MEDICAL EMERGENCIES IN RADIOLOGY DEPARTMENT

Radiology Department

The medical emergencies most likely occur in the ____

SHOCK

physiologic reactions to illness or trauma in which there is a disturbance of blood flow to the vital organs or decreased ability of the body tissues to use oxygen and other nutrients needed to maintain them in healthy state.

Hypovolemic shock

caused by inadequate blood volume

Septic shock

associated with infections

Cardiogenic shock

associated with heart problems

Neurogenic shock

caused by damage to the nervous system

Anaphylactic shock

caused by allergic reactions

General Symptoms of shock includes

1. Decrease temperature

2. A weak thready pulse

3. A rapid heart beat

4. Rapid shallow respirations

5. Hypotension

6. Skin pallor

7. Cyanosis and increased thirst

Hypovolemic Shock

caused by abnormally low volume of circulating blood in the body

Hypovolemic Shock

it maybe due to internal or external hemorrhage; loss of plasma because of burns; fluid loss from prolonged vomiting or diarrhea; heat prostration; or insufficient release of anti- diuretic hormone

Signs and Symptoms of Hypovolemic Shock

pale or bluish, cool moist skin

Signs and Symptoms of Hypovolemic Shock

altered conscious state

Signs and Symptoms of Hypovolemic Shock

restlessness or irritability

Signs and Symptoms of Hypovolemic Shock

rapid and weak pulse

Signs and Symptoms of Hypovolemic Shock

excessive thirst

Signs and Symptoms of Hypovolemic Shock

Nausea and /or vomiting

Signs and Symptoms of Hypovolemic Shock

Rapid breathing

Septic Shock

caused by severe systemic infections and bacteria (bacterial endotoxins released in the bloodstream)

Septic Shock

Symptoms progress somewhat differently from those other types of shock

Signs and Symptoms of Septic Shock

1. In early stages, the skin is warm, dry and flushed.

2. Urine output may be normal or excessive.

3. The patient have chills as shock progress, there may be an abrupt personality change or a decrease in the level on consciousness .

4. There is an increase in pulse and respiration and a decrease in urinary output.

5. The skin becomes cold and clammy.

6. Seizures, circulatory collapse and cardio-respiratory failure will follow if the course is not reversed.

Cardiogenic Shock

caused by a failure of the heart to pump an adequate amount of blood to the vital organs.

Signs and Symptoms of Cardiogenic Shock

1. Insufficient blood supply due to dehydration, bleeding or swelling.

2. A poor blood supply to the heart, where there is not enough oxygen and other nutrients for its work.

3. Poor lung function or obstruction to blood flow in the lungs, which places a strain on the heart muscle.

4. Too many or too few electrolytes (eg. potassium, magnesium) that cause irregular heartbeats or dangerous rhythms in the heart.

5. Weakness of blood vessel walls.

6. Heart muscle weakness

Neurogenic Shock

occurs when concussion, spinal cord injury , psychic trauma, or spinal anesthesia causes abnormal dilatation of the peripheral blood vessels.

Neurogenic Shock

This dilatation in turns causes a fall in blood pressure as blood pools in the veins. This leads to reduced cardiac output.

spinal cord

Damage to the _____ can cause significant injury to the part of the nervous system that controls the size and muscle tone of blood vessels

smooth muscle

If the _____ in the blood vessels is cut off from its impulses to contract, then the vessels dilate widely, increasing the size and capacity of the vascular system

Signs and Symptoms of Neurogenic Shock

1. Hypotension and Bradycardia

2. Initial alertness unless the patient is unconscious because of head injury.

3. Initially good, but deteriorating, tissue perforation.

4. Visible signs of poor tissue perforation; coolness of extremities and diminishing peripheral pulses.

Anaphylactic Shock

a life threatening type of allergic reaction

Anaphylactic Shock

it is the result of exaggerated hypersensitivity reaction (allergic reaction) to an antigen that was previously encountered by body’s immune system.

Anaphylactic Shock

The reaction is accompanied by contraction of non vascular smooth muscles, particularly the smooth muscles of the respiratory system.

