Chapter 20 Intro to Radiologic & Imaging Sciences & Patient Care

Subjective sensation or motor phenomenon that precedes and marks the onset of a paroxysmal attack, such as an epileptic attack

aura

device used for application of external electrical shock to restore normal cardiac rhythm and rate

Automatic External Defibrillators (AED)

sudden stoppage of cardiac output and effective circulation

cardiac arrest

Artificial substitution of heart and lung action as indicated for cardiac arrest and lung action as indicated for cardiac arrest or apparent sudden death resulting from electric shock, drowning, respiratory arrest, and other causes

Cardiopulmonary Resuscitation (CPR)

Condition with sudden onset caused by acute vascular lesions of the brain; often followed by permanent neurologic damage

Cerebrovascular accident (stroke or brain attack)

unexpected or sudden occasion; an urgent or pressing need

emergency

nosebleed; hemorrhage from the nose

epistaxis

escape of blood from the vessels; bleeding

hemorrhage

abnormally increased concentration of glucose in the blood

hyperglycemia

abnormally diminished concentration of glucose in the blood

hypoglycemia

abnormal drowsiness or stupor; a condition of indifference

lethargy

unpleasant sensation, vaguely referred to the epigastrium and abdomen and often culmination in vomiting

nausea

paleness; absence of skin coloration

pallor

condition of profound hemodynamic and metabolic disturbance characterized by failure of the circulatory system to maintain adequate perfusion of vital organs

shock

temporary suspension of consciousness as a result of generalized cerebral ischemia; faint or swoon

syncope

vascular reaction, usually transient, involving the upper dermis, representing localized edema caused by dilatation and increased permeability of the capillaries and marked by development of wheals; also called hives

Urticaria

disorganized cardiac rhythm

ventricular fibrillation

illusion of movement; sensation as if the external world were revolving around the patine tor as if the patient were revolving in space

vertigo

forcible expulsion of the contents of the stomach through the mouth

vomiting

bodily injuries caused by physical means with disruption of normal continuity of structures

wounds

separation of the layers of a surgical wound; may be partial, superficial only, or complete, with disruption of all layers

wound dehiscence

An ___________ is a situation in which the condition of a patient or a sudden change in medical status requiring immediate action

emergency

Radiologic Technologist objectives in an emergency are:

1. Must be able to recognize an emergency

2. Preserve life

3. avoid further harm

4. appropriate medical assistance ASAP

Most important thing as a radiologist technologist in an emergency situation is:

provide competent level of care, recognize when advance care is needed, and call for assistance

The technologist should keep in mind the following priorities when working with a patient in emergency situations:

1. Ensure an open airway

2. Control bleeding

3. Take measures to prevent or treat shock

4. attend wound or fractures

5. provide emotional support

6. continually revaluate and follow up appropriately

Highest level of surgical care to trauma patients

Level 1 trauma center

to be done at once

stat

if more than one patient in jeopardy determine which is the most urgent by:

unstable vital signs & severe respiratory distress

If both cases are of equal urgent emergency then:

do the patient that can be done in the shortest time

Lack of effective circulation to the central nervous system can cause irreparable brain damage in:

4 to 6 minutes

Locate Emergency Equipment

- emergency cart or crash cart

- oxygen

- wall-mounted suction

- AED's automatic external defibrillators

________ is used when a patient is unable to clear the mouth and throat of secretion, blood and vomitus

suction

_________ __________ is a peds resuscitation bag

Braslow bag

Before beginning of shift check your wall-mounted suction by:

1. Make sure pump is working

2. The receptacle is connected to pump

3. Connect the suction catheter to the receptacle

4. Have assortment of disposable catheters

Items in a code cart

-Defibrillator

-Oxygen -Ambu bag

-Portable suction

-Emergency Drugs

-IV solutions

-Respiratory Box

If patient begins to aspirate:

1. turn them to the side

2. attempt to clear airway

3. pull chin down & forward while inserting the suction, catheter tip over tongue

4. Suctioning beyond the pharynx done by physician or respiratory therapist

Analyzes the patients cardiac rhythm, determines whether defibrillation is necessary, advice the operator to deliver shock by pushing a button

semi automatic defibrillator

Analyzes the patients cardiac rhythm, determines whether fibrillation is necessary , and if necessary, delivers shock

fully automatic defibrillator

What are the levels of consciousness after an injury?

