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77 Cards in this Set
- Front
- Back
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What is the most often reported medical emergency?
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Unconsciousness
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Unconsciousness can be caused by many reasons. Name 3 reasons for loss for loss of consciousness?
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Vasodeppressor syncope
Orthostatic hypotension Hypoglycemic reaction |
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What are 2 other terms for syncope?
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Fainting
Vasovagal syndrome |
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What causes loss of consciouness?
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Decrease in the blood flow to the brain
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Patients faint during which phases of treatment?
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All
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What 2 groups can predisposing factors be divided into?
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Psychogenic factors
and Non Psychogenic factors |
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Name the 4 Psychogenic factors for loss of consciousness.
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Fear
Pain Emotional upset Anxiety |
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Name the 6 Nonpsychogenic factors for loss of consciousness.
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Hunger: decreases glucose levels
Exhaustion Poor Physical condition Hot, humid, crowded environment Patient positioning Age: more common in young adults age 16-35 |
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Syncope can also be defined as?
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sudden transient loss of consciousness.
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What are 4 ways to prevent syncope?
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Stop dental treatment
Place patient in the supine position Alleviate fear Remove or alleviate what ever caused the patient distress. |
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Signs and Symptoms of presyncope.
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Patient is pale
Cold perspiration Complaint of being hot, dizzy or nauseated Decreased blood pressure Very rapid pulse |
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Signs and symptoms of syncope.
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Death like apperance
Shallow, gasping breathing Dilated pupils Convulsive moments (possible) |
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Treatment
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Stop dental treatment
Remain calm Supine position Maintain open airway Use ammonia capsule Furnish O2 Monitor vital signs Make patient comfortable Record all info in chart |
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5 steps for management of syncope.
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Step1: Assesment of consciousness
Step 2: Activate DOE system Step 3: Position the patient Step 4: ABC If needed Step 5: Definitive care a) O2 b) Monitor vitals c) Other: Loosen binding clothing use of stimulant |
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What do you do for an unresponsive patient?
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Administer O2
Monitor vitals Definitive care |
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How long should it take for the patient to recover completely?
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15-20 Minutes
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What do you do if complete recovery has not occurred in 15 to 20 minutes?
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EMS should be activated
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What should happen during the resolution period?
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Patient may exhibit confusion
Reassure patient Determine if patient needs transport Document episode in chart |
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How long should the patient wait before undergoing additional treatment?
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24 hours
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Why does the patient need to wait 24 hours before undergoing additional treatment?
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It takes 24 hours for the body to return to its normal state.
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Why do we need to arrange for the patient fo be escorted home?
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Patient could be in danger of having recurring syncopal episodes.
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What is the 2nd leading cause of transient loss of consciousness (syncope).
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Orthostatic Hypotension
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What is orthostatic hypotension or postural hypotension?
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It is a failure of the baroreceptor-reflex-mediated increase in peripheral vascular resistance in responce to pasitional changes.
drop in systolic pressure by 20mmHg / on standing |
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What might a patient who exhibits postural hypotension act like?
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The patient may lose consciousness rapidly, or may merely become lightheaded or develop blurred vision.
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What is a trigger of postural hypotension?
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Standing up!
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What are 6 predisposing factors to postural/orthostatic hypotension?
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Administration and ingestion of drugs.
Prolonged recumbency /convalescence Inadequate postural reflex Pregnancy Advanced age Defects in legs (varicose veins) |
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What are some methods of prevention for postural/orthostatic hypotension?
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Medical history
Physical examination Alteration in dental treatment |
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What are the signs and symptoms of postural/orthostatic hypotension?
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Symptomatology develops on standing
Standing pulse goes up by 30bpm Standing systolic pressure drops at least 25mmHg Standing diastolic pressure drops at least 10 mmHg |
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What are the 7 steps in management of postural/orthostatic hypotension?
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Assess level of consciousness
Activate office emergency team Position patient w feet elivated Assess open airway Assess circulation Administer O2 Monitor vital signs |
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What should occur during the resolution phase of postural/orthostatic hypotension?
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Caution patient about rising too quickly
Return patient to sitting pos., slowly Patient remain at each level until all dizziness has passed. |
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What should you do if there is a delayed recovery from an postural/orthostatic hypotensive episode?
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Summon medical assistance!
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What is an altered state of consciousness do to low blood sugar called?
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Hypoglycemia
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What are some traits of type 1 diabetes?
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Seen often in young people
5-10% of all diabetics are type 1 Associated w additional health problms Usually requires daily insulin injections |
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What is type 1 diabetes commonly known as?
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Juvenile diabetes
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What are some traits of type 2 diabetes?
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Seen most often in obese adults
Usually controlled with diet and/or hypoglycemics 90-95% of diabetics are Type 2 |
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What is type 2 diabetes also known as?
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Adult-onset diabetes
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What is the role of the RDH with a diabetic patient?
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RDH n key position to assistpatient
Prevention thru questioning. Monitor b sugar readings that day Hypo<50-100norm<Hyperglycemic Did patient eat? Evidence of poor healing? Frequent thirst/urination? Education in oral manifestations |
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We are seeing children as young as ___ with type 2 diabetes.
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8
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What is considered old terminology for a hypoglycemic reaction?
ex: patient did not eat |
Insulin shock
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What is a hypoglycemic reaction?
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A result of too little glucose in the body.
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What are some predisposing factors for hypoglycemia?
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Genetic disorder
Primary destruction of the islets of langerhans n pancreas, caused by inflammation, cancer, or surgery. Endocrine condition such as hyperpituitarism Administration of steroids, resulting in diabetes (iatrogenic) |
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A rapid onset of hypoglycemia can be caused by?
