Dental Terminology Ch. 6

All about Emergency Care

Best treatment for emergencies

Prevent them from happening

Two of the fundamental methods employed in facility readiness

Patient health history and vital signs

Patient health history

Written and oral communication regarding the patient’s present and past health status, including medication, treatment, allergies, and health concerns

Vital signs

Body indications of the patient’s present health status, including blood pressure, pulse, respiration, temperature, and the patient’s concept of pain

Blood pressure (BP)

Indication of the pulsating force of blood circulating through the blood vessels at rest (diastolic) and while under the highest pressure of the circulating blood, the systolic pressure.

BP numbers are

Even

How are systolic and diastolic pressure numbers recorded

Systolic pressure placed before diastolic pressure numbers, Ex: 120/80 (systolic/diastolic)

Stethoscope

Device employed to intensify body sounds, it has a set of earpieces inserted into rubber tubing that combines the two ear tubes into one and extends to a metal bell-shaped or flat disc diaphragm, stethoscopes used in training may have two earpieces combined to one diaphragm for instructional purposes

Diaphragm

A thin layer over the disc end of the stethoscope that helps to enlarge or amplify pulse and body sounds

Sphygmomanometer

An instrument is available in portable, wall mounted, or mobile floor units and consists of a squeeze bulb on rubber tubing, an arm cuff, and a pressure or aneroid dial or a graduated marked mercury column, digital sphygmomanometers use only a wraparound cuff with machine read-out gauges; no stethoscope is required, the mercury column unit is considered the most reliable recorder and may be used to calibrate the aneroid system

Antecubital fossa

Interior depression or bend of the elbow’ the approximate area for the placement of the stethoscope diaphragm to determine blood-pressure sound. B

Brachial artery

Situated at the inside, upper arm area; selected site of blood-pressure cuff placement

Pulse

The beating force for blood circulating through arteries, which is classified according to rate, rhythm, and condition, pulse counts may be taken at various body areas

Accelerated

Faster pulse rate than normal or expected, aka “rapid”

Alternating

Changing back and forth of weak and strong pulsations

Arrhythmia

Irregular heartbeat or pulsations

Bradycardia

Pulse rate under 60 beats per minute (bpm)

Tachycardia

An abnormal condition of pulse rates over 100 bpd (except in children)

Deficit

Lower pulse rate at the wrist than at the heart site, “heart flutter”

Carotid pulse

Pulse at the neck

Cuff placement area

Around the bicep

Brachial pulse

Pulse at elbow

Radial pulse

Pulse at wrist

Febrile

Normal pulse rate becoming weak and feeble with prostration or illness

Frequency

Pulse count; number of pulsations, which differs with age, sex, body position, or health of patient

Types of pulse frequencies

Intermittent, irregular, regular, and thready

Intermittent frequencies

Occasional skipping of heartbeats

Irregular frequencies

Variation of force or frequency in pulse rate

Regular frequencies

Uniform pulse force, frequency, and duration

Thready frequencies

A fine, hard-to-locate, barely perceivable pulse

Respiration

The inhaling or breathing in of oxygen and the exhaling ort expelling of carbon dioxide

1 respiration count requires

An inspiration (breathing in) and expiration (breathing out)

Respirations are described according to

Rate, character and rhythemA

Absent

Suppresses respiratory sounds

Apnea

cessation of breathing, usually temporary

Cheyne-strokes

Respirations gradually increasing in volume until climax, and then subsiding and ceasing for a short period of time before starting again; may be noted in dying

Deep

Strong inhalation of air with exhalation

Dyspnea

Out of breath; difficult or labored breathing

Frequent

Rapid breathing that may be noted in children, those with disease, hysteria, or with a drug-induced condition

Rale

Noisy, bubbling sounds from lung mucous, heard on inhalation

Shallow

Short inhalation with small rise in chest

Slow

Fewer than 12 respirations per minute

Stertorous

Rattling, bubbling, or snoring sounds that obscure normal breaths

Temperature

The balance of heat loss and production in a body and may be taken at various sites, such as oral, rectal, axillary (armpit) and aural (ear)

Fever

Elevated body temperature, usually considered over 38.3 C (100-103 F)

Hyperthermia

Body temperature exceeding 40 C (104 F)

Hypothermia

Body temperature below 35 C (95 F)

Tympanic

(pertaining to eardrum) Measurement of body heat registered by an ear thermometer

Vital signs ranges

How is concept of pain measured

Patient rates the level of pain on a scale of 1-10 in intensity, any increase or decrease in pain may indicate the course of the disease, this vital sign is subjective compared to other vital signs

Emergency call list

Important phone numbers necessary in an emergency, which are located in a prominent position near every available phone

Oxygen source

Container with oxygen gas tank, colored green; obtained in various sizes and may be centrally supplied to each work station

