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.