emergencies

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Author:
mexident82
ID:
83378
Filename:
emergencies
Updated:
2011-05-02 22:25:57
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emergencies
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emergencies
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  1. What do you do in case of a suspected emergency? (5)
    • 1. Stop tx
    • 2. Position pt
    • - usually - trendelenburg position (feet up, head down)
    • - chest pain/resp prob - semisupine
    • 3. start O2
    • 4. get vitals
    • - BP, Pulse, resp rate
    • 5. call for help
  2. Predisposing factors of syncopy (3)
    • 1. young adult males
    • 2. Psychogenic factors
    • 3. Nonpsychogenic factors
  3. Psychogenic factors of syncope (6)
    • 1. Fright
    • 2. anxiety
    • 3. emotional stress
    • 4. unwelcom news
    • 5. pain
    • 6. sight of blood
  4. Nonpsychogenic factors of syncope (5)
    • 1. sitting upright/standing
    • 2. hunger
    • 3. exhaustion
    • 4. poor physical condition
    • 5. heat and humidity
  5. How do you prevent syncope? (2)
    • 1. eliminate nonpsychogenic factors
    • 2. relieve anxiety
  6. Manifestations of presyncope (4)
    later...(4)
    • Now
    • 1. warmth
    • 2. pallor
    • 3. sweating
    • 4. nausea
    • Later
    • 1. deep breathing
    • 2. hypotension
    • 3. bradycardia
    • 4. pupillary dilation
  7. Manifestations of syncope (5)
    • 1. loss of consciousness
    • 2. irreg, shallow/absent breathing
    • 3. convulsive movements/twitching
    • 4. extreme hypotension and bradycardia
    • 5. weak thready pulse
  8. postsyncope (5)
    • 1. pallor
    • 2. nausea
    • 3. weakness
    • 4. sweating
    • 5. return of vital sign toward normal
    • 6. tendency to faint may persist for several hours.
  9. Pathophysiology of syncope (4)
    • 1. catecholamine secretion
    • 2. peripheral pooling of blood
    • 3. vagal activation
    • 4 cerebral ischemia
  10. how to manage syncope (6)
    • 1. stop procedure
    • 2. place in trendelenburg position
    • 3. admin O2 - establish airway
    • 4. ammonia ampule of complete loss of consiousness
    • 5. muscle movement
    • 6. check vitals
  11. Predisposing factors of Hyperventilation (2)
    • 1. predominantly young women
    • 2. anxiety
  12. prevention of hyperventilation (2)
    • 1. education
    • 2. control anxiety
  13. manifestations of hyperventilation (6)
    • 1. complaints of chest tightness
    • 2. obvious overbreathing
    • 3. dizzienss
    • 4. paresthesias
    • 5. muscle tetany
    • 6. loss of consiousness
  14. pathophysiology of hyperventilation (3)
    • 1. increased RR --> decreased CO2-->increased pH
    • 2. increased pH -->decreased Ca ions -->neuromuscular irritation
    • 3. increased catecholamines -->palpitation, sweating, chest pains
  15. Mgt of hyperventilation (5)
    • 1. anxiety reduction
    • 2. terminate procedure
    • 3. position upright
    • 4. rebreath exhaled air (paper bag/hands)
    • 5. educate
  16. common allergens (4)
    • 1. Penicillin - 5-10% - rsh to anaphylaxis (10% die)
    • 2. ASA - .2-.9% - rash-anaphylaxis
    • 3 LA - dermatitis-anaphylaxis
    • 4. latex
  17. how to prevent allergy (3)
    • 1. obtain accurate health hx
    • 2. allergy testing (for L/A)
    • 3. avoid allergens and allergy prone meds
  18. manifestations of allergy (5)
    • 1. immediate vs. delayed rxn occur
    • 2. range from mild skin rxn to severe urticaria
    • 3. asthma
    • 4. angioedema
    • 5. anaphylaxis (urticaria, angioedema, CV collapse)
  19. Mgt of allergic rxn (delayed skin rxn)
    antihistamine (benadryl 50mg Q 6h PO)
  20. Mgt of allergic rxn (immediate skin rxn) (2)
    • 1. Epi (.3-.5 mL 1:1000)
    • 2. antihistamine (benadryl 50 mg Q 6h PO or 25 mg IV/IM)
    • Observe for more than 1hr
  21. Mgt of respiratory allergic rxn (8)
    • 1. position semi upright
    • 2. assess vitals
    • 3. basic life support if necessary
    • 4. administer O2
    • 5. brochodilator (epi 0.3mL 1:1000)
    • 6. Observe
    • 7. Antihistamine
    • 8. medical consult
  22. Mgt of allergic laryngeal edema/anaphylaxis (8)
    • 1. Position pt
    • 2. basic life support
    • 3. epi .5mg SQ/IM/IV
    • 4. maintain airway
    • 5. summon assistance
    • 6. antihistamine
    • 7. steroids
    • 8. cricothyroidotomy
  23. Predisposing factors of Angina (7)
    • 1. CAD
    • 2. Male
    • 3. increased age
    • 4. Smoking
    • 5. HTn
    • 6. DM
    • 7. Hypercholesterolemia
