rapid Pulse Rate ( > 100 BPM)
What is Bradycardia?
Slow Pulse Rate ( < 60 BPM)
True/ False:
Bradycardia may cause lightheadedness, dizziness, chest pain, syncope, or circulatory collapse.
TRUE
What is Bradycardia treated with?
Atropine because it increases heart rate
What is the normal respiration rate for newborns?
40-50 respirations per minute
What is Tachypnea?
An abnormally fast rate of respirations ( > 20 )
True/ False:
Tachypnea is usually seen during Hyperventilation.
TRUE
What is Bradypnea?
Slow rate of respiration ( < 12 )
(Often seen in syncope)
What is Pyrexia?
Fever
What would you see in a patient with hypothermia?
signs/symptoms
- Shivering
- Cool skin
- Pallor
True/ False:
Distolic pressure is the force of blood against the blood vessel walls during ventricular contraction and the norm is between 110-120 mmHg.
FALSE
This statement is true for SYSTOLIC pressure Not Diastolic pressure