Hypertension (HBP) CategorySystolicDiastolic Normal 100
Classifications of BP Levels in Adults
Slide 3
Hypertensive Emergency Symptoms similar to MI (heart attack) or
CVA (cerebrovascular accident or stroke) difficult to determine
exact emergency 12-12 Sudden increase in BP > 180/110 often as
high as 220/140 Dyspnea(labored breathing) Chest pain
Dysarthria(difficulty speaking) Weakness Altered consciousness
Visual loss Seizures Nausea/vomiting Eventually coma
Slide 4
Hypertensive Emergency Treatment Treat quickly to reduce BP to
prevent further end organ damage like acute MI, aortic dissection
or CVA. Treating hypertension secondary Seat patient upright
Contact EMS Monitor vital signs Administer O 2 4-6L/minute In
hospital pt will receive a vasodilator or nitroglycerin. 12-12
Slide 5
Hypotension Treatment Position supine with feet raised Assess
airway Administer O 2 4-6L/minute Monitor vital signs If no
improvement, contact EMS 12-12
Slide 6
Shock Condition produced when the cardio-vascular pulmonary
system fails to deliver enough oxygenated blood to body tissues to
support metabolic needs. Tissues use anaerobic (without air)
metabolic processes. Produces acidosis (increased acidity in blood)
and harmful toxins.
Slide 7
Shock Basic positioning Upright Semi upright Supine and horz
with the brain on the same level as the heart If face RED = raise
head Face is Pale = raise the tail
Syncope(cerebral ischemia) Sudden, transient loss of
consciousness and postural tone with spontaneous recovery. Often
caused by loss of cerebral oxygenation and perfusion Often sign of
another underlying condition Often associated with a stressful
condition Most common med ER in the dental office Most syncopal
episodes occur during the administration of local anesthetics.
Slide 10
Slide 11
Types of syncope Cardiac: usually from underlying heart
disease, common from arrhythmias or obstructions of the heart,
potentially fatal, referral to MD Noncardiac: due to seizures,
orthostatic hypotension, situation occurrences(coughing, urinating,
Valsalvas maneuver-forced expiratory effort against a closed
airway, hyperventilation, metabolic disease(hypoglycemia,
hypoxemia: low oxygen in blood) Neurocardiac: most common form
encountered by dental professionals, associated with pain, fear,
exhaustion, illness, activation of the autonomic nervous system:
fight or flight response
Slide 12
Treatment of Syncope Remove objects from oral cavity Position
supine with feet elevated Open airway Assess circulation Loosen
tight clothing Administer oxygen, 4-6L/minute Monitor vital signs
Call EMS if symptoms do not change 12-12
Slide 13
Treatment of Syncope If unconsciousness persists summon EMS No
longer recommended to use ammonia inhalants due to adverse side
effects in some patients. Longer patient in syncope more likely
seizure will occur. Recurrence of another syncopal episode is at a
higher risk for the first 24 hours following the episode. Once
consciousness returns Keep pt in supine position until patient
feels well enough to be returned to upright position and pulse
returns to normal. 12-12
Hyperventilation: signs & symptoms Lightheadedness,
dizziness, impaired vision Seizures possible Can cause
hypocalcemia: reduction in calcium levels in blood Tetany: caused
by low calcium levels, manifests as twitching of muscles or spasms,
with sharp flexion of wrist and ankle joints(carpopedal spasms)
Numbness of extremities: parasthesia Chvosteks sign: from
hypocalcemia-an abnormal spasm of the facial muscles elicited by
light taps on the facial nerve.
Slide 16
Hyperventilation Management Operator remain calm Place patient
in position of their choice: usually upright Loosen tight clothing
in neck area Work with patient to control rate of respirations Have
pt count to 10 in one breath Breath through pursed lips or nose NO
MORE PAPER BAGS: can cause suffocation and cardiac arrest.
Slide 17
Hyperventilation treatment Monitor vitals DO NOT ADMINISTER
OXYGEN: can make condition worse. Administer benzodiazepine
(Lorazepam 1-2mg IM or Diazepam 2-5mg IM) We do NOT have in clinic
No improvement call EMS
Slide 18
Asthma Airways are hypersensitive to certain triggers known as
stimuli. In response to the stimuli the bronchi contract into spasm
resulting in dyspnea (difficulty in breathing). Inflammation is the
result of the bodys immune response to inhaled allergen.