The common causes of anaphylaxis

Drugs

iodinated contrast agents

chemotherapeutic agents

anesthetics

certain foods

venoms

Early Signs and Symptoms of Anaphylactic Shock

1. Itching at the site of a medication injection or around the eyes and nose. 2. Sneezing and coughing.

3. Apprehensiveness, a feeling of doom

4. Nausea , vomiting , and diarrhea ; usually accompanies a reaction to food

sitting

lateral recumbent

A patient with nausea is assisted to a __ or ____ position given a receptacle for emesis

Lateral decubitus

_____ position to prevent aspiration of vomitus

epinephrine

People who know they are susceptible to anaphylaxis should carry emergency kits that contain an injection of ______

Angioneurotic edema

Late symptom of Anaphylactic Shock in the face, hands, and other body parts

Insulin shock

seen in diabetics who have injected too much insulin, causing severe hypoglycemia (low blood-sugar levels)

Diabetic Mellitus

chronic disease involving a disorder of carbohydrate, protein, and fats metabolism, which affects the structure and function of the blood vessels

Type I Insulin :IDDM ( Dependent Form )

Type II Insulin =NIDDM( Noninsulin Dependent Form )

Two Major Classification of Diabetes

Symptoms of Type I Diabetes

▪Being very thirsty

▪Feeling hungry

▪Feeling tired or fatigued

▪Having blurry eyesight

▪Losing the feeling or feeling tingling in your feet

▪Losing weight without trying

▪Urinating more often

Type II Insulin =NIDDM( Noninsulin Dependent Form

Occurs when the pancreas (an organ in the abdomen) produces insufficient amounts of the hormone insulin and/or the body's tissues become resistant to normal or even high levels of insulin

diabetes mellitus

The majority of persons with this type of ____ are overweight and middle –aged

overweight

middle –aged

The majority of persons with this type of diabetes mellitus are _____ and ____

Hypoglycemia ( insulin reaction )

deficiency of sugar in the blood; a condition in which the glucose in the blood is abnormally low , or inadequate diet to utilize the insulin.

Signs & Symptoms: of Hypoglycemia

1. Shaking ,nervousness and irritability

2. Dizziness and hunger , may complain of headache

3. Profuse sweating and hunger; cold skin

4. Blurred visions.

5. Tremor, numbness of lips and tongue and slurred speech

6. convulsions

7. Diminishing motor consciousness; quick lapse to coma

Cerebral Vascular Accident (CVA )

Caused by occlusion or rupture of the cerebral arteries directly into the brain tissue or into the sub-arachnoid area.

Cerebral Vascular Accident (CVA )

This is commonly called a stroke

Cerebral Vascular Accident (CVA )

occur with no little or may no warning and may possibly occur in the radiology department during stressful procedure.

SIGNS AND SYMPTOMS of Cerebral Vascular Accident (CVA )

1. Possible severe headache

2. Muscle weakness or flaccidity of face or extremities; usually one-sides

3. Eye deviation, usually one-sided; may lose vision.

4. Dizziness

5. Difficult speech( dysphasia ) or no speech(aphasia)

6. Ataxia

7. May complain of stiff neck.

8. Nausea or vomiting may occur.

9. Loss of consciousness.

Fainting and Convulsive Seizures

Caused by insufficiency in the supply of the blood to the brain. Heart disease , hunger, poor ventilation, fatigue and emotional shock are all causes.

SIGNS AND SYMPTOMS of Fainting and Convulsive Seizures

•Pallor, dizziness, and possibly nausea

•Cold, clammy skin

Convulsive Seizures

It may be associated with many physical disorders, including uremia, eclampsia, tetanus, infections characterized by high body temperature, positioning and increased intracranial pressure caused by brain tumor.

Epilepsy

is the most common cause of convulsive seizures

Routine Medication

required regularly for maintenance of a specific health condition

Emergency Medication

required for the emergency first-aid treatment of medical conditions (e.g. Midazolam for specific seizures, Ventolin for asthma).

Medications

are categorized as prescription medications and over-the-counter medications

Oral

Parenteral Route

Topical Route

Inhalant Route

Route of Medication Administration

Oral

safe, most convenient, least expensive

Parenteral Route

injection into a body tissue

Topical Route

skin or mucous membrane.

Inhalant Route

gaseous or volatile substance