patient care medical emergencies

shock

A failure of the circulatory system to support vital body functions

LEVELS+OF+CONSCIOUSNESS

Alert and conscious , Drowsy , Unconscious, Comatose

what constitutes an emergency

Any situation in which the condition of a patient or a sudden change in medical status necessitates immediate attention and action

LEVEL+OF+CONSCIOUSNESS+(LOC)

Ask patient to state name ,date, address and reason for coming to radiology. As you instruct patient in positioning, note patient's ability to follow your commands. Assess the patient's vital signs against a baseline to note change. Changes in patient's neurologic status or LOC must never be ignored!

KNOW,YOUR,PATIENT

Assess patient at beginning of procedure. Note signs of deterioration from one level of consciousness to another. Deteriorating head injury

HEAD+INJURIES

Assess patient's level of consciousness. Clinical symptoms may not manifest right away. Hematoma Brain swelling CT is the preferred modality for assessment.

respiratory distress

Asthma and Choking

hypovolemic shock classes

Class 1: Blood loss of 15% Class2: Blood loss of, 5% to 30% Class 3: Blood loss of 30% to 40% Class 4: Blood loss of more than 40%

cerebrovascular accident

Commonly called a stroke or brain attack More likely to occur in older patients' over 75 years of age but can occur in any adult May develop gradually or suddenly Warning signs: Loss of consciousness may necessitate CPR Patient needs to be placed in recumbent position ASAP.

the shock continuum

Compensatory Stage Progressive Stage Irreversible Stage

LOCATE+EMERGENCY+EQUIPMENT

Emergency cart or crash cart, Oxygen , Wall-mounted suction and AEDs (automatic external defibrillators)

EMERGENCY+PRIORITIES

Ensure open airway ,Control bleeding, Take measures to prevent or treat shock ,Attend to wounds or fractures Provide emotional support , and Continually reevaluate and follow up appropriately

epistaxis- nose bleed

Epistaxis is seldom life- threatening. Lean patient forward. Pinch affected nostril against the midline nasal cartilage with finger pressure. Keep patient upright in chair. If bleeding persists, apply a moist compress. Seek medical attention if bleeding continues for 15 minutes.

Hypoglycemia

Excessive insulin is present. Can occur if patient takes normal dose of insulin and does not eat( exam preparation) Signs of insulin shock patients often recognize early signs and need a quick form of carbohydrate or take a glucose tablet.

hyperglycemia

Excessive sugar in the blood and characteristic of diabetes Develops gradually over a period of hours or days Excessive thirst and urination, dry mucosa, rapid and deep breathing , drowsiness and confusion Insulin required - leads to diabetic coma if left untreated

diabetes

Healthy patient adjusts own insulin production and excretion to meet carbohydrate demands of the body. Patients with diabetes may be treated with insulin shot or diabetic pills and will need to adjust diet to balance insulin depending on whether they are type 1 or type 2

Deteriorating Situations (response)

Maintain an open airway, Move patient minimally , Stop radiographic procedure, Get medical assistance ASAP and Monitor patient's vital signs

how can shock be prevented?

Maintain normal body temperature, Avoid overheating, Manage or reduce pain, stress, or anxiety

anaphylactic shock - Vasogenic shock

Most common type of shock encountered in medical imaging May occur with contrast media administration Signs and symptoms must be monitored as routine procedure with contrast studies. Alert physician when signs occur

minor medical emergencies

Nausea and vomiting, Epistaxis ,Vertigo and syncope ,Seizures ,Falls, Wounds

classes of shock

Neurogenic , Hypovolemic shock, Cardiogenic shock and Vasogenic shock

vertigo

Patients experience dizziness. Vertigo is often a precursor to syncope. A patient who experiences vertigo should be assisted to a seated or recumbent position. Watch for orthostatic hypotension and vertigo when sitting patients up from a recumbent position.

Medical imaging Professional's Role

Preserve life , Avoid further harm to the patient, Obtain appropriate medical assistance as quickly as possible, must be able to recognize emergency situation and initiate emergency measures

Care of seizure patients

Prevent patient from injury. Gently secure patient to prevent injury. Call for assistance. Protect the patient's privacy. Do not insert hard objects into the mouth or put your finger(s) into the mouth. Remove dentures or foreign objects Do not finger sweep with your finger. Place blanket or pillow under the patient's head. Observe patient and record time of seizure duration. After seizure, place patient in sims position and place face downward to permit vomitus and secretions to escape. After event ensure an open airway

conclusion

Recognize emergency conditions and act appropriately. Ask for assistance in any emergency situation. Maintain competency with basic emergency skills. become certified in CPR and AED use. Use your medical "common sense" in emergencies.

common signs and symptoms of shock

Restlessness , Apprehension or general anxiety , Tachycardia , Decreasing blood pressure, Cold and clammy skin and Pallor

RADIOLOGY+EMERGENCIES

Shock, Anaphylaxis, Pulmonary embolus ,Diabetic reactions ,Cerebrovascular accident (CVA) ,Cardiac and respiratory failure , Syncope Seizures

Deteriorating Situations (signs)

Sudden irritability ,Lethargy, Slowing pulse rate Slowing respiratory rate, Change in level of consciousness (LOC)

syncope

Syncope means fainting. Syncope is a self-correcting ,temporary state of shock and the result of lack of blood flow to the brain. Treatment is aimed at increasing blood flow to the head. Assist patient into a recumbent position

seizures

Unsystematic discharge of neurons of the cerebrum that results in an abrupt alteration in brain function Accompanied by change in level of consciousness Generally a symptom of an underlying condition Take note of seizure event. Begins with little or no warning

CRASH+CART

You must know where the department crash cart is located. Become familiar with the crash cart contents and their locations. the ready availability of emergency equipment and drugs reduces the time required to respond to medical crises

hypovolemic shock

caused by a loss of blood or tissue fluid

cardiogenic shock

caused by a variety of cardiac disorders, including myocardinal infarction

vasogenic shock

caused by sepsis, deep anesthesia, or anaphylaxis

neurogenic shock

caused by spinal anesthesia or damage to the upper spinal cord