Medical Emergencies Flashcards

Emergencies in Healthcare Settings

  • Employee Responsibility: Every employee within a healthcare facility must know the specific procedures for obtaining help during an emergency.

  • Emergency Communication: Healthcare facilities utilize special phrases or codes to communicate emergencies without causing panic.

  • Response Protocol: Once an emergency call or code is broadcast, designated staff members must respond immediately to the scene.

  • Healthcare Team Roles:

    • Provider.

    • Nurse.

    • Clinical medical assistant.

    • Administrative medical assistant.

Emergency Equipment and Supplies

  • Storage: Supplies and medications may be stored in small boxes or specialized crash carts depending on the facility's size and needs.

  • Crash Cart Maintenance:

    • Perform checks on the crash cart on a monthly basis.

    • Verify expiration dates on all medications and supplies.

    • Replace any old or used supplies immediately.

    • Security: Never break the tamper-evident lock or utilize items from the cart unless a legitimate emergency is occurring.

  • Oxygen and Airway Supplies: Found on crash carts to help providers maintain a patent airway. Types include:

    • Esophageal tracheal tubes.

    • Laryngeal mask airways.

    • Laryngeal tubes (available in various sizes).

  • Endotracheal Tube (ET) Intubation Kit:

    • Laryngoscope: A device featuring a curved or straight blade with the size indicated on the side or back. The medical assistant (MA) hands the scope with the attached blade to the provider.

    • ET Tubes: Cuffed tubes in sizes 7.57.5, 88, or 8.58.5 are used for adults and older children. Uncuffed tubes in sizes 2.52.5, 33, and 3.53.5 are used for younger children.

    • Stylet: A metal or flexible plastic wire inserted into the ET tube to provide a firm, curved shape; it is removed once the ET tube is successfully inserted.

    • Ambu-bag: Attached to the ET tube and equipped with oxygen tubing for air administration.

    • Stethoscope: Used to verify bilateral breath sounds after intubation.

  • Defibrillator: A device that delivers an electrical shock to the heart muscle to restore a normal heartbeat. It uses two handheld paddles placed on gel pads on the patient's chest. Automated versions are portable and lightweight.

  • Additional Supplies:

    • Personal Protective Equipment (PPE).

    • Algorithms (step-by-step diagnostic/treatment reference instructions).

    • Clipboard containing necessary documentation.

    • Backboard for CPR or spinal stabilization.

    • Extra batteries for electronic devices.

Emergency Medications

  • Amiodarone: Used to slow the heart rate (HR).

  • Atropine: Used to increase the heart rate (HR).

  • Calcium chloride: Used to increase serum calcium levels.

  • Diazepam: Used to affect chemicals in the brain, often for seizure control or sedation.

  • Diphenhydramine: Used to reduce the inflammatory effects of histamine during allergic reactions.

  • Dopamine: Used to stimulate the heart.

  • Epinephrine: Acts as a heart stimulant, vasoconstrictor, and bronchial relaxant.

  • Glucagon: A hormone that stimulates the liver to release glucose into the blood.

  • Lidocaine: Used to help regulate heart rhythm.

  • Magnesium: An electrolyte used to maintain a regular heart rhythm.

  • Naloxone: Used to block or reverse the effects of opioids.

  • Nitroglycerin: A vasodilator used for chest pain.

  • Sodium bicarbonate: Used to decrease the pH of the serum (addressing acidosis).

Pediatric Emergency Care

  • Dosing: Pediatric medications are strictly based on the child's weight.

  • Broselow Tape: A measuring tape used to estimate a child's weight and determine equipment sizes. It is placed from the top of the head to the child's heel.

  • Broselow ColorCode Carts: Pediatric crash carts where each drawer is color-coded to match the color zones on the Broselow tape. Colored drawers contain the specific equipment sizes and emergency medication dosages appropriate for a child in that weight/height range.

Handling Common Emergencies and Screening

  • Scenarios:

    • A patient currently being treated suffers a life-threatening occurrence.

    • An individual has an accident or health issue on-site.

    • A walk-in patient arrives with a critical health issue.

    • An individual calls the facility regarding a remote emergency.

  • Medical Assistant (MA) Role: In small facilities, the MA is often responsible for screening emergency calls and walk-in patients.

Temperature-Related Emergencies

  • Cold-Related Conditions:

    • Frostbite: Affects the cheeks, nose, ears, chin, fingers, and toes. Treatment involves removing wet clothing, moving to a heated room, and providing warm beverages. Do Not Rub the affected area and do Not provide alcohol.

    • Hypothermia: Occurs when the core temperature drops below 95∘F95^{\circ}F. Severe cases involve temperatures below 82∘F82^{\circ}F. Treatment includes moving to a warm location, removing wet clothing, and giving warm fluids (No alcohol). Seek medical care immediately.

  • Heat-Related Conditions:

    • Heat Cramps: Muscle spasms caused by electrolyte loss. Treatment involves resting in a cool location and drinking cooled electrolyte beverages (No caffeine or alcohol).

    • Heat Exhaustion: Caused by loss of fluid and electrolytes. Treatment involves moving to a cool location, drinking cool sports drinks, and taking a cool sponge bath or shower.

    • Heat Stroke: The most serious heat illness where the body cannot sweat or cool down. Core temperature exceeds 103∘F103^{\circ}F. Treatment involves moving to air conditioning or shade, spraying/sponging down an unconscious person, and seeking immediate medical attention.

Burns and the Rule of Nines

  • Degrees of Burns:

    • First-degree: Superficial damage to the epidermis characterized by Erythema.

    • Second-degree: Partial thickness damage to the epidermis involving blisters and possible scarring.