1. Alert & Conscious

2. Drowsy, but responsive

3. Unconscious, but reactive to painful stimuli

4. comatose, unresponsive to stimuli

Used to evaluate changing status of patient and can be used by a variety of healthcare workers

glasgow coma scale

Quickly assess patient when procedure has began so that it is readily noticeable if patient deteriorates from one ________ _____ ________ to another

level of consciousness

Signs that someone is deteriorating:

1. sudden irritability

2. lethargy

3. slowing pulse rate

4. change in level of consciousness

how should one respond if someone is deteriorating?

1. Maintain an open airway

2. Move patient minimally

3. stop radiographic procedure

4. get medical assistance asap

5. monitor patients vital signs

________ is a general term that indicates a failure of the circulatory system to support vital body functions

shock

caused by loss of blood or tissue fluid

hypovolemic shock

caused by cardiac disorders, including myocardial infarction

cardiogenic shock

caused by spinal anesthesia or damage to the upper spinal cord

neurogenic shock

Caused by sepsis, deep anesthesia or anaphylaxis

vasogenic shock

Radiologist technologist most likely encounter hypovolemic shock or ____________ shock, a special type of vasogenic shock, as result of contrast media

anaphylactic

a solid swelling of clotted blood within the tissues

hematoma

a ____________ is usually minimal damage characterized as seeing stars or very brief loss of consciousness

concussion

______ is preferred method of head injury assesment

CT

Signs & symptoms of shock

-restlessness

-apprehension or general anxiety

-tachycardia

-decreasing blood pressure

-cold & clammy skin

-pallor

-change in cognitive ability

What is the most accurate indicative condition of shock?

decreasing blood pressure

Ways to prevent shock is by:

-Maintaining body temperature by keeping patient covered.

-Minimizing pain

-Working calmly and confidently

-Give them emotional support

If patient is going into shock what should the RT do?

Stop the procedure, ensure maintenance of body temp, call for medical assistance, and measure vital signs.

____________ shock is a type of vasogenic shock is most commonly encountered in the radiology department in connection with administration of iodinated contrast media

anaphylactic

The most severe reactions typically arise ___________.

quickly

_________ is the last sense to go

hearing

During anaphylactic shock, mild reactions include:

-localized itching

-urticaria

-nausea and vomiting

during anaphylactic shock, serious reactions include:

-Laryngeal edema

-shock

-cardiac arrest

During anaphylactic shock, life threatening !!! reaction early !!!!! symptoms include:

-difficulty swallowing (dysphagia)

-constriction of throat

-itching of palms and soles of feet

episodes of chest pain precipitated by exertion or stress, usually relieved by rest or nitroglycerin

Angina pectoris

sudden intese chest pain (crushing), caused when a portion of the heart wall is ischemic. Pain is in left arm, jaw or neck

heart attack

Sudden loss of consciousness. Time is vital, because of lack of effective circulation

cardiac arrest

bleeding into the pericardium interferes with heart's pumping ability

cardiac tamponade

treatment for pneumothorax or hemothorax

thoracotomoy

blood in the pleural space

hemothorax

air in the pleural cavity

pneumothorax

fracture in the ribs usually results in

pneumothorax and hemothorax

Every trauma patient should be considered to have a potential

spinal injury

Movement of a spinal injury can result in

paralysis or death

patient with spinal injuries you should ____ ____, avoid twisting or bending

log roll

Healthy patient adjust own _______ production and excretion to meet carbohydrate demands of the body

insulin

Symptoms of hyperglycemia include

excessive thirst, excessive urination, dry mucosa, rapid and deep breathing, drowsiness, confusion, sweet smelling and or fruity breath. Diabetic coma can occur if not treated

excessive sugar in the blood (needs insulin)

hyperglycemia

excessive insulin in body (low blood sugar) can result if patient takes insulin and doesnt eat

diabetic hypoglecimia

Hypoglycemia is characterize by sudden onset of:

