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MEDICAL EMERGENCIES

MEDICAL EMERGENCIES. Medical Emergencies Defined. A situation in which the condition of the patient or sudden change in medical status requires immediate action Head Injuries Shock Diabetes Respiratory distress Cardiac arrest Cerebral vascular accident. The Radiologic Technologist Role.

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MEDICAL EMERGENCIES

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  1. MEDICAL EMERGENCIES

  2. Medical Emergencies Defined • A situation in which the condition of the patient or sudden change in medical status requires immediate action • Head Injuries • Shock • Diabetes • Respiratory distress • Cardiac arrest • Cerebral vascular accident

  3. The Radiologic Technologist Role • Preserve life • Avoiding further harm • Obtaining further medical assistance • Knowing when assistance is warranted (most important)

  4. General Priorities • Ensure an open airway • Control bleeding • Take measures to prevent or treat shock • Attend to wounds or fractures • Provide emotional support • Continually re-evaluate and follow-up appropriately

  5. Emergency Cart • Know location and contents

  6. HEAD INJURIES • It is not the radiology technologist responsibility to diagnose, but it is useful to have basic knowledge for assessment purposes

  7. LEVELS OF CONSCIOUSNESS • Alert and conscious • Responds fully • More serious • Drowsy, but can be roused • Even more serious • does not respond to verbal commands, but can react to painful stimuli • Most Serious • Unresponsive or comatose

  8. Indications of Deteriorating Conditions • Irritability • Lethargy • Slowing pulse rate • Slowing respiratory rate

  9. Responses to Deteriorating Situations • Stop the procedure • Make sure there is an open airway • Obtain assistance • Obtain vital signs while waiting

  10. The Intoxicated Patient Inebriated vs. head injury

  11. SHOCK Failure of the circulatory system to support vital body functions

  12. Definition and Types • Hypovolemic – due to loss of blood or tissue fluid • Cardiogenic – due to a variety of cardiac disorders, including myocardial infarction • Neurogenic – due to spinal anesthesia or damage to the upper spinal cord • Vasogenic – due to sepsis, deep anesthesia, or anaphylaxis

  13. Prevention • Maintain body temperature • Avoid pain, if possible • Minimize stress and anxiety

  14. Signs and Symptoms • Restlessness • Apprehension • General anxiety • Tachycardia • Decreasing blood pressure • Cold and clammy skin • Pallor

  15. Contrast Media Reactions(Anaphylactic Shock) • Any medication can be harmful if not administered properly • Moderate to severe • As a general rule, the longer it takes for a reaction to develop, the less severe it is • Typically most severe reactions arise immediately

  16. Anaphylactoid reactions Allergic-like effects • Thought to be caused by the release of histamine • Mild • Warm sensation, metallic taste, sneezing • Moderate • Nausea, vomiting, itching • Severe • Respiratory or cardiac crisis

  17. Responses to Deteriorating Situations • Stop the procedure • Make sure there is an open airway • Obtain assistance • Obtain vital signs while waiting

  18. The role of the radiology technologist should be established in the procedures in each facility. • Very important to document condition of patient before and after event

  19. INFILTRATION or EXTRAVASATION: contrast or medication enters soft tissue instead of vein • Signs: swelling, pain, burning, redness • Cause: needle displacement • STOP EXAM IMMEDIATELY • Apply ice if <30min • Apply warm, wet compression of >30min

  20. THE DIABETIC PATIENT • NPO prep may create problem • If patient takes insulin without food, insulin production and excretion may be altered due to lack of carbohydrates • adjustment must be made immediately

  21. Hypoglycemia • A condition in which excessive insulin is present • Taking insulin without food • Depletes body’s energy and quickly leads to insulin shock Symptoms include: hungry, weak, shaky, confused, sweaty, irritable

  22. Hypoglycemia (con’t) • Solution: Carbohydrates • Glucose tablets • Orange juice sweetened w/sugar • A sugared soft drink • Candy bar, etc. • No food or drink should be given to an unconscious patient

  23. Hyperglycemia The condition of excessive sugar in the blood and is the characteristic typically associated with diabetes. • Symptoms: • Excessive thirst and urination • Dry mucosa • Rapid and deep breathing • Drowsiness and confusion

  24. Hyperglycemia (con’t) • Solution: Patient needs insulin

  25. RESPIRATORY DISTRESS AND RESPIRATORY ARREST • The Asthma Patient • Anxiety and stress of having the exam may cause reaction • The technologist role is to keep calm, as this will calm the patient • Allow patient to sit and determine if medical assistance is needed

  26. The Choking Patient • Evaluate the situation • “Can you speak?” • Clutching throat • Turning red in the face • Encourage patient to cough • Use Heimlich maneuver if necessary

  27. CARDIAC ARREST • Signs and Symptoms • Crushing chest pain that may or may not radiate down the left arm

  28. CPR (Cardiopulmonary Resuscitation) • Alert the proper personnel before beginning • Cerebral function is generally impaired if the brain is deprived of oxygen for more than 4 to 6 minutes

  29. 3 Primary Aspects of CPR • ABC’s • Airway • Breathing • Circulation

  30. Considerations • DNR request Once begun, basic life support should (and for legal reasons, must) be continued until the victim resumes spontaneous respiration and circulation, a physician or other responsible health care professional calls a halt, or the rescuer is too exhausted to continue.

  31. Cerebrovascular Accident • Stroke • Onset could be sudden or gradual • Paralysis • Slurred speech • Dizziness • Vission loss • Loss of consciousness

  32. Minor Medical Emergencies • Nausea and vomiting • Epistaxis • Vertigo and syncope • Seizures • Falls

  33. Nausea and Vomiting • Breath slowly and deeply • Turn head to side and give patient emesis basin

  34. Epistaxis • Defined: nosebleed • Lean forward, pinch nostril (do not lean back) • If not effective within 15 minutes, get help

  35. Vertigo and Syncope • Vertigo: dizziness • Allow patient to sit or lie down • Syncope: fainting • Temporary lack of blood flow to brain • Allow patient to lie down with feet elevated, loosen clothing

  36. Seizures • Mild to severe • Slight confusion or weakness, body trembling and drooling • Exam should be postponed • Protect patient with pillows, clear airway and summon help

  37. Falls • Attempt should be made to minimize impact when possible and then proceed to get assistance

  38. Wounds • Hemorrhage: note condition, if bleeding, apply pressure; if extremity, place above heart if possible • Burns: maintain sterile precautions, be extra gentle with patient • Wound dehiscence: uncommon; a patients sutures come apart and abdominal contents spill out

  39. SUMMARY Be alert and aware that emergencies do happen in the radiology department. Respond in a calm and confident manner.

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