    • Third-degree: Full thickness injury involving the epidermis, dermis, and subcutaneous tissue. Features deep red, brown, gray, or black eschar. There is typically no pain because nerve endings are destroyed.

    • Fourth-degree: Deep full thickness injury extending beyond subcutaneous tissue into the muscle or bone.

  • Rule of Nines: A tool used by providers to estimate the percentage of Total Burn Surface Area (TBSA):

    • Head and Neck: 9%9\%

    • Arms, hands, and shoulders: 18%18\%

    • Chest/Abdomen (Anterior): 18%18\%

    • Back (Posterior): 18%18\%

    • Perineum: 1%1\%

    • Legs: 18%18\% per leg (9%9\% anterior, 9%9\% posterior per leg).

Poisonings and Allergic Reactions

  • Poison Entry: Can occur via swallowing, inhaling, injecting, or skin absorption.

  • Risk Groups:

    • Children ages 1—2 are at the greatest risk.

    • Children under age 6 account for nearly half of all poisonings.

    • Teens account for 40%40\% of poisonings, often suspected as suicide attempts.

    • Adult poisonings frequently involve analgesics, sedatives, hypnotics, or antipsychotics (20%20\%).

  • Common Toxins: Medications, illicit drugs, household products, indoor/outdoor plants, pesticides, fertilizers, and metals.

  • Anaphylaxis: A life-threatening allergic reaction.

    • Top Allergens: Food, insect stings, medications, animal dander, plants, and pollen.

    • Common Allergenic Foods: Eggs, fish, milk, tree nuts, peanuts, shellfish, soy, and wheat.

    • Symptoms: Flushed skin, shortness of breath, Dyspnea, throat swelling/tightening, cough, anxiety, pain, nausea/vomiting/diarrhea (NVD), palpitations, shock, and dizziness.

  • Insect Bites and Stings: May cause pain, burning, Erythema, numbness, swelling, or Pruritus.

    • Tick Removal: Wear gloves; use fine-tipped tweezers as close to the head as possible. Pull the head out slowly without squeezing the abdomen (to prevent regurgitation of secretions). Kill the tick in rubbing alcohol, clean the site with soap and water, apply antibiotic ointment, and monitor.

  • Animal Bites: Screening questions should include the type of animal, whether it is known/vaccinated, wound depth/cleanliness, and the date of the patient's last tetanus shot.

Diabetic and Neurologic Emergencies

  • Diabetic Emergencies: Occur due to blood glucose imbalances.

    • Hypoglycemia (Insulin Shock): Symptoms include blurry vision, palpitations, irritability, nervousness, headache, unclear thinking, shaking, and sweating.

    • Hyperglycemia (Diabetic Ketoacidosis/DKA): Symptoms include polydipsia (excessive thirst), hunger, nausea/vomiting, polyuria (excessive urination), dry mouth, and shortness of breath.

  • Musculoskeletal Emergencies: Treat all injuries as a fracture until diagnosed. Signs of severity include inability to move the extremity, deformity, exposed bone, or heavy bleeding.

  • Vertigo and Dizziness: First aid involves sitting or lying down; often symptoms of other disorders.

  • Concussion: A traumatic brain injury from a blow to the head; may require radiologic testing for skull fractures or internal bleeding.

  • Seizures: Sudden electrical activity in the brain. Types include Generalized, Focal onset, and Unknown onset. First aid focus is patient safety.

  • Cerebrovascular Accident (CVA/Stroke):

    • Types: Ischemic, Hemorrhagic, or Transient Ischemic Attack (TIA).

    • FAST Assessment: Face drooping, Arm weakness, Speech difficulty, Time to call 911.

Respiratory and Cardiovascular Emergencies

  • Respiratory Signs: Moist, flushed, pale, or bluish (ashen) skin. Slow, rapid, or shallow breathing. Audible gasping, gurgling, or wheezing. Patient may feel lightheaded or fearful.

  • Hyperventilation: Overbreathing that lowers CO2CO_2 levels; first aid focuses on raising carbon dioxide levels in the blood.

  • Asthmatic Attack: Airway constriction. Help patient sit upright, provide short-acting inhalers, and monitor pulse oximetry.

  • Choking:

    • Partial Obstruction: Patient can still speak/cough but has labored or noisy breathing.

    • Total Obstruction: Patient clutches throat, cannot breathe, cry, or speak; skin turns blue.

  • Syncope (Fainting): If feeling faint, sit with head between knees. If fainted, position on back and check pulse/airway.

  • Bleeding: Apply pressure and wear PPE/gloves. For nosebleeds, pinch the nostrils.

  • Shock: Inadequate blood flow requiring immediate 911 contact. Perform rescue breathing or CPR if the patient is unresponsive.

  • Myocardial Infarction (MI/Heart Attack): Chest pain, cold sweats, and heartburn. Patient should rest and remain calm. Call 911 within 5 minutes of pain onset. Have patient chew an aspirin or take prescribed nitroglycerin. Monitor vitals.

  • Recovery Position: Used for unconscious patients or if a staff member must leave the patient. The hand supports the head and the knee prevents the body from rolling onto the stomach to keep the airway clear.

Patient Coaching, Legal, and Ethical Issues

  • Coaching: Instruct all patients, including children, on how to contact EMS. Healthcare staff must maintain current CPR and first aid certifications.

  • Legal Responsibility: The physician is legally responsible for care administered by staff. MAs must know state-specific limitations and adhere to office policy.

  • Patient-Centered Care: Maintain communication and sensitivity. Staff should provide regular updates to families while strictly adhering to HIPAA rules.

Questions & Discussion

  • The presentation concludes by inviting questions from the audience to clarify aspects of medical emergency management and first aid procedures.