Medical emergencies PDF

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Medical emergencies...

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Medical emergencies CHAPTER 31

Prevent the emergency from happening What some most important things we can do to prepare -

Current medical history Practice safety  No ligature on dental clamp (EX) Recognize things that during treatment can be stressful for patient  Look is the patient is stressed

Medical emergency: condition or circumstance require immediate action before or during a lifethreatening situation. Things we can to do prepare 1. 2. 3. 4. 5. 6. 7.

Take a CPR class BLS- Basic life support Staff is familiar with equipment Manual for protocols & Training Staff must recognize signs and symptoms of medical emergencies Each member has a role in the office Emergency numbers listed at each phone

What to have in a medical emergency bag 1. Epinephrine (Epi Pen) – Allergic reaction 1-50,000 highest dose in local anesthetic 1-1,000 is more concentrated and would be in a med bag Allergic reaction 2. Bendadryl—allergic reaction Taken orally and on hand because epinephrine will be over kill Itching and take care of it Allergic reaction 3. Apsprin—heart event Good for heart Heart issues can give an asprine  blood thinner

4. Nitroglycerin—heart event Given under the tongue For angina Anxiety Heart burn Chest pain like GURD 5. Inhaler 6. Bronco dialator Have patient self-medicate 7. Insulin Accurate recording device to test levels Patient can survive in low insulin but not on low glucose 8. Glucose tabs Sugar source Frosting or orange juice 9. Aeromantic acronym Fabric incased glass capsules and break it for patient to smell Incase patient passes out 10. AED Documenting an Emergency Include the patient’s record: Vital signs Emergency contacts Treatment provided Signs and symptoms Drugs used If yes what time? What was given? How was it given? Patient’s current condition Date of emergency and SIGN Recognizing signs and symptoms Symptoms: Something that patient tells you he/she is feeling or experiencing Sign: Something that you observe in the patient

Most dentist if systolic is below 150 the patient will be treated if the diastolic is normal But will not use epinephrine Has a vasoconstrictor—constricting the blood vessels

Medical Emergencies A. Syncopy – Fainting -

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Etiology ( cause) Physical – pregnant Physiological –scared EX big guy sees a little needle Can faint is if blood sugar is low Signs and symptoms Patient feels warm/ flushed Nausea Increase heart rate Pallor—turning pale Decreased blood pressure. Treatment Place patient in supine position and feet higher than the head Call for assistant Loosen clothes and anything tight Inhalant aid Monitor vital signs B. Postural Hypotension—low blood pressure

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Etiology(cause) Lack of sufficient blood flow to the brain following change in position Common in pregnancy/old people Caused by sudden position change Common after N2O – flush with oxygen after being on N2O Sign and symptoms Low blood pressure Altered/loss of consciousness

Treatment Place patient in supine position with feet higher (Trendeldonburg position ) Establish airway Slowly return patient to upright position Call for assistant if not responding well Monitor vital signs Larger people lay on their side Pregnant people lay on left side--- Has as artery on right side for baby

C. Hyperventilation— -

Etiology Stress and anxiety Remain conscious

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Signs and symptoms Remains conscious Rapid shallow breathing Tight chest Rapid heart beat Panic-stricken appearance Lump in throat Treatment Place patient in a comfortable position Use calm voice Have patient put their hands over their mouth and breathe slowly Control breathing helps get Co2 back in the blood D. Airway obstruction— Etiology Accidental aspiration May be a total/partial block of airway

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Signs and symptoms Grasp of throat Ineffective cough High pitched breathing sound Repertory difficulty Change in skin color – pale to blue

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Treatment Heimlich maneuver if total blockage Let patient try to clear if partial Monitor vital signs

Allergic Reactions Molecule that our bodies recognize that’s foreign A person doesn’t have a allergic reaction they are exposed to an allergen Molecule that causes the immune response Histamine that the body releases to fight a immune response to a foreign substance

Different types A. Skin reaction - Contact dermatitis Dermatitis – inflammation and contact of skin where the contact has touched Signs and symptoms Itching & vesical formation Treatment Remove contact Corticosteroids – med used -

Urticaria Hives Hive can be allergic or stress response Itching and blotches Signs and symptoms Redness and swelling Treatment Remove the problem Hives are psychological stress related

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Angioedema Swelling Signs and symptoms Localized swelling of mucosa Usually a single lesion No pain or itching Treatment Remove cause and take a antihistamine

B. Respiratory reactions Farmer’s lung Immune response to particles inhaled and left in the lungs Asthma Signs and symptoms Coughing wheezing Increased anxiety Pallor- pale color Cyanosis – blue in color Increased pulse rate Treatment Call for assistant

** Ask patient when going over medical history if they brought their inhaler with them and then ask where its at.*** Position comfortably Have patient self medicate if he/she has inhaler Administer O2 as needed Call EMS

C. Anaphylactic shock Life threatening Signs and symptoms Feel ill Nausea Shortness of breath Heart arrhythmia Sudden Blood pressure drop Loss of consciousness Swelling of tissues – swelling of bronchial tubes (can’t breath) Rapid onset Treatment Call 911 Place patient in supine position or sit them up Start Basic life support Administer oxygen Monitor vital signs

*** Hyperventilation is the ONLY treatment you can’t use oxygen on***

Seizures Types 1. Grand Mal Most common type 3 stages Prodromal before the seizure (dogs can sense this) Convulsive active seizure Postictal  after the seizure has happened 2. Petit Mal “Absent seizures” Blank stare, twitch and rapid blinking Patient often unaware of seizure

Most often in kids 3. Partial seizure Involves one hemisphere of brain Movements in only one part of body May appear in trace-like state 4. Status Elipticus Most dangerous Causes death in 10% of case Can be multiple or one long seizure Body cannot handle the condition Patient can die from exhaustion Causes Possible brain damage from car accident or fall Injury during birth Severe infection High fever Unknown in majority of cases

Treatment Summon emergency help Remove dental objection from patient’s mouth Move patient to the floor Do not restrain patient- this is for your and there safety Let patient recover Give reassurance and he/she comfortable DO NOT give food or drink

Diabetes Mellitus -

Disease of metabolism that occurs as a result of either deficiency or complete lack of insulin in the body Glucose is the fuel for the body that is manufactured from food we eat insulin is needed or glucose to be able to enter the cell and provide it with fuel We need insulin in order for glucose to enter our cells

2 types 1. Type I Juvenile diabetes Insulin dependent—has to check glucose level on regular basis and daily injections of insulin. Only 10% of cases are type 1 2. Type 2 Adult onset diabetes Most cases are in middle aged obese individuals Insulin can controlled by diet Etiology Most causes re not definitely known Hereditary Pregnancy  She is more at risk for type 2 later in life if she had type 1 during pregnancy Signs and symptoms Increased thirst and urination Loss in appetite Nausea and vomiting Tired Abdominal pains Body aches Treatment Conscious patient Self-medicate Administer sugar source Did you check insulin and glucose? Did you eat? Hypoglycemia ( insulin shock ) Unconscious patient Inject of glucose Administer sugar source when they come too...