Vasovagal syncope

Question 1

what would you observe with the patients airway?

Answer 1

patent

Question 2

what would you observe with the patients breathing?

Answer 2

high RR (>25)
decreased sp02 (<96%)
shallow breathing

Question 3

what would you observe with the patients circulation?

Answer 3

low HR (<60bpm)
hypotension ( 90/60)
pallor

Question 4

what would you observe with ACVPU?

Answer 4

alert but anxious
blood glucose may be low

Question 5

what would you observe with exposure?

Answer 5

distressed
flustered
brief LOC

Question 6

why is does a patient with vasovasal syncope have a low HR?

Answer 6

vasovagal reflex

Question 7

why may patient have low blood glucose levels?

Answer 7

lack of food

Question 8

how do you manage the pt before LOC?

Answer 8

reassurance
dextrose tablets/ glucose to increase blood glucose
open window for fresh air
supine position

Question 9

what would you do to address hypotension?

Answer 9

put pt in supine position

Question 10

what should blood glucose levels be?

Answer 10

above 4mmol/l

Question 11

what forms of glucose can you give your pt when they are conscious and able to swallow?

Answer 11

10-20g glucose - orange juice, non-diet fizzy drinks, 4 x glucose tablets or gel

Question 12

what forms of glucose can you give your pt when they are unconscious?

Answer 12

buccal glucose gel and/or glucagon 1mg IM

Question 13

what is the glucagon dose for kids <8 years/ <25kg?

Answer 13

0.5mg

Question 14

how would you manage your pt if LOC?

Answer 14

check airway is open
assess breathing
loosen tight clothes

02 15l/min until regain consciousness through the non re-breather mask
titrate down to 6/min

recovery position if necessary to maintain patent airway

plenty of reassurance on awakening

Question 15

how much 02 would you deliver if patient looses consciousness?

Answer 15

02 15l/min through non re-breather mask

titrate down to 6 litres/min once conscious