Inflammation leads to airway narrowing and mucus production which
leads to coughing and wheezing on expiration and inspiration.
Slide 19
Asthma Bronchial inflammation is the result of the bodys immune
response to an inhaled allergen. Typical allergens: waste from
household insects, grass, pollen, mold, pet epithelial cells Cause
body to initiate humoral immune response which produces antibodies
Immunoglobulin E (IgE)is the specific antibody for environmental
allergens Causes inflammatory response leading to asthma attack
symptoms
Slide 20
5 types of Asthma Extrinsic Intrinsic Drug-induced
Exercise-induced Infectious
Slide 21
Extrinsic Most common 50% of all asthmatics Inherited allergic
predisposition Triggers or stimuli from outside of body Pollen,
dust, mold, tobacco smoke Dental office: eugenol, impression
materials, resins, latex
Slide 22
Intrinsic asthma Second major category Develops in adults over
the age 35, but can be found in children Triggered by psychological
and physiological stress example: dental appointments
Slide 23
Drug-induced asthma NSAIDS: nonsteroidal anti-inflammatory
drugs like ibuprofen and aspirin. Metabisulfite: a preservative
found in some foods or local anesthetics containing
epinephrine
Slide 24
Exercise induced Begins shortly after start of exercise
resulting in severe bronchospasms. Inhalation of cold air may
provoke mucosal irritation and airway hypersensitivity. Often found
in children and young adults due to increased activity levels.
Slide 25
Infectious Viral infections of respiratory tract most common
cause. Frequently seen in children and results in increased airway
resistance caused by inflammatory response to the bronchi to
infection. Treatment of infection reduces asthma symptoms.
Slide 26
Treatment of asthma attack Prevention of acute episodes in
dental setting important goal. Including limiting exposure to known
allergens and identified triggers. Patients should bring
bronchodilator to appointment and should have ready access. Nitrous
oxide not contraindicated, but used with judgment of patient
symptoms. Local anesthetics with epinephrine may trigger attack not
recommended.
Slide 27
Treatment asthma attack Stop treatment Position patient upright
with arms forward Self-administer own bronchodilator Inhale slowly
and exhale through pursed lips If patient does not have own inhaler
use inhaler from emergency kit Albuterol recommended fast acting
and long duration (4-6 hours)
Slide 28
Treatment of Asthma Attack Position patient upright with arms
forward Self-administer own bronchodilator Inhale slowly and exhale
through pursed lips If patient does not have own inhaler use
inhaler from emergency kit Albuterol recommended fast acting and
long duration (4-6 hours) 1-13
Slide 29
Resp Emerg: COPD Management Emphysema, bronchitis, chronic
asthma Manage sitting upright and encourage coughing Low flow O 2 :
too much can reduce hypoxic drive May not be able to breathe on own
again
Slide 30
Cardiac Emergencies Categories 1. Congestive Heart Failure 2.
Chest Pain 3. Angina 4. Angina and MI 5. Angina vs AMI
Slide 31
Cardiac Emerg: Congestive Heart Failure RT heart failure Edema
ankles Cyanotic Prominent jugular veins More popular LF heart
failure Dyspnea, coughing, orthopnea Congestive heart failure:
combo of both, sign will be Pink frothy sputum (saliva and blood
mixed) Manage: seated upright and initiate CPR LIFE
THREATENING!
Slide 32
Cardiac Emerg: Chest Pain Criteria: acute, substernal pain,
conscious victim Angina or AMI Management Position comfortable ABCs
Definitive care: hx of angina admin nitroglycerine 0.3mL if needed
up to 3x then call EMS. Admin O 2 90- 100% No hx angina: same as w/
angina except use AED if needed. May admin ASA 325mg or 50/50 N 2 O
Monitor pt
Slide 33
Nitroglycerine Fairly unstable med Allow pt to admin their own
Various types: sprays, pill, patch Never give to pt with low blood
pressure Do not give to pt who has consumed alcohol
Slide 34
Angina Chest pain due to angina is one of the more common
medical emergencies in the dental office. Angina due to inadequate
supply and/or increased demand for oxygen to the myocardium
(myocardial ischemia). Clinicians should be aware of the patients
whose medical hx indicate past incidences of angina. CAD,
presenting as angina or AMI, is the leading cause of sudden death
in the US.
