More Medical Emergencies

Spinal Injuries

When there is question of the spinal cord injury, DO NOT move the patient until the injury is proven or disproven. If the patient must be turned, 3 to 4 people must use the "log roll".

The patient's spine should stay straight and all involved should move as a single unit. Do not let the patient move and keep the patient warm.

The patient may already be partially paralyzed, have trouble breathing or have bowel or bladder incontinence.

Fractured Extremity

A patient who has a fracture may have swelling, deformity of the limb, a grating sound when moved and possible shock. Make sure to keep the limb immobilize at all times.

Support the limb by placing one hand above the fracture site and the other hand below the fracture site. Make sure you support the extremity while the patient is moving.

Cerebrovascular Accident (CVA)

CVA - The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain. A CVA is also referred to as a stroke.

Symptoms:

1. The most common symptom is weakness or paralysis of one side of the body. The paralysis can be with partial or complete loss of voluntary movement or sensation in a leg or arm.

2. There can be speech problems and weak face muscles, causing drooling.

3. Numbness or tingling is very common.

4. A stroke involving the base of the brain can affect balance, vision, swallowing, breathing and even consciousness.

Cardiac Arrest

Cardiac arrest is the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. In cardiac arrest, death results when the heart suddenly stops working properly.

Heart attacks are caused by a blockage that stops blood flow to the heart. A heart attack (or myocardial infarction) refers to death of heart muscle tissue due to the loss of blood supply.

A myocardial infarction does not necessarily result in the death of the person. But, a heart attack could cause cardiac arrest and sudden death.

Diabetic Crisis

 

Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia.

There are 2 types of Diabetes:

1. Diabetes Insipidus

2. Diabetes Mellitus:

 

There are two types of diabetes mellitus:

•Type I

•Type II

 

Diabetes Insipidus - An uncommon condition that occurs when the kidneys are unable to conserve water as they perform their function of filtering blood. The amount of water conserved is controlled by antidiuretic hormone ADH, also called vasopressin. It is caused by a kidney or pituitary disorder. It is characterized by polyuria and thirst.

Symptoms:

1. Fever

2. Vomiting

3. Convulsions

If untreated, dehydration results, so fluid replacement is essential.

 

Diabetes Mellitus - A chronic metabolic disease caused by a disturbance in the production, action or utilization of insulin in the pancreas.

 

Type I (Previously known as juvenile diabetes) - Insulin-dependent form of diabetes.

Treatment for type 1 diabetes may include:

1. Taking insulin - Anyone who has type 1 diabetes needs lifelong insulin therapy.

2. Carbohydrate counting

3. Frequent blood sugar monitoring

4. Eating healthy foods

5. Exercising regularly and maintaining a healthy weight

The goal is to keep your blood sugar level as close to normal as possible to delay or prevent complications.

People with type 1 diabetes are more likely to lapse into diabetic coma.

Signs and symptoms:

1. Extreme thirst

2. Polyuria

3. Fruity-smelling breath

 

Hypoglycemic Reactions (Insulin Shock) - Caused by excess insulin and not enough sugar in the body (low blood sugar). Can occur when a patient takes the daily dose of insulin, but has not eaten. Occurs in Type I when insulin is taken and a meal is skipped

Sudden Onset (5-20 minutes)

Symptoms and Signs:

1. Shaking, nervousness, irritability, dizziness and hunger

2. Profuse perspiration, cold and clammy skin

 

Type II - Insulin-resistant form of diabetes., your body produces insulin, but does not use it properly. It is related to obesity.

Type 2 diabetes is the most common form of diabetes.

Treated with hyperglycemic drugs, these are oral diabetes medications that help control blood sugar levels.

 

Hyperosmolar hyperglycemic nonketotic (HHNK) syndrome is a emergent condition and occurs in neglected type II DM as a result of dehydration and hyperglycemia.

 

Hypoglycemia is a condition characterized by an abnormally low level of blood sugar (glucose). It must be treated very promptly because it interferes with the oxygen supply to nerve tissues, which can lead to severe brain damage and death.

Radiographer's Response - Administer some type of sugar immediately. You can give the patient sugar, a piece of candy, orange juice or other sugar containing foods.

 

Hyperglycemia ( Ketoacidosis) - Caused by insufficient insulin in the body. Occurs with the patient misses an insulin injection.

Slow Onset (6-12 hours)

Symptoms:

1. Weakness, drowsiness and a dull headache

2. Dry hot skin

Radiographer's Response - Notify a radiologist immediately. Sugar may be given as a preventative measure, sugar will not hurt a patient in ketoacidosis, but will save a hypoglycemic patient. Sometimes symptoms overlap and it is difficult to distinguish one reaction from another.

Treatment:

1. Candy

2. Sweet fruit juice

Emergency medications may include squeeze tubes of glucose gel administered inside patient's cheek.