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Emergency:
Any situation in which the condition of the patient or a change in medical status makes necessary immediate attention and action.
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Role of medical imaging professional: (5)
- -preserve life
- -avoid further harm to patient
- -obtain medical assistance ASAP
- -be able to recognize emergency situation and initiate emergency measures.
- -demonstrate calm and confident presence.
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Emergency priorities: (6)
- -ensure open airway
- -control bleeding
- -prevent/treat shock
- -attend to wounds or fractures
- -provide emotional support
- -continually reeavaluate
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Facts on crash cart:
- -know location
- -familiarize with contents
- -availability reduces time to respond to medical crisis
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Emergency Equipment includes:
- -crash cart
- -oxygen
- -wall-mounted suction
- -AED
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Oxygen appearance/location:
located on walls, green in color
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2 types of AED:
- 1) fully automatic- does all the work
- 2) smiautomatic- you need to push button to deliver shock
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Radiology Emergencies: (8)
- -shock
- -anaphylaxis
- -pulmonary embolism
- -diabetic reactions
- -cardiac and respiratory failure
- -cerebrovascular accident
- -syncope
- -seizures
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Head injury facts:
- -assess patients level of consciousness
- -symptoms may not manifest right away
- -CT is prefered method of assessment
- -may have hematoma (blood clot) or brain swelling
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Levels of consciousness:
- -alert and conscious: least severe; respons fully to questions and other stimuli
- -drowsy: responds to loud speaking and gentle stimuli
- -unconscious: reacts only to painful stimuli (pinches and pinpricks) and no verbal stimuli
- -comatose: unresponsive to all stimuli
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Know your patient (head injury):
- -assess patient at beginning of procedure
- -note signs of deterioration from level to another
- -deteriorating head injury
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Signs of deteriorating situations of consciousness: (5)
- -irritability
- -lethargy
- -slow pulse rate
- -slow respiratory rate
- -changes in level of consciousness
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Response to deteriorating situations of consciousness: (5)
- -maintain open airway
- -minimize motion
- -stop radiographic procedure
- -get medical assistance
- -monitor vital signs
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Assessment of level of consciousness: (4)
- -ask patient to state name, date, address and reason for coming to radiology
- -note ability of patient to follow commands
- -access patients vital signs for baseline to note change
- -changes in patients neurologic status or LOC should never be ignored
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Shock:
Failure of the circulatory system to support vital body functions.
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The shock continuum:
compensatory stage- progressive stage- irreversible stage
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Progressive stage symptoms:
BP falls, tachycardia, chest pain, confused mental state and problems with kidneys, liver, bowel and spleen.
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Compensatory stage symptoms:
clammy skin, decreased urine output, increased respiration and anxiety
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Irreversible stage symptoms:
BP remains low, renal and liver failure, overwehelming lactic acidosis
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Classes of Shock:
- -neurogenic: caused by spinal anesthesis or damage to the upper spinal cord
- -hypovolemic: results from sudden decrease in intravascular fluid (15-20%)
- -cardiogenic: caused by hearts failure to pump an adequate supply of blood to vital organs
- -vasogenic: occurs when pooling of blood takes place in peripheral blood vessels
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Result of vasogenic shock:
- -decreased venous return of blood to heart
- -decreased BP
- -decreased tissue perfusion
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