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Skipped meals:
(insulin too high/ glucose too low) Exercise:Too much burns up sugar resources in the body. Change in routine: schedules, emotional stress, ect. |
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What are some signs and symptoms of hypoglycemia?
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Weakness, dizziness
Pale, moist skin Normal or depresses respirations Headache Altered level of consciousness Personality change, confusion |
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What are some prevention methods you can apply as there RDH?
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Adequate preliminary evaluation
Physical examination Alteration in dental treatment appt later n day after they eat. |
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What are some things you can do to manage a patient having a hypoglycemic episode?
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Terminate dental treatment
Position patient comfortably Basic life support, as indicated Administer oral carbohydrates |
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What are some predisposing factors for hypoglycemia?
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Genetic disorder
Primary destruction of the islets of langerhans n pancreas, caused by inflammation, cancer, or surgery. Endocrine condition such as hyperpituitarism Administration of steroids, resulting in diabetes (iatrogenic) |
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A rapid onset of hypoglycemia can be caused by?
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Skipped meals:
(insulin too high/ glucose too low) Exercise:Too much burns up sugar resources in the body. Change in routine: schedules, emotional stress, ect. |
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What are some signs and symptoms of hypoglycemia?
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Weakness, dizziness
Pale, moist skin Normal or depresses respirations Headache Altered level of consciousness Personality change, confusion |
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What are some prevention methods you can apply as there RDH?
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Adequate preliminary evaluation
Physical examination Alteration in dental treatment appt later n day after they eat. |
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What are some things you can do to manage a patient having a hypoglycemic episode?
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Terminate dental treatment
Position patient comfortably Basic life support, as indicated Administer oral carbohydrates |
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What are the emergency treatment procedures for a conscious patient undergoing a Hypoglycemic episode?
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Terminate dental procedure
Position patient ABC assess & perform BLS as needed Definitive care: administer sugar source |
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What are the emergency treatment procedures for an unconscious patient undergoing a Hypoglycemic episode?
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Terminate dental procedure
Place patient n supine w legs elevated ABC assess & perform BLS as needed Definitive care: Summon EMS Give carbs- 1mg glucagon Allow patient to recover Discharge per medical recommendations |
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What should occur during the resolution phase of a patient undergoing a Hypoglycemic episode?
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Administer oral sugar:
(cubes, juice, candy or frosting) Observe patient for 1 hour before dismissal Determine time since previous meal Set next appt after mealtime |
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What are the steps to follow for treatment of unresponsiveness with a patient undergoing a Hypoglycemic episode?
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Basic life support
Position: Supine Maintain airway Administer O2 by bag valve Monitor vital signs |
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What should be done if unconsciousness continues with a patient undergoing a Hypoglycemic episode?
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Summon EMS
Administer intramuscular glucagon or intravenous glucose. |
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comp?
List 3 presyncope symptoms. |
Complaint of being; hot, dizzy or
nauseated. Decreased blood pressure Very rapid pulse |
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comp?
List 2 visible signs of presyncope. |
Patient is pale
Cold perspiration |
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List 3 of the signs of syncope.
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Deathlike apperance
Shallow, gasped breathing Dilated pupils Convulsive movements possible |
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List 2 treatments for syncopes.
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Place patient in supine poaition.
Maintain open airway |
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What is the procedure for maintaining an open airway?
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Head tilt chin lift.
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comp?
List 3 presyncope symptoms. |
Complaint of being; hot, dizzy or
nauseated. Decreased blood pressure Very rapid pulse |
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comp?
List 2 visible signs of presyncope. |
Patient is pale
Cold perspiration |
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comp?
List 3 of the signs of syncope. |
Deathlike appereance
Shallow, gasped breathing Dilated pupils Convulsive movements possible |
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comp?
List 4 steps in treatment of syncope. |
Place patient in supine position.
Maintain open airway Use ammonia capsule (stimulate) Provide O2 (bag-mask-valve) |
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comp?
What is the procedure for maintaining an open airway? |
Head tilt chin lift.
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comp?
When a patient is under treatment for syncope what are the correct vitals to monitor and the correct values? |
Pulse: ped 60-140 / adult 60-80
Resp: ped 15-25 / adult 12-20 |
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comp?
How do you determine the success of treatment? |
Recovery
Activate EMS if complete recovery has not occured in 15-20 min. |
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comp?
Give 3 symptoms of hypoglycemia. |
Weakness
Dizziness Normal of depressed respirations Headache Altered level of consciousness Personality change Confusion |
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comp?
What are 2 visible signs of hypoglycemia? |
Pale
Moist skin |
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comp?
What is the treatment procedure for hypoglycemia? |
Position patient
Maintain open airway If conscious offer juice or other high carbohydrate liquid Glucose gel |
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comp?
List 3 presyncope symptoms. |
Complaint of being; hot, dizzy or
nauseated. Decreased blood pressure Very rapid pulse |
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comp?
List 2 visible signs of presyncope. |
Patient is pale
Cold perspiration |
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comp?
List 3 of the signs of syncope. |
Deathlike apperance
Shallow, gasped breathing Dilated pupils Convulsive movements possible |
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comp?
List 2 treatments for syncopes. |
Place patient in supine poaition.
Maintain open airway Use ammonia capsule (stimulate) Provide O2 (bag-mask-valve) |
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comp?
What is the procedure for maintaining an open airway? |
Head tilt chin lift.
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comp?
What vital signs should be monitored for a hypoglycemic patient? What should you do with that information? |
Blood pressure and pulse
Record on patient record. |
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comp?
How do you determine if the treatment is a success? |
If the patient remains remains conscious
if patient loses consciousness activate EMS. |
