Seminar Content (scope of practice, ageing and disability, contrast media, seizures)

Flashcards about seminar content, ageing and disability, contrast media, fluids and electrolytes, brain death, organ donation, and seizures.

Scope of Practice

Governed by AHPRA + MRPBA, reflection on individual capacity and training; factors include knowledge, experience, competency, and legal framework.

Scope of practice

Procedures, actions, and processes permitted for a licensed individual, limited by law, education, experience, and demonstrated competency.

Ageing/Disability Changes

Cardiovascular, pulmonary, renal, neuro, endocrine, GI, MSK, integumentary changes

Cardiovascular Changes with Ageing

↓ blood flow, dysrhythmias, lower limb oedema

Pulmonary Changes with Ageing

↓ lung expansion/gas exchange, ↓ breath sounds at bases

Renal Changes with Ageing

↑ dehydration risk, incontinence, osteoporosis, ↑ UTIs

Neurological Changes with Ageing

Slower reflexes, ↓ thermoregulation, ↑ fall risk

Endocrine Changes with Ageing

↓ thyroid function/metabolism; ↑ blood glucose, diabetes risk

GI Changes with Ageing

Tooth loss, altered taste, aspiration, slowed digestion, constipation

Integumentary Changes with Ageing

Slow wound healing, fragile skin, ↑ infection & hypothermia risk

Miscellaneous Changes with Ageing

Grey/thinning hair, ↓ tactile sensation, dry skin, ↓ body odour

Cognitive/Psychosocial Changes with Ageing

Personality, memory, learning, attention, depression

Sensory Changes with Ageing

Hearing loss, vision impairment

Contrast Media Routes of Administration

Orally, Rectally, Intravenously, Intraarterially, Intrathecally, Intraarticularly

Enteral Routes of Administration

Oral, rectal, sublingual

Parenteral Routes of Administration

Subcutaneous, Intramuscular, Intravenous, Intrathecal, Intra-Articular, Intra-arterial

Topical Routes of Administration

Skin, eyes, nose, etc.

Vascular areas with faster absorption

Liver, kidneys

Main excretion route

Kidneys

Side Effects of Contrast Media

Metallic taste, warm flush

Adverse Effects of Contrast Media

Allergic reactions, nephrotoxicity, anaphylaxis

Purpose of IV Fluids

Restore hydration, deliver meds

Dehydration Complication

Electrolyte imbalance

Positive (Radiopaque) Contrast Media

Barium, iodinated agents (e.g., Omnipaque, Gastrografin)

Negative (Radiolucent) Contrast Media

Air, CO₂, water

Ionic Contrast Agents

Higher osmolality → more reactions

Non-Ionic Contrast Agents

Less reactive, more expensive

Contrast Reaction Types

Vasomotor, anaphylactic, vasovagal, renal failure

Signs of Contrast Reaction

Warmth, metallic taste, nausea, rash, hypotension

Check renal function during patient screening

Creatinine, BUN

Metformin Warning

Withhold 48h post-CM if renal risk

Allergy History to Check During Patient Screening

iodine, asthma, other drug allergies, H/O dermatitis/hives

Barium Use

Coats mucosa, not for suspected perforation

Gastrografin Use

Water-soluble, use if perforation suspected

Double Contrast

Air + barium for mucosal detail

Comatose

Minimum 4 hours continuous recorded observations consistent with brain death (GCS = 3, no reflexes, no respiration (apnoea test))

Glasgow Coma Score (GCS)

Severe = 3-8, Moderate = 9-12, Mild = 13-15

Eyes (GCS)

4 - Open spontaneously, 3 - Open to voice, 2 - Open to pain, 1 - Don’t open

Verbal (GCS)

5 – Normal, 4 – Confused Speech, 3 – Inappropriate or incomprehensible speech, 2 – Moans and groans, 1 – No verbal response

Motor (GCS)

6 – Obeys commands, 5 – Localises to pain, 4 – Withdraws from pain, 3 – Flexes to pain, 2 – Extends to pain, 1 – No movement

Confirm Brain Death via

CTA, radionuclide perfusion scan

DBD

Donation after brain death

DCD

Donation after circulatory death

Seizure Definition

Abnormal, excessive brain activity causing clinical symptoms

Epilepsy Definition

Chronic seizure disorder

Provoked Seizures

Triggered by acute event (e.g., fever)

Psychogenic Non-Epileptic Seizures (PNES)

Psychogenic, no EEG changes

Focal (Aware) Seizure

One region, no LOC; motor/sensory/psychic symptoms

Focal (Impaired Awareness) Seizure

Altered consciousness, automatisms

Generalised Tonic-Clonic Seizure

Stiffening/jerking, LOC

Generalised Absence Seizure

Brief unresponsiveness (e.g., daydreaming)

Generalised Myoclonic Seizure

Brief muscle jerks

Generalised Atonic Seizure

Sudden loss of tone → falls

Seizure Response

Time seizure, clear space, protect head, maintain airway (side position), do not restrain, call for help; stay and reassure during post-ictal phase

Common Seizure Triggers

Missed meds, illness, sleep deprivation, stress, alcohol, photosensitivity