Week Two: Medical Emergencies cont Flashcards
What other types of medical emergencies can there be in a dental setting?
- Neurological Emergencies: Seizures, Stroke
- Endocrine Emergencies
- Hypersensitivity reactions
What are the signs and symptoms of a stroke?
- Weakness or numbness
- Difficulty of movement of one side of the body
- paralysis of the face, arm or leg on one or both sides of the body
- Difficulty or slurred speaking or understanding
- Dizziness, loss of balance
- Loss of vision or sudden blurred vision in one or both eyes
- Severe headache and difficulty swallowing
- Transient or total loss of consciousness
What is the pneumonic to help remember stroke?
FAST
F: Face look uneven
A: Arm hanging down
S: Speech slurred
T: Time, Call 000 now!
How do you manage a stroke?
- Cease dental treatment
- Call 000 and for red bag
- Give oxygen
- Maintain airway
- Monitor patients vital signs and perform basic life support until assistance arrives.
How do you manage a seizure?
- Cease dental treatment
- Call 000 and for red bag
- Give oxygen
- Maintain airway
- Monitor patients vital signs and perform basic life support until assistance arrives.
A seizure can have a number of underlying conditions, including but not limited to:
Epilepsy, Syncope, Stroke, Hypoglycaemia, Stroke, Cerebral Hypoxia, Fever
What are the signs and symptoms of seizures?
- It can be generalised or partial
There can be a: - Aura
- Sudden spasm of muscle (producing rigidity so patient falls/ can’t maintain posture)
- jerky movement of head arms and legs
- loss of consciousness (which may be associated with noisy breathing, salivation, urinary incontinence)
What is status epilepticus?
Recurrent seizures without recovery of consciousness between attacks - call 000 immediately and keep patient safe from harm.
How do you manage a seizure?
- Cease dental treatment
- Protect patient from harm/injury
- Avoid restraining patient
- Wait until obvious fitting has subsided
- Check conscious state by engaging patient in conversation
- Maintain airway and check patient is breathing, remove anything from oral cavity (vomit etc…)
- If the patient recovers, keep them under observation at least 30 minutes, do not allow them to drive home
- If seizures last for more than few minutes, call 000, maintain airway and monitor patient until assistance arrives.
Hypoglycaemia?
- Can occur at any time
- Factors that increase an individuals risk:
- Inappropriate high doses of insulin
- Forgotten or delayed meals
- Insufficient carbohydrate
- Excessive alcohol intake
- Unaccustomed exercise
You can obtain all this information through medical history, ask patient how they are feeling, schedule appointments that are suitable for the patient.
What are signs and symptoms of hypoglycaemia?
- Adrenergic: Pale skin, sweating, shaking, palpitations and feeling of anxiety
- Neuroglycopenic: hunger, suboptimal intellectual function, confusion and inappropriate behaviours, coma and seizures.
- Conscious diabetic patient may alert you to these feelings.
How do you manage hypoglycaemia?
- Cease dental treatment
Give 20-25g glucose ‘glucodin’ to adult or if not available fast acting glucose drink i.e. lemonade, jelly, beans, honey - this needs to be followed by a lower glycaemic load carbohydrate meal (sandwich or dry fruit) - Normal diabetic therapy/management should be maintained
- Monitor until patient has recovered, arrange for someone to accompany them home, advise to seek medical advice from GP
How to manage hypoglycaemia for an unconscious patient?
- Cease dental treatment
- Call 000
- Manage as per syncope
What is a hypersensitivity reaction?
- Allergy
- Exaggerated response of the patients immune system to an allergen
- prevention is paramount.
Latex allergy, local anaesthetic reaction = example
Signs and Symptoms of Hypersensitivity
- Skin: itching, flushing, angioedema (swelling), urticaria (hives)
- GIT: cramps, nausea, vomiting, incontinence
- Respiratory: Tightness, pain in chest, wheeze, shortness of breathing, respiratory distress, cyanosis, constriction of airways from swelling
- CVS: Pallor, light headedness, palpitations, increased heart rate, decreased BP, Arrhythmias, Los conscience, cardiac arrest
What is Uticaria?
- Characterised by transient erythematous or oedematous swelling of the dermis or subcutaneous tissue
- lesions persists for few minutes to 24hrs
- superficial swelling tend to be itchy while deeper swelling may be painful
