emergency response/acute situations

chapter 16/17 of patient care

____________________ is a serious, unexpected event that demands immediate attention

emergency

the ________________________ is a special unit of the hospital equipped to care for persons who arrive in need of immediate care

emergency department

why do some patients misuse the emergency department (ED)?

seek for narcotics for abuse, seek care for minor illnesses

________ units are specialized care facilities usually within a hospital designed to cope with life-threatening injuries

trauma

___________ trauma - all levels of injuries and are staffed around the clock with physicians, surgeons, and support personnel who are highly trained in the care and treatment of traumatic injuries

level 1

_________ trauma - smaller community hospitals that usually have an ED physician and radiographer on call at night

level 3

__________ trauma - ED physicians are on 24-hour duty, as are emergency trained nurses and radiology staff, patients will be transferred if neccessary

level 2

3 radiographer roles in trauma:

1. take x-rays in ED

2. operate CT scanner

3. take x-rays and operate around others

if there are multiple patents that require imaging at the same time, the radiographer will need to _______________

prioritize the worst one

in two equally urgent cases, what exam should be performed first?

shortest exam

_______________ is defined as an emergency of huge magnitude that creates an unforeseen, serious, or immediate threat to public health

disasters

3 types of disasters:

1. natural

2. accidental

3. manmade

examples of natural disasters:

tornado, earthquake, flood

examples of accidental disasters:

plane crash or train wreck

example of manmade disaster:

terrorist attacks

_________ is an essential part of disaster response

triage

_________ is defined as the process of identifying the victims, performing initial exams, and assigning priorities for further care

triage

code red = ______

fire

code blue = _______

heart or respiration stopping

code orange = ___________

hazardous material spill or release

code gray = _____________

combative person

code silver = _____________

weapon or hostage situation

code amber = _________

infant/child abduction

code clear = _________

situation is resolved

also known as code team

emergency response team

___________ is a designated group of healthcare workers who respond to emergency codes

emergency response team

3 members of emergency response team:

1. one or more physician

2. nurses

3. respiratory therapist

when the code team arrives, what 4 things must we do:

1. allow them to take over

2. provide history of situation

3. stand by to follow directions

4. record keeping

also called “crash carts”

emergency carts

Which of the following items are typically found on a crash cart?

1. backboard

2. ET tubes

3. needles, syringes

1,2,3

reverses hypoglycemia

Glucagon

Opioid antagonist

narcan

Inhibits blood coagulation

heparin

Vasoconstrictor, increases cardiac output, raises blood pressure

adrenalin (epinephrine)

Tranquilizer, antiseizure agent

valium (diazepam)

Cardiac antidysrhythmic medication

verapamil

Anesthetic, cardiac antidysrhythmic medication

lidocaine

Anti-inflammatory

solu-medrol

3 ways patients in the ED are classified:

1. non-urgent

2. urgent

3. life-threatening

the most _____ cases are seen first.

acute

A _______________ oxygen mask is preferred to be used for patients with COPD.

high-flow

A ________ oxygen delivery system is frequently used in pediatric departments because children tolerate them better. 

tent

most common oxygen administration

nasal cannula

___________ oxygen mask adds humidity

simple face

___________ oxygen mask can supply 100% oxygen

nonrebreathing mask

The oxygen should be delivered at a rate of _______ L/min providing a _________ oxygen concentration

1-6; 24-45%

trauma patients may need oxygen as high as ___ L/min

10

patients with COPD should be no higher than __ L/min

3

______________ is placement of a tube, common term for an airway tube

intubation

________________ intubation to maintain an open airway or oxygen administration

ET

_____________ is a surgical opening through the anterior neck into the trachea

tracheostomy

___________ is used when a patient is unable to clear the mouth and throat of secretions, blood or vomitus

suction

As a general rule, STAT orders must be completed within _________, as opposed to ASAP orders, which have a time limit of __________, and routine orders that must be completed within __________

30 minutes, 2 hours, 12 hours

_________________ is usually caused by blockage of airway by foreign object (choking)

airway obstruction

________________________ is a general term for conditions of coughing, wheezing or SOB, sometimes used to describe asthma

reactive airway disease

_____________________ is a substance that travels through the vascular system and lodges in on the pulmonary vessels

pulmonary embolism

___________________ is when a coronary artery becomes occluded, heart wall becomes ischemic and heart muscle will die

myocardial infarction

__________ is a condition in which the heart has stopped beating

cardiac arrest

____________ are episodes of chest pain caused by excertion or stress

angina pectoris

can also be known as “heart attack”

myocardial infarction

patient complains of sudden intense chest pain, left arm, jaw or neck pain may be present are signs of ___________________

heart attack

initiate emergency response, elevate head and administer O2, pain meds, vasodilators and clot dissolving meds may be administered:

myocardial infarction

shake and shout to ensure it is not a syncope, if no response - check carotid pulse and respirations. if not present, call code and begin CPR until code team arrives:

cardiac arrest

T or F: radiographers can use a defibillator.

false

______________ delivers an electric shock to correct an ineffective cardiac rhythem

defibrillator

when using a defibrillator, personnel must be __ feet away when administered.

2

_________ can be used by any by stander

AED

glasgow coma highest possible score is ____

15

________ patients are assumed to have a spinal injury until ruled out

trauma

blood in pleural space

hemothorax

air in the pleural space

pneumothorax

multiple rib fractures causing the chest structure to be compromised

flail chest

hemorrhage into the pericardial sac

cardiac tamponade

fluid in pleural space

pleural effusion

if there’s fluid in the pleural space, ___________ is used to drain it

chest tube

bone fragments protude through the skin

compound

no wound associated with fracture

closed

_________ is a general term used to describe a failure of circulation in which blood pressure is inadequate to support oxygen perfusion of vital tissues and is unable to remove the by-products of metabolism

shock

early signs include pallor, increased HR, increased respirations, restlessness or confusion

shock

five main types of shock:

1. hypovolemic

2. septic

3. neurogenic

4. cardiogenic

5. allergic

_________________ is caused by massive blood or plasma loss

hypovolemic shock

_________________ results from internal and external hemorrhage, plasma loss from burns, or severe dehydration

hypovolemic shock

_________ is caused by severe, often systemic infection

septic shock

___________ occurs with nervous system injuries, loss of blood pressure control

neurogenic shock

________________ results from cardiac failure or interference with heart function

cardiogenic shock

______________ occurs from exposure to foreign substances to which they are sensitized

allergic shock

symptoms include restlessness, increased HR, pallor with weakness, decrease in BP:

shock

if someone goes into shock, the best thing to do is:

elevate their feet to increase blood flow

medical term for fainting

syncope

assist patient into supine position with feet elevated if a patient __________

syncope

known as a post-traumatic stress disorder

psychological shock

symptoms include changes in mood, behavior long after traumatic event

psychological shock

CVA is the abbreviation for the term that refers to

stroke

The term evisceration refers to:

abdominal organs protruding from a wound

While taking care of a trauma patient it is important to watch for signs of:

syncope

Laryngeal and bronchial edema

anaphylatic

Warmth, metalic taste

mild reaction

Erythema, bronchospasm

Moderate reaction

Hypotension, bradycardia

Vasovagal

Laryngeal and bronchial edema

Severe (anaphylactic)