MEDICAL

EMERGENCIES
 ANAPHYLAX
IS
• Exaggerated response by the body to a substance.
• Anaphylaxis is an extreme allergic reaction that is
life threatening and involves multi organ system.
Sign and Symptoms:
• Involvement of skin and mucosal tissues (urticarial,
pruritus or flushing, swollen lips tongue, uvula) also
known as angioedema.
• Respiratory compromise (e.g.; difficult breathing,
bronchospasm, stridor)
• Reduced blood pressure or associated symptoms
of end organ dysfunction (e.g.; collapse)
• Persistent GIT disturbance (e.g.; abdominal cramp,
nausea, vomit, diarrhea)
CAUSES:
• Almost any substance can trigger the body's
immune system
• Insect bites and stings (like: insects, ants or
honeybee)
• Medications
a. Penicillin
b. Even if med taken previously its no guarantee.
c. Slower onset >30 min if oral meds
• Plants
• Pollen
• Dusts
 Management
• ABCD
• AB > comfortable
• C > raised legs
• Trigger and move
• Administer high flow oxygen (15 liter/minutes)
• I/M adrenaline
• Pt who have pulse should not have adrenaline
administered IV.
• In event of cardiac arrest, however, patient should
receive adrenaline IV repeated after 5 minutes.
• IV access, senior clinician may administer fluid and
consider other second line treatments like
antihistamines and hydrocortisols.
AUTO-INJECTORS

• Patient who are known to have anaphylactic

reactions may be provided with there own
adrenaline auto-injector.
Diabetes
• Common metabolic disorder
• Chronic high blood sugar level (hyperglycemia)
• Low blood sugar level (hypoglycemia)
Types of Diabetes:
• TYPE 1:
Insulin dependent diabetes( IDDM)
Unable to produce any insulin
Auto immune disease destroys the insulin produce
by beta cells in pancreases.
• TYPE 2:
Insulin resistant is developed, insulin is deficient.
Diet Controlled
INSULIN
• It regulates the metabolism of carbohydrates, fats
and protein by promoting the absorption of,
especially glucose from the blood into liver, fat and
skeletal muscle cells. In these tissues the absorbed
glucose is converted into either glycogen.
• Beta cells are sensitive to glucose concentrations,
also known as blood sugar levels. When the
glucose level is high, the beta cells secrete insulin
into the blood; when glucose levels are low,
secretion of insulin is inhibited.
Causes/ Risk of Diabetes
• Genetic
Especially Type 1, family history
• Obesity
• Age
• Ethnicity (south Asian, afro Caribbean)
Diabetic emergencies
• Blood sugar is typically maintained in the narrow
range of 3.0-5.6 mmol/l.
• Child: 4.0-8.0 mmol/l
• Adult: 4.0-7.0 mmol/l
Hypoglycemia
• Symptoms/Signs:

• Sweating
• Palpitations
• Shaking
• Hunger
• Confusion
• Drowsiness
• Aggressive behavior
• Speech problems
• Headache
• nausea
Management:
• Conscious: orally Glucose 10-20 mg
• 100 ml Coca-Cola
• Glucogel
• Dextrogel
• 2 teaspoon of sugar
• 2 sugar lumps

• May be repeated after 10-15 minutes

Hyperglycemia
• High blood sugar level
• Life threatening complication like diabetic
ketoacidosis and hyperosmolar, hyperglycemic
syndrome
• SIGNS AND SYMTOMS:
• High blood sugar compared to patients normal
value
• Excessive urination (polyuria)
• Excessive thirst (polydipsia)
• Increased Appetite
• Lethargy, confusion and loss of consciousness.
• Dehydration, dry mouth
• Hyperventilation
Management
• Transfer to hospital
• Iv fluids
• Oxygen, if hypoxemia
GLUCOMETER
• Wash and dry hands and insert strip of same code
as the
code mentioned on glucometer.
• Flashing blood drop appears. Now, encourage
blood flow to finger tips and use lancet to prick.
• Squeeze finger to assist blood ooze out and touch
the blood drop to edge. Observe egg timer flash.
• Wait for the value to appear on screen and report in
the patient form.
Complications of Diabetics:
• Heart disease
• Visual disturbances
• Renal failure
• Stroke
• Ulcers
• Infections of the feet and toes
• Seizures
• Altered mental status
Sepsis
• Introduction:
• Life threating condition arises when body response
to an infection injures its own tissues and organs.
• It leads to complications like
• Multiple organ failure
• Death
• Sepsis induced hypovolemia
• Hypo perfusion
• Hypotension

• Sepsis usually present with respiratory tract

infection.
Recognition and Management
• Screening tool is developed for hospital to
diagnose.
• Signs and symptoms of Systemic Inflammatory
response syndrome.
• Receiving antibiotics.
• THANKS !!