Final Review Medical Emergencies PDF

CHAPTER 1 Morbidity is the state of having a disease or illness Mortality is DEATH Risk factors of older patients; which organ system should dental professionals pay attention to? The heart/cardiovascular, periodontal disease Cardiovascular disease is the leading cause of deat...

CHAPTER 1 Morbidity is the state of having a disease or illness Mortality is DEATH Risk factors of older patients; which organ system should dental professionals pay attention to? The heart/cardiovascular, periodontal disease Cardiovascular disease is the leading cause of death in older pt 65 years older CHP 2 To rule out a condition of a patient we should know their medical history and ASA HEMATURIA: presence of RBC in urine MYOCARDIAL INFARCTION: occurs when the flow of blood is reduced to the heart muscle METRONIDAZOLE: antibiotic for infection CYCLOSPORINE: organ rejection meds ASA 140/90 = ASA 1 -HEALTHY PT 140/159 & 90/94 = ASA II -MILD TO MODERATE RECHECK BEFORE APPT 160/199 ASA III -SEVERE 200/115 ASA 4 -DON'T PERFORM TREATMENT EXPECTED TO DIE CHAPTER 3 What is the proper flow for Basic Life Support? - PCABD In a dental office there are always team groups set up in case of an emergency: Please describe what each personal Duties are for Team Member #1-3 (you can list two examples of each). Your Answer: Team 1 stay with patient, provide BLS, call for help Team 2 bring AED kit and check weekly that kit is in order Team 3 acts as a circulating nurse, writing down all medication information and administering drugs if needed, most likely a dentist. STERILIZATION AREA is where the first aid kit being stored Oxygen/ nitrous tank is GREEN KISS - KEEP IT SIMPLE STUPID Intramuscular injections – VASTUS LATERALIS Anaphylaxis shock - EPINEPHRINE Vasodilator and expansion of lungs - ALBUTEROL Drug used during an emergency– EPI When viewing this equipment what is the name of this equipment; purpose for its usage? Magill Tube- Helps to maintain the airway open to be able to provide oxygen. List (2) examples of antidotal drugs opioid/Narcan benzodiazepine antagonist What is the use of Diazepam (valium) treats anxiety, seizures CONTRACT LAW- Contractual between dentist and pt CRIMINAL LAW – fraud, misuse of narcotics. TORT LAW- breaching of duty to the disadvantage of another BREACH OF DUTY- failure to act reasonable GOOD SAMARITAN LAW- helping someone, lifeguard, health professional and professional rescues. CHAPTER 5 You see this patient lying on the floor unconscious, what would be the first thing as a dental clinician you would do based on your understanding of patients and syncope. UNCONSCIOUS PT – supine position with feet elevated, airway, breathing and administering oxygen. CHAPTER 6  Factors for psychogenic to syncope – FRIGHT, ANXIETY, STRESS, SIGHT OF BLOOD Non psychogenic syncope – heat, position, exhaustion and hunger When is CAB activated? CARDIAC ARREST POST SYNCOPE - is recovery usually rapid may last up to 24hrs PRESYNCOPE – fear / or pain triggers release of epinephrine and norepinephrine CHAPTER 7-8 KNOW WHAT ADDISON DISEASE LOOK LIKE Sign of Addison disease – confusion, weakness, extreme fatigue, hypotension more female 30-35 years Adrenal cortex LOCATION: in the outer part of adrenal gland, top of kidney FUNCTION; produce hormones that help regulate your metabolism, immune system, blood pressure, response to stress and other essential functions. Signs of adrenal insufficiency – HYPOTENSION, ALTERED MENTAL STATUS, ANOREXIA, VOMITING, WEIGHT LOSS, FATIGUE, AND RECURRENT ABDOMINAL PAIN KNOW HOW TO MANAGE WITH ADRENAL INSUFFICIENCY CONSCIOUS ​ Stop dental treatment. ​ Position A > B > C assessment Monitor vital signs Summon medical assistance Emergency kit & oxygen UNCONSCIOUS. Stop dental treatment Position BLS Emergency kit & oxygen Summon medical assistance Evaluate medical history CHAPTER 9 DEFINE PALLOR – loss of skin pigmentation associated with clammy skin Tonic- clonic movement can occur with movements during vasodepressor syncope CHAPTER 10 HYPOXIA -is defined to lead to low levels of 02 in the body DYSPNEA - shortness of breath APNEA – Absence of respiratory movement INSTRUMENT TO USE TO STOP FOREIGN OBJECTS FROM AIRWAY- Magill Intubation forceps CHAPTER 12 How to manage pt that hyperventilates? Prioritize communication, listen to their concern and assure them you will be there the whole time. 5’AS CHAPTER 13 Asthma and what is being affected – obstruction of the airway Intrinsic Asthma- affects what age group of people- older adults 35 years Extrinsic = children and younger adult STATUS EPILEPTICUS is considered the most severe form of asthma GOAL OF PHYSICIAN WHEN DEALING WITH ASTHMA PT – to improve pt breathing and find out how severe an asthma attack is and to see whether the treatment is working. Signs of asthma – wheezing, difficulty speaking, fast heart rate, cough and chest pain. What is bronchospasm: when the muscle narrow and tighten Hypercarbia – poor air exchange, high level of carbon dioxide in blood Signs and symptoms - Fatigue, headache, flushed skin, shortness of breath, nausea, irritability SEVERE - Confusion, depression or paranoia, anxiety, nausea and vomiting, seizure, fainting CHAPTER 14 2-3 % OF AMERICAN HAVE HEART FAILURE Leading causes of left ventricle failure – chest pain, whole body weakness, fatigue, shortness of breath and excess urine. Leading cause of right ventricle failure – cause of left ventricular failure, low oxygen, weakness, fatigue, cyanosis, coolness of extremities. ASA FOR HEART FAILURE; ASA I normal healthy patient ASA 2 can walk one flight of stairs or walk two city blocks without distress but must stop once completed task bc of distress. pt with heart failure most likely experiences shortness of breath or undue fatigue ASA 3 pt can climb one flight of stairs or walk two city blocks but must stop and rest before complete task ASA 4 PT cannot negotiate a flight of stairs or walk two level city blocks because of shortness of breath or fatigue. ACute pulmonary Edema – fluid leaves the capillaries and infiltrates the alveolar sacs of the lungs. Reason- STRESSFUL SITUATION, too much salty meals CHAPTER 15 Chest pain hyperventilation- feeling of weight or pressure, shooting or stabbing sensation Respiratory distress – occurs when the body needs more oxygen than its receiving, leading to difficulty breathing or low oxygen in the blood What does cyanosis look like? CHAPTER 16 ALTERED CONSCIOUSNESS- temporary change in a person awareness Causes; drug overdose, hyperthyroidism, hypothyroid DELIRIUM- change of mental state, confusion, disorientation, difficulty talking and remembering. How to manage altered unconsciousness - Ensuring basic life support (ABC’S) CHAPTER 17 DM what system being affected – endocrine system Type 1 / II -TO DO PPD TB TEST – a small amount of tuberculin is injected into the arm and checked 24-72 hrs later. BUT TO CONFIRM THE TEST WE CAN TAKE CHEST X-RAY.  HYPERGLYCEMIA – the body increased demand for insulin (usually a much longer process 48 hrs) HYPOGLYCEMIA – Decreasing body demand for insulin – occurs in mins with rapid loss of consciousness HEMOGLOBIN A1C KNOW ASA FOR DM - CHAPTER 18 HYPOTHYROIDISM – loss of consciousness, it may take a relatively mild form, inadequate supply of thyroid hormones, not eating for hours HYPERTHYROIDISM / EXOPHTHALMOS – related to high blood sugar, Wendy Williams bulging eyelids, thyroid disease such as graves' disease. Chapter 19 TIA- transient ischemic attack AKA incipient stroke WHAT IS CVA – Cerebrovascular accident – 3rd leading cause of death. Leading causing in adult disability EMBOLIC STROKE – may cause transient interference with blood flow CHAPTER 22 TYPES OF SEIZURE Tonic-clonic or grand mal seizures – MOST DANGEROUS Prodromal phase Several minutes to hours before seizure, changes in emotional reactivity NOT noticed by dental staff Noticed by friends and family Should not sit for dental treatment Prepare for a seizure to occur An aura signals start of seizure Most have same aura each time Lasts a few seconds Management of seizure Drugs use; DIAZEPAM (VALIUM) CHAPTER 23 PREVENTION FOR PATIENT THAT HAVE OVERDOSE – lidocaine administered via IV doses of 1.0 to 1.5 mg/kg Pg 351- 352 Chapter 24 Allergy- Hypersensitive state acquired through exposure to a particular allergen. Penicillin – leading cause of fatal anaphylaxis PEANUTS AND LATEX is the leading cause of death from allergy MADGE confirms allergy to anesthetics, use diphenhydramine (histamine blocker) if allergic to anesthetics. Chapter 25 table 25: 1 Chapter 26 KNOW PG 421- 429 CHEST PAIN CHAPTER 27 ANGINA – chest pain caused by reduced blood flow to heart Stable angina – chest pain with activity or emotional stress Variant angina - chest pain from spasm in coronary arteries METOPROLOL - treat high blood pressure Carvedilol - used for hypertension, also heart failure. Amlodipine – treat high blood pressure in adults and children 6 years or older Chapter 28 Myocardial infarction - lack of blood flow to the heart Location where this usually affects – the heart muscle.