RTA Medical Emergenciesand Infection Control

Week 13

Caution – some images may be disturbing to the viewer

…but this is what we may see in the course of our work

http://www.mercysiouxcity.com/services/trauma/level2trauma.shtml

TRAUMA- X-RAY READY

2 PROJECTIONS ARE BEST FOR THE PATIENT

SPINAL INJURY PT

X-TABLE LATERALSCERVICAL SPINE

Dislocation of the C3 and C4 articular processes

Note that C7 is not well demonstrated

Some studies of spinal trauma have recorded a missed injury rate as high as 33%.

C1 c2 sublux c4 wedge fx

GSW TO ABD

QSWMARKING ENTRANCE /EXIT WOUNDS

Fractured Forearm

Trauma and Surgical Radiography

Blast wave injury

NEAR DROWING

Compound Fx of Femur

Medical Emergencies

• Definitions

• What should the RT know?

• Common Radiology Emergencies

Medical Emergencies

• Definition: Sudden change in medical status requiring immediate action.

• For RT’s medical emergencies are rare, however as medical personnel we must be prepared to recognize emergencies.

What an RT should know…..

• How to…..

• Avoid additional harm to the patient

• Obtain appropriate medical assistance quickly

• Recognize emergency situations• Remain calm and confident

Anaphylactic ReactionAnaphylactic Reaction

An immune response to foreign materialAn immune response to foreign material Bronchospasm – wheezing and edema Bronchospasm – wheezing and edema

in the throat and lungsin the throat and lungs

Can lead to shockCan lead to shock

Requires prompt recognition and Requires prompt recognition and treatment from the technologisttreatment from the technologist

Water Soluble Water Soluble IodineIodineHigh atomic # 53High atomic # 53

RadiopaqueRadiopaque

Used to radiographUsed to radiograph– VesselsVessels– ArteriesArteries– VeinsVeins– Function of internal Function of internal

organsorgans

Radiology DepartmentRadiology Department

Patients are usually sent to the Patients are usually sent to the radiology department only after radiology department only after they have been stabilized, they have been stabilized, however, however, their status may their status may change!change!

General PrioritiesGeneral Priorities

Ensure an open Ensure an open airwayairwayControl BleedingControl BleedingTake Measures to Take Measures to Prevent shockPrevent shockAttend to wounds Attend to wounds or fractures or fractures appropriatelyappropriately

Provide emotional Provide emotional supportsupport

Continually Continually reevaluate and reevaluate and follow upfollow up

ABC• A = Air Way

• B = Breathing

• C = Circulation

Become familiar with………..

• In your work environment:– Emergency assistance protocol (how to

get help)– Emergency Cart/Crash Cart Location

Important Conditions to be Aware Important Conditions to be Aware of……of……

Level of Consciousness: ALOCLevel of Consciousness: ALOC Altered Level Of Consciousness Altered Level Of Consciousness

Anaphylactic Shock: vasogenic shockAnaphylactic Shock: vasogenic shock

Hypoglycemic/HyperglycemiaHypoglycemic/Hyperglycemia NPO – Nothing by MouthNPO – Nothing by Mouth

Important Conditions to be Important Conditions to be Aware of:Aware of:

NPO instructions can result in:NPO instructions can result in:

Hypoglycemia – excessive insulin, can result Hypoglycemia – excessive insulin, can result from normal dose of insulin & no food.from normal dose of insulin & no food.

Hyperglycemia – excessive sugar, usually seen Hyperglycemia – excessive sugar, usually seen in diabetics, pt. needs insulinin diabetics, pt. needs insulin

Medical Terms to Know…..Medical Terms to Know…..

Pallor = paleness; absence of skin Pallor = paleness; absence of skin colorationcoloration

Shock = failure of the circulatory systemShock = failure of the circulatory system

CPR = cardiopulmonary resuscitationCPR = cardiopulmonary resuscitation For program must be for For program must be for Health Care ProviderHealth Care Provider

More Medical Conditions:More Medical Conditions:

Stroke = Cerebrovascular Accident (brain)Stroke = Cerebrovascular Accident (brain)

Heart Attack = Myocardial Infarct (heart)Heart Attack = Myocardial Infarct (heart)

N/V = Nausea & VomitingN/V = Nausea & Vomiting

Epistaxis = nosebleedEpistaxis = nosebleed

Vertigo = dizzinessVertigo = dizziness

Syncope = faintingSyncope = fainting

Hemorrhage = bleeding outside the blood Hemorrhage = bleeding outside the blood vessels.vessels.

• Zoomed lower pelvis demonstrating multiple fractures (arrows).

Zoomed bony thorax shows rib fractures

Radiologic Technology

• You never know when a medical emergency may occur.

• Helping your patients depends on your abilities to stay calm and perform you duties!

FX RADIAL HEAD

greenstick

comminutedOpen fracture

Rt leg torn off after patient hit by a car

Third Degree Burn

INFECTION CONTROL

Infection Control

• Microorganisms

• Infectious Disease

• Chain of Infection

• Nosocomial Infection

• Disease Control

• Environment

Microorganisms that cause Microorganisms that cause disease:disease:

BacteriaBacteria

VirusesViruses

FungiFungi

ProtozoaProtozoa

MicroorganismsMicroorganismsCan grow in or on an animal or plant and Can grow in or on an animal or plant and cause diseases.cause diseases.

HostHost: animal or plant that provides life support : animal or plant that provides life support to another organism.to another organism.

Disease:Disease: Any change from the normal structure Any change from the normal structure or function in the human body.or function in the human body.