Slide 35
Cardiac Emerg: Angina and MI Symptoms similar Pale, cool skin
Chest pain: possible after exertion/meal/stress Substernal pain
Levine sign (hand on chest from pain) What is the Difference? MI
pain more intense and lasts longer Not relieved by nitroglycerine
tablets Diabetics may experience a silent MI: because of
neuropathy, may not even feel it
Slide 36
Cardiac Emerg: Angina vs AMI Acute Myocardial Infarction (AMI)
May or may not have previous hx of disease Not relieved by
nitroglycerine Longer duration
Slide 37
Acute Myocardial Infarction (AMI) Necrosis of a portion of the
myocardium due to total or partial occlusion of a coronary artery.
Occlusion caused by atherosclerosis, thrombus, or a coronary spasm.
May form rapidly or over a period of time. MI can lead to cardiac
arrest: when the heart fails to beat. Providing basic life support
prior to EMS arriving could save a life. 1-13
Slide 38
Acute Myocardial Infarction (AMI) Cardiac dysrhythmia may occur
after MI and is a high risk for death Dysrhythmia may present as:
Bradycardia Ventricular tachycardia rapid contraction with
inadequate ventricular filling Ventricular fibrillation
disorganized, irregular contraction of ventricles Asystole absence
of heart contraction 1-13
Slide 39
Signs and Symptoms of AMI Classic symptom: chest pain lasting
20 minutes or longer Pressure, tightness, heaviness, burning,
squeezing, crushing sensation in middle of chest and/or lower 1/3
of epigastrium Pain may radiate down arms, shoulders, jaw, or back
1-13
Slide 40
Signs and Symptoms of AMI Weakness, dyspnea, diaphoresis,
irregular pulse, nausea, vomiting, sense of impending doom,
clutching chest (Levine Sign) Women show different symptoms:
atypical discomfort, upper abdominal pain, shortness of breath,
fatigue Diabetics suffer silent MIs. The elderly show signs of
shortness of breath, dizziness, pulmonary edema, and/or an altered
mental status 1-13
Slide 41
Treatment of AMI Recognize signs and symptoms Terminate
procedure If there is a history of angina, follow protocol for
angina If no history of angina, contact EMS immediately Position
patient comfortably, probably upright or semi-supine Assess ABCs
1-13
Slide 42
Treatment of AMI Administer oxygen 4-6L/minute via nasal
cannula Monitor vital signs: taken before giving nitro or
immediately after. Administer nitroglycerine from emergency cart 3
doses over a 15 minute period Do not give nitroglycerine to
patients with low blood pressure Nitroglycerin should alleviate
pain within 2 to 4 minutes If pain diminishes and then returns,
most likely AMI 1-13
Slide 43
Treatment of AMI Administer aspirin chewed 325 mg.
antithrombotic effect clinical effect reached in 20 minutes Aspirin
should be chewed to enter bloodstream quicker Manage pain to
prevent cardiogenic shock with nitrous oxide, if available If
cardiac arrest occurs, perform CPR with AED 1-13
Slide 44
Cerebrovascular Accident (CVA) Interruption of blood flow to
the brain Symptoms Severe headache Paralysis Slurred speech, slowed
reactions Management Semi-upright ABCs Lay pt paralyzed side down
when possible BLS, EMS No drugs admin. GET THEM TO HOSPITAL!
Slide 45
CVA: cerebrovascular accident AKA stroke, brain attack Abnormal
condition of the brain characterized by occlusion or hemorrhage of
a blood vessel resulting in lack of oxygen (ischemia) Leads to cell
death Using brain attack instead of stroke so people will become
more familiar with the signs and symptoms 12-12
Slide 46
CVA Second leading cause of death world wide 4.6 million
annually United States third leading cause of death and disability
700,000 cases per year 100,000 recurrent strokes per year
12-12
Slide 47
CVA: Treatment Primary goal in CVA treatment is to minimize the
cognitive and physical limitations associated with the CVA Contact
EMS immediately Position semi-supine Basic life support check
airway, breathing, and circulation Administer O 2 4-6L/min if
patient is having dyspnea (shortness of breath) or shows signs of
hypoxia (body showing signs of lack of oxygen) Test glucose levels
to rule out hypoglycemia 12-12
Slide 48
CVA: Treatment Monitor vital signs Transport to ED as soon as
possible Aspirin for ischemic CVA reduces death and recurrence
rates Aspirin for intracranial hemorrhage CVA patients also
improved outcomes however not recommended to be administered by
anyone but a healthcare provider in the emergency department
12-12
Slide 49
CVA: Treatment In hospital CT scan to determine etiology
Hemorrhagic probably surgery Ischemic < 3 hours onset of
symptoms then IV thrombolytic therapy with altaplase (r-tPa)
removes thrombus or embolus to restore blood flow Ineffective after
3 hours Contraindicated for hemorrhagic CVA because it can lead to
further brain bleeding. 12-12
Slide 50
New info about strokes New evidence that there is a
relationship between early tooth loss and both ischemic and
hemorrhagic CVA. Theory is that the relationship between the
microorganisms that cause periodontal disease, a chronic oral
infection, producing more inflammatory markers and clotting
factors, leading to an increase in platelet aggregation, thus
contributing to atherosclerosis and thrombi formation. Another
theory states that diseases that cause caries and perio disease are
linked with CVA due to the fact that they share some common
lifestyle factors.
