Emergency situations and all hazards prep

What are the priorities in an emergency situation in the operating room

• First priority: Check for a provide a patent airway to ensure respiratory status

• Second priority: maintain or restore cardiovascular status and provide hemostasis to maintain circulatory status

How many minutes until brain damage occurs due to lack of oxygen

4-6

What are the warning signs of cardiac arrest?

• Chest pain ( in awake patients)

• Unstable blood pressure

• Tachycardia

• Cardiac dysrhythmias

• Respitory changes

• Hypovolemia

• Laryngospasm

What drug is typically administered first during resuscitation?

Epinephrine

What are the key components of high quality CPR?

• Early recognition of cardiac arrest

• Early activation of trained responders

• Early CPR

• Early defibrillation

• Early advanced cardiac life support

What are the surgical technologists responsibilities during a cardiac arrest in the operating room?

• Primary function is to protect the sterile field!

• May be required to use CPR skills in the OR if asked

How should they assist in maintaining sterility while responding to an emergency?

What is malignant hyperthermia?

Pharmacogenetic disorder developing during or after anesthesia

• Triggered by some anesthetic agents and possibly muscle relaxants

What agents or conditions can trigger malignant hyperthermia

some anesthetic agents and possibly muscle relaxants

What anesthetic agents are high risk triggers for malignant hyperthermia

• Halothane

• Enflurane

• Isoflurane

• Succinycholine

What are some early indications of MH (malignant hyperthermia) in a patient?

• Rapid increase in body temperature

• Unexpected tachycardia

• Unstable blood pressure

• Muscle rigidity

• Tachypnea (rapid shallow breathing)

• Cyanosis

What are the most important emergency responses when managing a MH crisis

The key is dantrolene

• Muscle relaxant that restores a healthy level of calcium in the muscle and reduces high body temperature

What substances are most likely to cause an anaphylactic reaction in the OR

• Local anesthetic

• Codeine

• Antibiotics

• Animal- derived drugs such as insulin

• Contrast media

• Latex

What are some possible physiological reactions that indicate anaphylaxis?

• Itching

• Swelling

• Difficulty breathing

• Hives

If symptoms are ignored, they can process to further difficulty breathing, vascular collapse, hypotension, tachycardia, and diminished urine output

Why is hemostasis critical during surgery

Vital to surgical success

How does excessive bleeding impact patient outcomes?

• Impacts visibility and ability to work

• Patient loses to much bloo

Define hemostasis

The body’s process of stopping bleeding and repairing damaged blood vessels by coagulation

What processes and techniques are used to stop bleeding intraoperatively

• Topical agents

• Tourniquets

How might the CST role change during an all hazards situation

Roles and duties may expand, and you may be asked to fill many roles typically not preformed on a daily basis

How should the CST prepare for such events in terms of training and emergency protocols

What does code blue indicate?

Cardiac arrest

What are some other codes commonly used in healthcare settings

• Code red- fire

• Code black- bomb threat

• Code white- evacuation

• Code green- emergency activation

• Code pink- missing child/ infant

• Code orange- hazardous spill

• Code violet- violent individual

• Code yellow- disaster

• Code brown- severe weather

• Code silver- active shooter

What do the different triage colors represent in a mass casualty situation?

Red- immediately

Yellow- delayed

Green- minor

Black- deceased