2 LEARNING OBJECTIVESBy the end of this Lecture the student will be able to:Define the emergency trolley its purpose in the radiology departmentIdentify the external contents of the emergency trolley and state the purpose of each content.Classify the different drawers of the emergency trolleyList the various emergency drugs and state their action
3 Lecture .2ReferencesM.A.Seraj, The new manual of basic emergency procedures, first aid and updated CPR.Useful websites
4 The emergency trolley Goal of emergency trolley It is a multi drawer wheeled cabinet that is kept in in the imaging department. with the essential medication and tools that required in emergency situations.Other names:Emergency cart/Emergency response cart/Code cart/Crash cart.Goal of emergency trolleyTo begin addressing the emergency conditions while waiting the emergency team to arrive:Compromised AirwayRespiratory Distress /Respiratory ArrestCardiac ArrestDrug OverdoseHypoglycemiaAnaphylactic Reaction.
5 NOTE:A radiologic Tchnologist should know the location of emergency cart and be familiar with its contents.At the beginning of each shift the in charge Technologist should check with the radiology department nurse the equipment and medication to ensure if they are prepared for use in critical situation
6 The emergency trolley contents of the trolley A/ Top of emergency trolley (External Contents)Oxygen supplyDefibrillator with MonitorPortable suction apparatusLaryngoscopeShuttle forcepsSphygmomanometerStethoscopeEmergency Crash Cart Check SheetCheck List of cart contents.Emergency drug information sheet
7 Contents of the trolley External ContentsOxygen supply:To arise alveolar oxygen tension.To relieve hypoxemia or hypoxia.Oxygen regulator with flow metera valve to adjust the rate of oxygen flowOxygen cylinder
8 Contents of the trolley External ContentsDefibrillator:Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmia as ventricular fibrillation usually by electrical shock.
9 Contents of the trolley External ContentsSuction apparatus:Mechanical suction is used when a patient is unable to clear mouth or throat of secretions, blood, or vomits.Sphygmomanometer:It is an Instrument used to measure blood pressure.Stethoscope:It is an instrument used in auscultation of heart sounds and also it is used in measuring blood pressure.Tissue forceps
10 Contents of the trolley B/ Drawer contents: Drawer 1- MedicationsDrawer 2- Breathing and AirwayDrawer 3- Circulation: IV suppliesDrawer 4- Circulation: I.V. solutions and tubingDrawer 5- Cardiac, Chest ProceduresDrawer 6- Special Procedure Trays
11 Contents of the trolley Drawer contents: Drawer 1- Medications
12 Contents of the trolley Emergency medication ListActionDrugIncrease cardiac output, constricts blood vessels, raises blood pressure, relaxes bronchioles, aids respirationAdrenalinBronchodilator (Prevention of bronchial asthma )AminophyllineReduce secretions, Dilate the bronchiAtropineAntihistamine drug used in the prevention of the symptoms of allergic conditions such as rhinitis and urticariaBenadrylRespiratory stimulant (increase activity) treat hypotensionIntropinIncreases cardiac output, for the treatment of various heart conditions, such as atrial fibrillationDioxin (Lanoxin)an anti-epileptic (anticonvulsant)DilantinFor maintaining normal concentrations of glucose in blood, (having the opposite effect of insulin)Glucagon
13 Contents of the trolley Emergency medication ListActionDrugDiuretic , increase amount of urineLasixEmetics (produce vomiting)ApomorphineFluid replacement .Sodium bicarbonateFor sever bronchospasmHydrocortisoneAnti arrhythmic drug For ventricular arrhythmiasBretylolsedative ,used in treatment of anxietyValium (Diazepam )Anti Acid, Treat of hypertensionCalcium gluconateCorrect hemodynamic imbalanceDopaminePrevent & treat cardiac arrhythmiapotassium chlorideAnticoagulant (Inhibits blood coagulation)Heparin
14 Legal considerationIt is important to radiologic technologist to make certain that all information is documented on the patient chartIf patient experiences any adverse side effects to the drug, make certain to document the details of the incidentErrors associated with drug administration are among the most common legal problems in which radiologic technologists are involved.
15 Contents of the trolley Drawer contents:Drawer 2- Breathing and AirwayExamples:-Oropharyngeal AirwaysNasopharyngeal AirwaysEndotracheal tubesTracheostomy tubesFace maskPocket maskSuction tubeTracheostomy maskNasal cannulaLaryngoscopeTongue bladesSuction catheter
16 Contents of the trolley Breathing and AirwayLaryngoscope:It is used to obtain a view of the glottis.It is also used in intubation.Bag valve mask (Ambo bag)is a hand- held device used toprovide ventilation to a patientwho is not breathing or who isbreathing inadequately
17 Contents of the trolley Breathing and AirwayTracheostomy set :Tracheostomy is a surgical procedure on the neck to open a direct airway through an incision in the trachea to provide immediate relief for a patient’s upper airway obstruction..Patients who must have a higher continues rate of oxygen flow, require a Tracheostomy that is connected to the oxygen supply.The set includes Tracheostomy tubes: B- Plain tube E- Cuffed tube
18 Contents of the trolley Breathing and AirwayVentilation Devices:Pocket maskDesigned for mouth-to-mask ventilation of a non-breathing person. It is an alternative to a bag-valve mask device for providing ventilation.
19 Contents of the trolley Breathing and AirwayAirway adjuncts:Oropharyngeal Airways:known as an oral airway, or OPA. It is used to maintain a (open) airway It does this by preventing the tongue from (either partially or completely) covering the epiglottis, which could prevent the patient from breathing.Nasopharyngeal Airways:Also known as an NPA or a nasal trumpet. It is a tube that is designed to be inserted into the nasal passageway to secure an open airway.
20 Contents of the trolley Endotracheal tubes:The Endotracheal tube serves as an open passage through the upper airway. The purpose of Endotracheal intubation is to permit air to pass freely to and from the lungs in order to ventilate the lungs.It s place is confirmed with chest radiography ,the distal end of the tube must be 3-4 cm superior to tracheal bifurcation.
21 Contents of the trolley Drawer contents: Drawer 3- Circulation: IV suppliesExamples:-Needles different sizesSyringes different sizesButterfliesSterile water vialsIV cannulasTourniquetAlcohol swabsCotton ballsBlood tubesTape
22 Contents of the trolley Drawer contents: Drawer 4- I.V. solutions and tubingExamples:-0.9% sodium chloride 500ml)5%Dextrose (500ml)10% dextrose (500ml)Hase-steril 6% (500ml)Ringer lactate (500ml)Blood pump tubingI.V. Tubing
23 Contents of the trolley Drawer contents:Drawer 5- Cardiac, Chest ProceduresExamples:-ECG electrodesSterile glovesSuturesCardiac needleSterile towelsCut down trayCatheter kitChest tubesScalpels with bladesDressingssutures(knife)Scalpels
24 Contents of the trolley Drawer contents: Drawer 6- Special Procedure Trays
25 Contents of the trolley Sample suppliesI.V CannulaButterflySyringeTourniquetTourniquet
26 Contents of the trolley Sample suppliesmasksProtective gownsTongue bladesKidney bowelScissorsThermometer
27 assignment (1) First assignment Write about the principles of drug administration(The golden rules of drug administration)Total marks = 5maximum time = 2 weeks