-weakness

-sweating

-tremors

-hunger

-confused and irritable

-loss of consciousness

Diabetes type 1 usually:

-insulin dependent

-characterized by lean person under 25

-produces little or no insulin

-blood glucose levels monitored closely

-insulin administered parenterally

-diabetic coma more likely to occur than a type 2

Diabetes type 2 usually:

-most commonly obese person over 40

- responds to oral medications and changes in diet and lifestyle

___________ ___________ is another medical crisis that occasionally occurs in the radiology department. Asthma attacks are often triggered in asthmatic patients when they are exposed to stressful situations, such as might experienced in a radiology department.

Respiratory distress

If the object if visible in the open mouth, the rescuer should perform a ________ _________. If unsuccessful, begin CPR to force obstruction up.

finger sweep

The purpose of the _________ _________ is to increase intrathoracic pressure sufficiently to propel dislodged object out of the throat. To apply, the rescuer stands behind the victim and wraps both arms around him or her, clutching one fist with the other hand.

Heimlich maneuver

Because abdominals thrusts can be dangerous women in late stages of pregnancy, _____ thrusts are used instead.

chest

Heimlich maneuver modified for ________, a combination of 4 back blows and 4 chest trusts using two fingers is recommended.

infants

________ are more likely to occur in older patients (over 75 years of age0 but can occur in any adult

strokes

During a stroke,

-symptoms may develop gradually or suddenly

-loss of consciousness may necessitate CPR

-patient needs to be placed in recumbent position ASAP

Main warning signs of a stroke are:

Paralysis, slurred speech, loss of vision

Questions to help determine if someone is having a stroke:

Face is drooping?

Arms can you raise?

Speech is it slurred or jumbled?

Time to call 9-1-1 right away

___________ or nosebleed, is a common occurrence. This event is seldom life-threatening. Patients should lean forward and pinch the affected nostril against the midline nasal cartilage with digital pressure.

Epistaxis

If noise bleeding persists, apply a ________ compress and seek medical attention if bleeding continues for 15 minutes

moist

Nausea and vomiting are frequent occurrences.The patient should be in a position in which aspiration of vomitus into lungs is not likely. Recumbent patients should be helped into a ________ _______ position if posible.

lateral decubitus

Vertigo is often a precursor to syncope. A patient who experiences vertigo should be assisted to a

seated or recumbent position, which prevents injury from falling as a result of problems with equilibrium.

__________ is a self-correcting, temporary state of shock and the result of lack of blood flow to the brain

syncope

__________ are caused by a variety of factors, few of which are clearly understood, and may range from mild to severe. A patient who undergoes a mild __________ may experience a brief loss of consciousness or may stare into space for a brief time.

Seizure

________ __________ are characterized by involuntary contraction of muscles on either one or both sides of the body, They may last for only a minute or up to several minutes. The patient may drool because of loss of control.

severe seizures

unsystemic discharge of neurons of the cerebrum that results in abrupt alteration in brain function

seizure

Steps for caring for a seizure patient:

1. Gently secure patient to prevent injury- do not restrain

2. Call for assistance

3. Protect the patients privacy

4. Do not insert hard objects into the mouth or put your fingers into the mouth

5. Do not finger-sweep with your finger

6. Place blanket or pillow under the patient's head

7. Observe patient and record time of seizure duration

8. After seizure, place patient in sims position and place face downward to permit vomitus and secretions to escape

9. After event ensure an open airway