Slide 51
Diabetes Millitus Metabolic disorder characterized by
hyperglycemia Etiology: reduction or absence of production of
insulin by beta cells of pancreas or defect of insulin receptors
Insulin aids in conversion of sugar and starches to a form
transported to cells and used for energy
Slide 52
Diabetes 3 types Type 1 (formerly IDDM or Juvenile) Type 2
(formerly NIDDM or adult onset) Gestational 4th category
pre-diabetes or impaired glucose tolerance
Slide 53
Type 1 Absolute lack of insulin Pancreatic beta cells within
Islets of Langerhans destroyed due to immune dysfunction In Islets
of Langerhans: alpha cells secrete glucagon- raising blood glucose;
beta cells secrete insulin lowering blood glucose. Dependent on
supplemental insulin for survival 5-10% of all diabetics
Slide 54
Type 2 This type of diabetes is increasing comprising 90-95% of
all diabetics due to: Increase in life span Sedentary lifestyle
Poor diet and exercise of adolescents Pancreas unable to produce
sufficient insulin or the body is not able to use the insulin that
is produced
Slide 55
Gestational diabetes Glucose intolerance with initial onset
during pregnancy Usually disappears after pregnancy, but may return
years later Etiology: enzyme in placenta and destruction of insulin
by placenta causes the development of gestational diabetes. If
untreated infant can have fetal macrosomia (big baby syndrome),
hypoglycemia, hypocalcemia, or hyperbilirubinemia( too much
bilirubin in infants blood and the newborns liver can not process
the bilirubin causing jaundice. Bilirubin is produced in the liver,
when the liver breaks down red blood cells
Slide 56
Role of Dental Professional Questions to ask all diabetic
patients Do you monitor glucose levels? If so, how often? What were
your most recent glucose levels? How are you feeling? Do you take
medication and if so, did you take it today? 1-13
Slide 57
Role of Dental Professional Questions to ask all diabetic
patients Have you eaten today? If so, when? Are you having problems
with your eyes, feet, legs? Do you see your physician regularly? Do
you see an eye doctor yearly? Do you know your average hemoglobin
value? 1-13
Slide 58
Role of Dental Professional Strategies to implement: Schedule
appointments in early to mid-morning Keep appointments short
Instruct patients to continue normal dietary intake prior to
appointment Check patients blood glucose level prior to any
invasive procedure or if patient complains of not feeling well
1-13
Slide 59
Role of Dental Professional Strategies to implement: Frequent
recall examinations and prophylaxis Use of topical fluoride:
Prevident 5000 paste or gel, Gelkam Recommending saliva
substitutes: Biotene or Oral Balance 1-13
Slide 60
Diabetic Medical Emergencies Many 4 major Diabetic retinopathy
Diabetic neuropathy Diabetic nephropathy Oral Manifestations
1-13
Slide 61
Retinopathy Common sequela (resulting from) diabetes Leading
cause of blindness age 20 74 Mild form increased vascular
permeability Moderate form vascular closure Severe form growth of
new blood vessels on retina and posterior surface of vitreous(layer
of collagen) Macular edema or a retinal thickening from leaky blood
vessels can develop at all stages of retinopathy Prevention: early
screening for diabetes and glucose control.
Slide 62
Neuropathy Mild to severe forms of nervous system damage
affecting 60-70% of diabetics. Condition not well understood.
Common symptoms: pain in the feet and hands, slow digestion, other
neurological problems.
