Emergency Care

Chapter 6

sphygmomanometer

instrument to measure arterial blood pressure; squeeze bulb, arm cuff, pressure dial

aneroid

an instrument that measures changes in air pressure without using a liquid

antecubital fossa

interior depression of the elbow; placement of stethoscope diaphragm to determine blood-pressure

brachial artery

artery of the upper arm; the site of blood pressure cuff placement

arrhythmia

irregular heartbeat

bradycardia

pulse rate under 60 beats per minute

tachycardia

an abnormal condition of pulse rates over 100 bpm

frequency

pulse count; number of pulsations, which differs with age, sex, body positions, health of patients

intermittent

occasional skipping of heartbeats

irregular

variation of force or frequency in pulse rate

apnea

temporary cessation of breathing

cheyne-stokes

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

rale

noisy or bubbly sounds from lung mucous, heard on inhalation

stertorous

rattling, bubbling, or snoring sounds that obscure normal breaths

aural

pertaining to the ear

fever

elevated body temperature 38.3 c (100-103 f)

hyperthermia

body temperature exceeding 40 c (104 f)

hypothermia

low body temperature below 35 c (95 f)

tympanic

pertaining to the eardrum; measurement of body heat registered by an ear thermometer

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

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 patients nose and mouth and used to force atmospheric air into the patients lungs; may also be attached to the oxygen supply to force oxygen to lungs

emergency 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. emergency trays must be updated frequently and close at hand. all dental personnel should know how to use each item.

cyanosis

bluish discoloration of the skin caused by lack of oxygen

abdominal thrust

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

asphyxiation

not breathing, results from oxygen imbalance (suffocation)

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

an insert or 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 insertion of a tube into the trachea for an emergency air supply

cardiopulmonary resuscitation (cpr)

a life-saving measure that combines artificial respiration with external cardiac massage

automated external defibrillator

a mechanical/electrical device used to revive and stimulate the heart of a patient in cardiac arrest

airway device

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

finger sweep

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

syncope

fainting

anaphylactic

shock arising from reaction to a body allergen

cardiogenic

shock arising from improper heart action

neurogenic

shock arising from nervous impulses

postural

shock arising from a sudden change in body positions

psychogenic

shock arising from mental origins

respiratory

shock arising from insufficient breathing

septic

shock arising from a microbial infection

anaphylaxis

an allergic 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

a red rash or blotching of the skin

edema

a tissue swelling, enlargement of a body area

urticaria

commonly referred to as hives, is a kind of skin rash notable for pale red, raised, itchy bumps. hives may cause a burning or stinging sensation.

extrinsic

resulting from allergens (animal, dust, foods) entering the body (usually affecting children)

intrinsic asthma

resulting from bronchial infection allergens (usually affecting older patients)

status asthmaticus

severe asthma attack that may be fatal

diabetic acidosis

a serious consequence of hyperglycemia when the patient has too much sugar and not enough insulin. the body produces acids and the ph level is lowered often resulting in a coma and death if left untreated.

glucose

the form of sugar that circulates in the blood and provides the major source of energy for body tissues. when its level is low, we feel hunger.

ketone

acidic substance resulting from metabolism; sometimes produces an acetone mouth odor similar to the odor of nail polish remover

epilepsy

chronic brain disorder characterized by recurrent seizure activity

petit mal

small seizures consisting of momentary unconsciousness with mild body movements or actions of staring off into space; sometimes called absence seizers

grand mal seizure

significant epileptic attack that may include an aura, unconsciousness, spasms, mouth frothing, incontinence, and coma

status epilepticus

rapid succession of epileptic attacks without regaining consciousness

aura

a subjective sensation that precedes a seizure; it could be auditory, visual, or motor.

clonic

seizure that involves the same jerking movements throughout the body

partial epilepsy

form of epilepsy consisting of convulsions, without loss of consciousness, that are restricted to certain areas, such as one side of the body

tonic seizure

seizure marked by continuous muscular tension, producing rigidity or violent spasms

incontinence

inability to control bladder and/or bowels

hyperventilation

the condition of taking abnormally fast, deep breaths

acapnia

absence of carbon dioxide

pericardium

membrane surrounding the heart

epicardium

outer layer of the heart

myocardium

muscular, middle layer of the heart

endocardium

inner lining of the heart

atrium

upper chamber of the heart

ventricle

the two lower chambers of the heart; little belly

valve

a structure for temporary closing of the blood vessels; valves also control the flow of blood through the heart

atrioventricular orifice

opening between the atrium and the ventricle on each side of the heart where valves are situated

semilunar valves

heart valves. the aortic valve is found at the entrance of the aorta to the heart, and the pulmonary or tricuspid valve is situated between the right atrium and the right ventricle of the heart. the mitral, or bicuspid valve, is on the left side between the atrium and the ventricle

aorta

main artery that exits from the heart

murmur

abnormal sound heard over the heart or blood vessels, an indication of improper blood flow or valve action

arteriosclerosis

thickening, hardening, and loss of elasticity of the walls of the arteries

atherosclerosis

blocking of larger artery from plaque buildup

angina pectoris

a pain in the chest caused by a heart malfunction

myocardial infarction

necrosis of a portion of cardiac muscle caused by partial or complete occlusion of one or more coronary arteries; also called heart attack

bacterial endocarditis

sometimes termed infective endocarditis, an inflammation of the heart lining of patients who have had rheumatic fever, open-heart surgery, body part replacements, or implants. although this is not an immediate emergency chairside threat, these patients require pretreatment with antibiotic therapy to ward off future infections

nitroglycerin

medication for the immediate relief of heart pains, particularly angina pectoris

cerebrovascular accident

stroke; a common illness related to the blood supply and circulation

hemorrhagic stroke

occurs when a blood vessel in some part of the brain weakens and bursts open causing damage to the brain cells; occurs in 15% of strokes

ischemic stroke

caused when the blood supply to the brain is blocked by either a blood clot traveling to the brain (embolic shock) or a blood clot forming in an artery (thhrombotic stroke); 85% of strokes

transient ischemic attack (tia)

localized, temporary anemia resulting from an obstruction of the blood circulation

ischemia

a holding back of blood

embolism

a floating clot in blood vessel or air bubble that may lodge in blood vessel or brain

infarction

a decreased blood supply causing necrosis or tissue death

thrombosis

a clot forming in a blood vessel; atherosclerosis

hemiplegia

paralysis of one side of the body

aneurysm

ballooning of a weakened portion of an arterial wall

alveolitis

dry socket, infection associated with loss of blood clot following an extraction

avulsed

torn away or dislodged by force

epistaxis

nosebleed

astringent

treatment for hemorrhage, agent that has a binding effect; constricts