InfectionInfection: Growth of a microorganism on or in : Growth of a microorganism on or in a host.a host.

Varicella Zoster (Shingles)Varicella Zoster (Shingles)

DiseaseDisease

Disease Disease occurs only occurs only when the when the microorganismicroorganism causes m causes injury to the injury to the hosthost

PathogenPathogen

A disease producing microorganism.A disease producing microorganism.

– Multiply in large numbers and cause an Multiply in large numbers and cause an obstructionobstruction

– Cause tissue damageCause tissue damage– Secrete substance that produce effects in Secrete substance that produce effects in

the body the body Exotoxins ( high body temp, nausea, vomiting)Exotoxins ( high body temp, nausea, vomiting)

BacteriaBacteria

Strep ThroatStrep Throat

Bacterial Bacterial PneumoniaPneumonia

Food PoisoningFood Poisoning

VirusesViruses

Common coldCommon cold

MononucleosisMononucleosis

WartsWarts

Oral WartsOral Warts

SmallpoxSmallpox

FungiFungi

Athlete’s FootAthlete’s Foot Tinea pedisTinea pedis

RingwormRingworm

ProtozoanProtozoan

• Trichomonas Trichomonas VaginalisVaginalis– STDSTD

• Plasmodium Plasmodium VivaxVivax– MalariaMalaria

6 Steps of Infection6 Steps of Infection

EncounterEncounter

EntryEntry

SpreadSpread

MultiplicationMultiplication

DamageDamage

OutcomeOutcome

Chain of InfectionChain of Infection

HostHost

Infectious Infectious MicroorganismMicroorganism

Mode of Mode of TransmissionTransmission– Vector/ FomiteVector/ Fomite

ReservoirReservoir

Chain of InfectionChain of Infection

Nosocomial InfectionsNosocomial Infections Iatrogenic InfectionIatrogenic Infection

Compromised Compromised PatientsPatients

Patient FloraPatient Flora

Hospital Hospital EnvironmentEnvironment

Blood borne Blood borne PathogensPathogens

Types of Nosocomial InfectionsTypes of Nosocomial Infections Iatrogenic Infection – related to Iatrogenic Infection – related to

physician activitiesphysician activities

Compromised Patients - weakened Compromised Patients - weakened resistance; resistance; immunosuppressedimmunosuppressed

Patient Flora - microbes in healthy Patient Flora - microbes in healthy peoplepeople

Contaminated Hospital EnvironmentContaminated Hospital Environment

Blood borne Pathogens – Hepatitis B Blood borne Pathogens – Hepatitis B and HIVand HIV

Blood borne PathogensBlood borne Pathogens

Disease-causing microorganisms that Disease-causing microorganisms that may be present in human blood. Ex: may be present in human blood. Ex: Hepatitis, Syphilis, Malaria, HIV.Hepatitis, Syphilis, Malaria, HIV.

Two most significant blood borne Two most significant blood borne pathogens: Hepatitis B and HIVpathogens: Hepatitis B and HIV

Syphilis

Syphilis in the eye

How Blood borne Pathogens are Transmitted:

• You must make contact with contaminated fluids and permit them a way to enter your body.

• Contaminated body fluids can be saliva, semen, vaginal secretions, or other fluids containing blood (urine).

Controlling the spread of Disease

• Chemotherapy

• Immunization

• Asepsis– Medical– Surgical

• Disinfectants

Physical Methods of Controlling Diseases

• Handwashing• Standard

Precautions– Gloving– Gowns– Face masks– Eyewear

HandwashingHandwashing

Single most important means of Single most important means of preventing the spread of infection.preventing the spread of infection.

7 to 8 minutes of washing to remove the 7 to 8 minutes of washing to remove the microbes present, depending on the microbes present, depending on the number present.number present.

Most effective portion of hand washing is Most effective portion of hand washing is the mechanical action of rubbing the the mechanical action of rubbing the hands together.hands together.

Personal Protective Equipment Personal Protective Equipment (PPE)(PPE)

GlovesGloves

MasksMasks

GownsGowns

Protective EyewearProtective Eyewear

CapsCaps

Universal PrecautionsUniversal Precautions

Since there is no way you can know if a person Since there is no way you can know if a person is infected, you should ALWAYS use universal is infected, you should ALWAYS use universal precautions:precautions:

Wash your handsWash your handsWear glovesWear glovesHandle sharp objects carefullyHandle sharp objects carefullyProperly clean all spillsProperly clean all spillsWear mask, eye protection, and apron if Wear mask, eye protection, and apron if splashing is a possibility.splashing is a possibility.

Airborne Precautions

• Patients infected with pathogens that remain suspended in air for long periods on aerosol droplets or dust.

• TB, Chickenpox, Measles

• Respiratory protection must be worn when entering pt room.

• Pt should wear mask.

Droplet Precautions• Patients infected with pathogens that

disseminate through large particulate droplets expelled from coughing, sneezing, or even talking.

• Rubella, Mumps, Influenza

• Surgical mask must be worn when within 3 feet of the pt.

• Pt should wear a mask.

Contact Precautions

• Patients infected with pathogens that spread by direct contact with the pt or by indirect contact with a contaminated object (bedrail, pt dressing).

• Methicillin-resistant staphylococcus aureus (MRSA), Hepatitis A, Varicella, Flesh-eating Virus

• All PPE should be used and equipment must be disinfected after use.

So What, and Who Cares?

• Students and Techs are challenged both physically and mentally by the microbial world.

• In this world of newly found, life-threatening diseases, education has become the key to survival.

• Health care providers must be committed to infection control so that diseases can be conquered!