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MEDICAL EMERGENCIES
Medical Emergencies Defined A situation in which the condition of the
patient or sudden change in medical status requires immediate action
Head Injuries Shock Diabetes Respiratory distress Cardiac arrest Cerebral vascular accident
The Radiologic Technologist Role
Preserve life Avoiding further harm Obtaining further medical
assistance Knowing when assistance is
warranted (most important)
General Priorities Ensure an open airway Control bleeding Take measures to prevent or treat
shock Attend to wounds or fractures Provide emotional support Continually re-evaluate and follow-
up appropriately
Emergency Cart Know location and contents
HEAD INJURIES
It is not the radiology technologist responsibility to diagnose, but it is useful to have basic knowledge for assessment purposes
LEVELS OF CONSCIOUSNESS Alert and conscious
Responds fully More serious
Drowsy, but can be roused Even more serious
does not respond to verbal commands, but can react to painful stimuli
Most Serious Unresponsive or comatose
Indications of Deteriorating Conditions
Irritability Lethargy Slowing pulse rate Slowing respiratory rate
Responses to Deteriorating Situations
Stop the procedure Make sure there is an open airway Obtain assistance Obtain vital signs while waiting
The Intoxicated Patient
Inebriated vs. head injury
SHOCK
Failure of the circulatory system to support vital body functions
Definition and Types Hypovolemic – due to loss of blood or
tissue fluid Cardiogenic – due to a variety of cardiac
disorders, including myocardial infarction
Neurogenic – due to spinal anesthesia or damage to the upper spinal cord
Vasogenic – due to sepsis, deep anesthesia, or anaphylaxis
Prevention
Maintain body temperature Avoid pain, if possible Minimize stress and anxiety
Signs and Symptoms
Restlessness Apprehension General anxiety Tachycardia Decreasing blood pressure Cold and clammy skin Pallor
Contrast Media Reactions(Anaphylactic Shock)
Any medication can be harmful if not administered properly
Moderate to severe As a general rule, the longer it takes
for a reaction to develop, the less severe it is
Typically most severe reactions arise immediately
Anaphylactoid reactions Allergic-like effects Thought to be caused by the release
of histamine Mild
Warm sensation, metallic taste, sneezing
Moderate Nausea, vomiting, itching
Severe Respiratory or cardiac crisis
Responses to Deteriorating Situations
Stop the procedure Make sure there is an open airway Obtain assistance Obtain vital signs while waiting
The role of the radiology technologist should be established in the procedures in each facility.
Very important to document condition of patient before and after event
INFILTRATION or EXTRAVASATION: contrast or medication enters soft tissue instead of vein
Signs: swelling, pain, burning, redness Cause: needle displacement
STOP EXAM IMMEDIATELY Apply ice if <30min Apply warm, wet compression of >30min
THE DIABETIC PATIENT
NPO prep may create problem If patient takes insulin without
food, insulin production and excretion may be altered due to lack of carbohydrates adjustment must be made
immediately
Hypoglycemia A condition in which excessive
insulin is present Taking insulin without food
Depletes body’s energy and quickly leads to insulin shock
Symptoms include:hungry, weak, shaky,
confused,sweaty, irritable
Hypoglycemia (con’t) Solution: Carbohydrates
Glucose tablets Orange juice sweetened w/sugar A sugared soft drink Candy bar, etc.
No food or drink should be given to an unconscious patient
Hyperglycemia
The condition of excessive sugar in the blood and is the characteristic typically associated with diabetes.
Symptoms: Excessive thirst and urination Dry mucosa Rapid and deep breathing Drowsiness and confusion
Hyperglycemia (con’t)
Solution:
Patient needs insulin
RESPIRATORY DISTRESS AND RESPIRATORY ARREST The Asthma Patient
Anxiety and stress of having the exam may cause reaction
The technologist role is to keep calm, as this will calm the patient
Allow patient to sit and determine if medical assistance is needed
The Choking Patient Evaluate the situation
“Can you speak?” Clutching throat Turning red in the face Encourage patient to cough
Use Heimlich maneuver if necessary
CARDIAC ARREST
Signs and Symptoms Crushing chest pain that may or may
not radiate down the left arm
CPR (Cardiopulmonary Resuscitation)
Alert the proper personnel before beginning
Cerebral function is generally impaired if the brain is deprived of oxygen for more than 4 to 6 minutes
3 Primary Aspects of CPR ABC’s1. Airway2. Breathing3. Circulation
Considerations DNR request
Once begun, basic life support should (and for legal reasons, must) be continued until the victim resumes spontaneous respiration and circulation, a physician or other responsible health care professional calls a halt, or the rescuer is too exhausted to continue.
Cerebrovascular Accident
Stroke Onset could be sudden or gradual
Paralysis Slurred speech Dizziness Vission loss Loss of consciousness
Minor Medical Emergencies
Nausea and vomiting Epistaxis Vertigo and syncope Seizures Falls
Nausea and Vomiting
Breath slowly and deeply Turn head to side and give patient
emesis basin
Epistaxis
Defined: nosebleed Lean forward, pinch nostril (do not
lean back) If not effective within 15 minutes, get
help
Vertigo and Syncope
Vertigo: dizziness Allow patient to sit or lie down
Syncope: fainting Temporary lack of blood flow to brain Allow patient to lie down with feet
elevated, loosen clothing
Seizures
Mild to severe Slight confusion or weakness, body
trembling and drooling Exam should be postponed
Protect patient with pillows, clear airway and summon help
Falls
Attempt should be made to minimize impact when possible and then proceed to get assistance
Wounds Hemorrhage: note condition, if
bleeding, apply pressure; if extremity, place above heart if possible
Burns: maintain sterile precautions, be extra gentle with patient
Wound dehiscence: uncommon; a patients sutures come apart and abdominal contents spill out
SUMMARY
Be alert and aware that emergencies do happen in the radiology department.
Respond in a calm and confident manner.