Oxygen regulator

Device used to control the flow of oxygen

Oxygen flowmeter

Gauge used to adjust the flow amount of oxygen

Oxygen mask

Device placed over a patient’s nose and mouth to administer gas; may be clea or tinted plastic or rubber material

Demand-valve resuscitator

Device attached to an oxygen mask to apply pressure to the oxygen flow and thereby inflate the lungs

AMBU-bag

Handheld squeeze device with a mask that is placed over the patient’s nose and mouth and used to force atmospheric air into the patient’s lungs; may also be attached to the oxygen supply to force oxygen to lungsEmer

gnecy tray

A tray assembled with materials and items necessary for emergencies; often supplied in kit form with medicines, administration items, and chemicals to be used for various emergency events, must be updated frequently and close at hand, all dental personnel should know how to use each item

Airway obstruction

Occurs when a blockage prevents the patient from receiving air into the lungs

Symptoms of airway obstruction

Inability to speak or make a noise, fearfulness, opened eyes, clutching of throat, and cyanosis

Abdominal thrust

Quick, jabbing pressure and force at belt line to force air up the windpipe

Asphyxiation

Not breathing; a result of oxygen imbalance

Chest thrusts

Applying quick pressure on the chest to force air upward in the windpipe to dislodge the obstruction; may be used on pregnant women as a substitute for abdominal thrusts

Cricothyrotomy

(ring, shield, cut) An insert or cut into the thyroid and cricoid cartilage to introduce an emergency air supply

Gastric distension

A condition resulting from air having been forced into the abdomen instead of the lungs

Heimlich maneuver

Procedure in which abdominal thrusts are applied to a choking patient, which forces air from the diaphragm upward to expel a blockage in the airway

Hypoxia

A lack of inspired oxygen

Stoma

An artificial opening into the windpipe that is placed between the mouth and lung; the opening is at the frontal base of neck into the windpipe for air intake

Tracheotomy

A cut and an isertion of a tube into the trachea for an emergnecy air supply

Cardiopulmonary resuscitation

CPR, combines artificial respiration with external cardiac massage CAB regimen is now what’s preffered

What is CAB

Compression, airway, breathing

CAB method

1. Perform immediate compression to distribute the oxygen already present in the lungs. The purpose of compressions is not to “restart the heart” but to circulate the victim’s blood supply

2. After 30 compressions, establish an open airway, and give two breaths

3. Maintain the breathing cycle with 2 breaths and 30 chest compressions at 100 compressions per minute rate

   Compression should be 2 inches deep using 1 hand, unless for infants, then it’s 1.5 inches using two-fingers

Rescuers should avoid leaning on chest

If present at an emergency involving an unresponsive victim

It is wise to survey the immediate surroundings fort the presence of life-saving devices that could be used such as an AED

AED

Automated external defibrillator, a mechanical/electrical device used to revive and stimulate the heart of a patient in cardiac arrest, dated electrode pads are placed on the patient’s chest to determine if pulseless ventricular tachycardia or a ventricular fibrillation is occurring

Airway device

Tube inserted into the mouth and down the throat to provide air to the windpipe

Compression

Force applied to the chest, providing pressure on the heart to imitate a heartbeat or pulsation

Finger sweep

Using a finger on the mouth of an unconscious person to locate and wipe out any airway obstruction

Sternum

“breastbone” the flat bone between the ribs

Xiphoid process

Lowest portion of the sternum with no ribs attached

Most common symptom of shock

Syncope (fainting)

How many basic types of shock are there

9

Anaphylactic shock

Shock arising from a reaction to a body allergen

Cardiogenic shock

Shock arising from an improper heart action

Hemorrhage shock

Shock arising from excessive blood loss

Metabolic shock

Shock arising from endocrine diseases and disorders, such as diabetes

Neurogenic shock

Shock arising from nervous impulses

Postural shock

Shock arising from a sudden change in body positions

Psychogenic shock

Shock arising from mental origins

Respiratory shock

Shock arising from insufficient breathing

Septic shock

Shock arising from a microbial infection

Allergic reaction

Caused by a person’s sensitivity to a specific antigen that can result in a variety of symptoms

Anaphylaxis

An allergy reaction of the body resulting in lowered blood pressure, swelling of the throat, shock and even death

Itching

A condition of irritation to the skin, scalp, or mucous membranes

Erythema

(skin redness) a red rash or blotching of the skin

Edema

A tissue swelling, enlargement of a body area

Vesicle formation

(small blister) Small, water blisters

Urticaria

(vascular skin reaction) Commonly called hives or wheals

Asthma

(panting) A chronic disorder characterized by shortness of breath, wheezing, and coughing caused by spasms of the bronchial tubes or swollen mucous membranes

Extrinsic asthma

Resulting from allergens entering the body

Intrinsic asthma

Resulting from bronchial infection allergens