  24. Prevention of angina (4)
    • 1. control risk factors
    • 2. stress reduction
    • 3. O2
    • 4. NG
  25. Manifestations of Stable angina (4)
    • 1. substernal chest pain or dull aching discomfort
    • 2. exercise or stress induced (identifiable cause)
    • 3. Relieved by rest or NG
    • 4. Consistent with prior chest pain over last 2 months
  26. Manifestationsof unstable (transitional) angina (4)
    • 1. may occur at rest
    • 2. no identifiable cause
    • 3. not relieved by rest or NG
    • 4. variable presentation
  27. Mgt of Angina (5)
    • 1. stop tx
    • 2. position upright
    • 3. sublingual NG (repeat 3x over 10 mins)
    • 4. give O2
    • 4 if not improved get help
  28. Predisposing factor of Acute MI (7)
    • 1. CAD
    • 2. Male
    • 3. increased age
    • 4. smoking
    • 5. HTN
    • 6. DM
    • 7 Hypercolesterolemia
  29. Prevention of Acute MI (4)
    • 1. control risk factors
    • 2. stress reduction
    • 3. O2
    • 4. NG
    • Post MI - avoid elective care for 6 mos
  30. Manifestations of AMI (7)
    • 1. sudden onset of severe pain
    • 2. crushing chest pain
    • 3. not relieved by rest or NG
    • 4. Sweating, weakness, restlesness
    • 5. sense of impending doom
    • 6. dyspnea
    • 7. abdominal bloating
  31. Mgt of AMI (8)
    • 1. Stop tx
    • 2. BLS
    • 3. chew one aspirin
    • 4. get help
    • 5. admin O2, monitor vitals
    • 6. relieve pain (morphine, N2O)
    • 7 manage complications (arrhythmias, HF)
    • 8. transport
  32. Predisposing factors of extrinsic asthma (2)
    • 1. exposure to allergens
    • 2. decrease with age (tend to become mild, disappear in adulthood)
  33. predisposing factors of intrinsic asthma (2)
    • 1. more common >35
    • 2. precipitated by:
    • - URI
    • - irritation inhalents
    • - smoke
    • - cold air
    • - exercise
    • - emotional stress
  34. predisposing factors of Status Asthmaticus (2)
    • 1. true medical emergency
    • 2. does not respond to usualy therapy
  35. prevention of asthmatic attacs (4)
    • 1. assure adequate med mgt
    • 2. relieve anxiety
    • 3. avoid allergens
    • 4. use inhaler prior to appt
  36. manifestations of asthma (6)
    • 1. wheezing
    • 2. SOB
    • 3. cough
    • 4. chest tightness
    • 5. anxiety
    • 6. orhtopnea
    • 7. cyanosis
  37. pathophys of asthma (4)
    • 1. bronchial hyperactivity --> bronchospasm
    • 2. bronchial edema and hypersecretion
    • 3. increased airway resistance-->hyperinflation
    • 4. Tachypnea -->fatigue, hypercardia, hypoxia
  38. Mgt of asthma (7)
    • 1. stop tx
    • 2. position upright
    • 3. use bronchodilator
    • 4. admin O2
    • 5. admin epi 1:1000 IM, .3 mL if needed
    • 6. give aminophylline, hydrocortisone
    • 7. get assistance
  39. Precipitation factors of Hypoglycemia (5)
    • 1. weight loss
    • 2. increased exercise
    • 3. recovery from infxn and fever
    • 4. omission/delay in meals
    • 5. insulin overdose
  40. manifestations of hypoglycemia (4)
    • 1. rapid onset
    • 2. decreased ventilation, may progress to rapid LOC, seizures
    • 3. hunger, nausea, increased GI
    • 4. sweating, tachycardia, anxiety
  41. Tx of conscious hyperglycemic pt (2)
    • 1. give Carbohydrates (OJ)
    • 2. assess vital signs and assure recovery
  42. Tx of unconscious pt (3)
    • 1. assess ABC's - provide BLS if needed
    • 2. parenteral carbohydrate (50 mL of 50%dextrose)
    • 3. summon assistance
  43. predisposing factors of seizures (7)
    • 1. hypoxia
    • 2. hypoglycemia
    • 3. hypocalcemia
    • 4. flickering lights
    • 5. fatigue
    • 6. poor health
    • 7. phsycial/ emotional stress
  44. prevention of seizures (4)
    • 1. avoid IV L/A injection
    • 2. Manage Hyoglycemia
    • 3. consider psychosedation/ manage anxiety
    • 4. be prep'd to prev injury
  45. Stages of seizures (3)
    • 1. Prodromal stage
    • - subtle changes in emotional reactivity
    • 2. Convulsive stage
    • - LOC, tonic contration, clonic movement 2-5 mins
    • 3. Postictal stage
    • - gradual return of consciousness, disorientation
  46. Status epilepticus (4)
    • 1. continuation of tonic-clonic seizures
    • 2. Hyperthermia
    • 3. Hypertension
    • 4. Hypoventilation
  47. Mgt of seizures (6)
    • 1. position supine
    • 2. prev injury (restrain w/o force)
    • 3. BLS (open airway, suction in vestibule, O2)
    • 4. Monitor vitals
    • 5. if continuous- valium 2mg/minute up to 10 mg
    • 6. summon assistance

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