Slide 63
Macrovascular and Microvascular Complications Microangiopathic
changes where the basement membrane of the capillaries thickens and
can lead to the formation of a thrombi, impeding blood flow.
Diminished blood flow can increase the risks of a stroke and/or
myocardial infarctions. Lack of blood flow to nervous tissues can
damage the nerves. Gangrene: loss of blood to a part of the body
increasing the risk of losing a limb.
Slide 64
Diabetic Nephropathy (kidneys) Damages small blood vessels in
kidneys Impairs ability to filter impurities from blood Require
transplant or dialysis to cleanse blood Once occurs 100% morbidity
within 10 years
Slide 65
Oral Manifestations of Diabetes Increased incidence of: Delayed
wound healing leading to secondary oral and systemic infections
Periodontal disease Abscesses Xerostomia (dry mouth) Caries Lichen
planus (white lacy streaks on oral mucosa) Candidiasis (yeast
infection in the oral cavity)
Slide 66
Monitoring Best method to avoid complications is to maintain
optimum glucose levels. Diabetics test blood several times a day
Glucose monitor used Lancet drop of blood Placed on test strip
Inserted into a calibrated glucometer which will display the
patients blood glucose readings.
Slide 67
Glucose Readings Normal reading 50 150 mg/dL Less than 50
hypoglycemic Greater than 150 hyperglycemic Adjustment in
medication needed or referral to MD
Slide 68
Diabetic Medical Emergencies Diabetic Ketoacidosis (DKA)-
severe hyperglycemia Hyperosmolar Hyperglycemic Nonketotic Syndrome
(HHNKS) Hypoglycemia
Slide 69
Diabetic Ketoacidosis (DKA): severe hyperglycemia Not a common
occurrence in dental office Types of patients at risk for DKA Newly
diagnosed Type 1 diabetics Patients that are not medicating or
eating properly Brittle diabetics(when type 1 diabetics have
unstable glucose levels) Patients with infections Alcohol and
cocaine
Slide 70
Diabetic Ketoacidosis (DKA) Etiology: insufficient insulin
levels in blood to sustain normal fat metabolism- severe
hyperglycemia Glucose metabolism insufficient energy source so body
metabolizes fatty acids for energy By products of fatty acids are
ketones which cause the blood to be more acidic Ketones are one of
a number of substances that increase in the blood as a result of
faulty carbohydrate metabolism Ketones excreted in urine along with
sodium and potassium can cause a severe electrolyte
disturbance
Slide 71
Diabetic Ketoacidosis (DKA) Body exhales carbon dioxide in an
attempt to reverse acidosis Leads to tachypnea and increased depth
of respirations Kussmaul respirations (air hunger)
Slide 72
Signs and Symptoms of DKA Alteration in mental status Ranging
from drowsiness to coma Dehydrated poor skin turgor Skin and mucous
membranes warm and dry Increased thirst Muscle weakness, severe
fatigue, and difficulty walking
Slide 73
Signs and Symptoms of DKA Nausea and vomiting Blurred vision
due to fluid accumulation in lens of eye Tachypnea and Kussmaul
breathing Fruity odor on breath Hypotension Tachycardia In
children: cerebral edema is a common complications with a high
mortality and morbidity rate.
