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Rad T 216
Adler/Carlton Ch 17 and 19
Aseptic Techniques
Medical Emergencies
Aseptic Technique
• The purpose of aseptic technique is to reduce the number of microorganisms.– Surgical asepsis – protection against infection
before, during, and after a procedure using sterile technique.
– Medical asepsis – removal or destruction of infected material
Radiology Procedures Requiring Sterile Technique
• Angiography
• Arthrography
• Hysterosalpingography
• Surgical procedures
Sterile Field
• A microorganism free area that can receive sterile supplies– Sterile drape– Sterile packages– Surgical scrub
• This will be dependent on the facility which exams require surgical scrub
– Numbered stroke
– Timed scrub
– Sterile gowning• Follows sterile scrubbing
Basic Principles of Sterile Technique
• Only sterile items in sterile fields• If you doubt the sterility considered it un-sterile• Create the field when ready not long before• Below the table or waist is considered un-sterile• Gowns are sterile on the sleeves and front from
the waist up• Un-sterile personnel cannot reach over or above
a sterile field• Sterile materials must be kept dry
Surgical Radiography
• Sterile Corridor– The area between the patient drape and
instrument table
What is an emergency?
• Sudden change in medical status that requires immediate attention
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
• Know the location of the nearest crash/emergency cart
Head Injuries
• Level of Consciousness– Any patient who has suffered a head injury
needs to be constantly monitored for changes to their level of consciousness
Types of Shock
• Hypovolemic– Loss of blood or tissue fluid
• Cardiogenic– Due to any number of cardiac problems
• Neurogenic– Spinal anesthesia or upper spinal cord trauma
• Vasogenic– Sepsis, deep anesthesia, or anaphylaxis
Signs and Symptoms of Shock
• Restlessness,
• Apprehension or general anxiety
• Tachycardia
• Decreasing blood pressure
• Cold and/or clammy skin
• Pallor
Contrast Media Reactions
• Anaphylactic or vasogenic shock
• Ranges from mild to severe– Impossible to accurately predict
• Generally, the longer it takes to develop the less severe
• If you suspect a reaction don’t hesitate call for help
Diabetic Crises
• Hypogylcemia– Excessive insulin
• Confusion, irritablility, • Patient needs carbohydrates
• Hypergylcemia– Excessive sugar in the blood
• Takes time to develop• Excessive thirst and urination• Can lead to diabetic coma
Respiratory Distress/Arrest
• Asthma– Stress may trigger an attack
• Allow the patient self-medicate, get them is a sitting position
• Choking– Heimlich maneuver
Cardiac Arrest
• ABCs
• Remember, the first step is to call for help before beginning CPR
CVA
• Sudden or protracted onset– Slurred speech, dizziness, confusion, loss or
blurred vision
Minor Medical Emergencies
• Nausea and vomiting– Maintain airway, patient on side
• Epistaxis– Lean forward and pinch the nose
• Vertigo and syncope– Recumbent, loosen clothing
• Seizures– Protect the patient from falling
Wounds
• Hemorrhage– Notice dressings, saturated dressings should not be
removed, a new one should be applied over the existing one
– Extremity- if possible put the extremity above the level of the heart
• Burns– Maintain sterile precautions
• Dehiscence– Sutures separate