RAD-128 CH.9 MEDICAL EMERGENCIES
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. What would you like to do?
what is a life threatning emergencies
list the possible emergencies
- a sudden change in the patients condition that requires immediate attention
- Anaphylaxis (a type of shock)
- Pulmonary embolus
- Reactions related to diabetes mellitus
- Cerebral vascular accident (CVA)
- Cardiac and respiratory failure
what are emergency carts and what is there alternative name
- crash carts
- and they are rolling, multi-drawer cabinets that are kept in strategic locations throughout the hospital.A cart that contains medications and equipment that are needed when a patient’s condition suddenly becomes critical.
what the areas observed in the glasgow coma scale
what are the max points for patient assessment
eyes opening, motor response and verbal responseA patient can be rated a maximum of 15 points for neurological functioning.
If the patients score begins to drop after your initial assessment, notify the physician in charge immediately.
what is the first level of consciousness
Ask the patient to state his name or her name, date, address, and the reason for coming to the radiology department.
If the patient gives you the responses readily and correctly, you learn that the patient responds to verbal stimuli and is oriented.
what is the second LOC
. As you instruct the patient in positioning, note his or her ability to follow directions. Also note any movement that causes pain or other difficultly in movement, as well as any alteration in behavior or lack of response.
These measures provide a baseline against which changes in the patient’s mental and neurological status can be assessed.
what is third LOC
Assess the patient’s vital signs at this time if current readings are not on the chart. You must have baseline reading against which to note changes if they occur.
An increasing systolic BP, or slowing of the pulse could indicate increasing intracranial pressure. As compression of the brain increases vitals signs change.
what is shock
- Body’s pathological reaction to illness, trauma, or severe physiologic or emotional stress. May be caused by body fluid loss, cardiac failure, decreased tone of the blood vessels, or obstruction of blood flow to the vital body organs.
- A life-threatening condition that may occur rapidly and without warning.
- Shock continuum is the progression from onset that may not be detectable to dangerous stage from lack of oxygen.
what are the signs of shock
- Restlessness and a sense of apprehension.
- Increased pulse rate.
- Pallor accompanied by weakness or a change in thinking ability.
- Cool, clammy skin (except for septic or neurogenic shock).
- A fall in blood pressure of 30 MM below the baseline systolic pressure.
what is the onset portion of the shock continuum
- Changes at cellular level
- Blood gets shunted away from vital organs to accommodate the brain & heart need for oxygen
symptoms begin to be noticeable
what happens in the compensatory stage of shock 6 things
- Skin is cold and clammy.
- 2. Urine output decreases.
- 3. Respirations increase.
- 4. Bowel sounds are hypoactive.
- 5. Blood pressure is normal.
- 6. Anxiety level increases; patient may begin to be uncooperative.
list the 7 things that happen in the progressive stage of shock
- BP falls
- Respirations are rapid and shallow
- Severe pulmonary edema (acute respiration distress or shock lung)
- Tachycardia as rapid as 150 bpm.
- Chest pain
- Mental status changes.
- Renal, hepatic, GI and hematological changes occur
what stage of shock happens when we pass the progressive stage
list the qualities of the stage
- irreversible stage
- BP remains low
- Renal and live failure
- Release of necrotic toxins and lactic acidosis
what his hypovolemic shock cardiogenic distributive and obstructive shock
- Hypovolemic - due to loss of blood or tissue fluid
- Cardiogenic - due to cardiac disorders (MI) cardiac failure
- Distributive - (Vasogenic) due to the blood vessels’ inability to constrict and assist in the return of blood to the heart
- 3 types
- Obstructive - due to pathological conditions that interfere with the normal pumping action of the heart
when does hypovolemic shock occur
a large amount of blood has been lost due to a bleed (treated with fluids).
-loss of plasma from burns.
-loss of fluids from prolonged vomiting, diarrhea or medications.
what are the three types of distributive shock
- Loss of sympathetic tone causing vasodilation of peripheral vessels
- Least likely seen in the department; caused by a gram-negative bacteria ( ex.TSS)occurs from a massive infection that produces toxins, causing the blood pressure to drop rapidly (treated by antibiotic therapy).
- More commonly seen in the department due to iodinated contrast media. Result of hypersensitivity reaction to an exposure to an antigen that was previously encountered by the body’s immune system (allergic)
what are the medicines for anaphylactic shock
what is a pulmonary embolous
Occlusion of one or more pulmonary arteries by an embolus
what is diabetes mellitus
what is it caused by and the results of it
- - a group of metabolic diseases resulting from a chronic disorder of carbohydrate metabolism.
- It is caused by:
- Insufficient production of insulin
- Inadequate utilization of insulin
- The result
- An abnormal amount of glucose in the blood (hyperglycemia)
what are the three major types of diabetes
type 1 and 2 and gestational diabetes
what happens in all the three types of diabetes
- type 1- Pancreas stops producing insulin or Cells stop responding to insulin
- Usually under the age of 30
- Abrupt onset
- Insulin by injection
- Autoimmune disorder
- This leads to a series of metabolic complication including ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome.
- type 2 - Impaired sensitivity to insulin or decreased production of insulinMost common form
- Patient’s usually older than 40
- Gradual onset
- Can be controlled by weight loss, diet, and exercise, but must be controlled
- gestational - Occurs in the later months of pregnancy
- Controlled by diet, but insulin may be given
- May develop diabetes later in life
what is hypoglycemia
what is diabetic ketoacidosis
- too much insulin in body tissue
- not enough insuling in body tissue
what causes a stroke
what are they called
- Caused by occlusion of the blood supply to the brain, rupture of the blood supply, rupture of a cerebral artery resulting in hemorrhage directly into the brain tissues or into the spaces surrounding the brain.
- Strokes are as critical as a heart attack.
- Called “brain attacks” or TIA
how long can the human brain survive without oxygen
what are the signs of cardiac arrest
- When the heart fails to beat effectively, the blood cannot circulate through the body, and the person no longer has an effective pulse.
- Loss of consciousness, pulse and BP
- Dilation of pupils
- Possibility of seizures
what are the signs of respiratory distress
- Labored, noisy breathing
- Neck vein distention
- Cyanosis of lips and nail beds
what is the CAB of CPR
- Compressions – 30 - 2” compressions
- Open the airway by head-tilt, chin lift
- Give two breaths through the use of a disposable mask with at one way valve
how do we dislodge an airway obstruction caused by a foreign object in the main bronchi
- Abdominal thrust: standing or sitting behind, push straight back toward the spine below the diaphragm
- Chest thrust: sit astride patient’s thighs and push in and upward on the diaphragm
what is a seizure
- An unsystematic discharge of neurons of the cerebrum that results in an abrupt alteration in the brain function.
- Seizures are a syndrome or symptom of a disease, not a disease in themselves.
what are the two types of seizures
what is syncope and what is known as
- known as fainting
- it a is a loss of consciousness which usually results from an insufficient blood supply to the brain
what is orthostatic hypotension
Abnormally low blood pressure occurring when a person stands up before the blood in the extremities has time to circulate to the upper body.
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