Slide 74
Treatment of DKA Determine an accurate blood glucose level Need
to lower blood glucose level with insulin Should only be
administered by medical professional to prevent hypoglycemia
Contact EMS IV fluids needed to reverse dehydration Monitor vital
signs Position patient supine
Slide 75
Hyperosmolar Hyperglycemic State Patient will be hyperglycemic
and dehydrated, but not acidotic Usually affects infirm, neglected,
institutionalized, or mentally deficient diabetic patients Cannot
recognize thirst Uncommon in dental office
Slide 76
Severe Hypoglycemia Used to be known as insulin shock Blood
glucose level below 40 50 mg/dL (milligram per deciliter) Severe
hypoglycemia affects 30% of diabetics Etiology: missed meal,
alcohol, increased exercise without adjusting insulin dosage
Slide 77
Signs and Symptoms of Severe Hypoglycemia Dizziness Fainting
Weakness Headache Intense hunger Cold, clammy skin More likely to
occur in dental office than DKA or Hyperosmolar state
Slide 78
Signs and Symptoms of Severe Hypoglycemia Profuse perspiration
Irritability or aggressive behavior Confusion Seizure Eventually
coma
Slide 79
Treatment of Severe Hypoglycemia Conscious Patient Administer
15-20 grams of sugar: table sugar, honey, candy, OJ, glucose
tablets/paste Secure airway Monitor vital signs Positive response
should occur within 10 15 minutes
Slide 80
Treatment of Severe Hypoglycemia Unconscious Patient Tx of
choice is Glucagon: 1 mg administered subcutaneously,
intramuscularly or intravenously. Contact EMS Maintain airway
Monitor vital signs
Slide 81
Thyroid Hypothyroidism: emergency is Myxedema Coma
Hyperthyroidism: emergency is Thyroid Storm Management Supine w/
legs slightly elevated ABCs Call EMS Admin IV 5% dextrose if
available and O 2 Hospital Care Hypo: mass doses of thyroid hormone
for days Hyper: mass doses of antithyroid drug propranolol to block
andrenergic-medicated effects of thyroid hormones and lg doses of
glucocorticosteroids to prevent acute adrenal
Slide 82
Thyroid Storm Life threatening Exacerbation of hyperthyroid
state Etiologies: undiagnosed hyperthyroid disease, overzealous
treatment of hypothyroidism, discontinuance of medication, trauma,
infection, DKA, CVA, stress, toxemia of pregnancy, fright, surgery
10 50% fatal 1-13
Slide 83
Signs and Symptoms of Thyroid Storm Exaggeration of
hyperthyroid symptoms Fever: as high as 108 degrees F. Diaphoresis
CNS restlessness, confusion, anxiety, psychosis Pg 212, Table 18.2
1-13
Slide 84
Signs and Symptoms of Thyroid Storm GI symptoms nausea,
vomiting, diarrhea, jaundice Increased systolic BP Widened pulse
pressure Arrhythmias 1-13
Slide 85
Seizures Criteria: unconscious victim, tonic-clonic seizure
activitiy Most critical stage if the postictal phase (once seizure
has stopped) Airway management imperative If unconscious: might
close off airway Management Prevent injury, NEVER place fingers in
mouth ABCs Low O 2 after seizure: EMS needed Key time=5min. If
seizure longer= call EMS
Slide 86
Seizures See handout for Types
Slide 87
Allergy Usual progression Skin eyes nose GI Resp - Cardio
Allergic rxns Mild to mod usually involves skin, eyes, nose,
sometimes resp Anaphylaxis Severe allergic response Involves all
systems, esp resp Will lead to cario collapse and death
Slide 88
Allergy Management Position comfortable ABCs Admin Benadryl
50mg tablets for 2-3 days, 3-4x/day or Benadryl IM Anaphylaxis:
admin a pre-loaded epi syringe sublingually 0.1ml for a total of 3
doses every 5min Call EMS, pt will need more then epi
Local Anes Overdoes Situations Unconscious pt Pre-Injenction
Stage: hyperventilation or syncope Supine, syncope management, calm
pt During Injection: allergy Admin epi if severe Admin benadryl if
mild Post-Injection: overdose Manage symptoms and monitor
vitals
Adrenal Crisis Body severely lacking cortisol 2 reasons:
Individual not yet diagnosed needs cortisol to maintain
carbohydrate and protein metabolism Often happens as this condition
mimics other illnesses like gastrointestinal illness or psychiatric
disease. 1-13
Slide 93
Adrenal Crisis 2nd reason: Patient with adrenal insufficiency
in a stressful situation and requires additional cortisol Often
occurs in individuals on long time steroid therapy and the adrenal
cortex atrophies. 1-13
Slide 94
Signs and Symptoms of Adrenal Crisis Fatigue Lethargy Muscle
weakness Headache 1-13
Slide 95
Signs and Symptoms of Adrenal Crisis Confusion Fever Nausea
Vomiting 1-13
Slide 96
Signs and Symptoms of Adrenal Crisis Abdominal pain Hypotension
when coupled with stress can lead to shock and cardiovascular
collapse Tachycardia Diaphoresis- profuse sweating Dehydration
1-13
Slide 97
Treatment of Adrenal Crisis Contact EMS Stabilize until EMS
arrives Maintain airway Monitor vital signs 1-13
Slide 98
Treatment of Adrenal Crisis Administer O 2 if needed IV fluids
needed, as well as glucocorticoids which should only be
administered by medical professional Therapy will help alleviate
cardiac arrhythmias, GI disturbances, hypotension, and electrolyte
inbalance 1-13
