Medical emergencies
Medical emergencies occurring in the radiology department may be due to:
Patients may develop cardiac arrhythmias, hypotension, inadequate ventilation or adverse drug/radiographic contrast reactions. Complications arise from sedative drug administration, invasive procedures and human error; poor monitoring and organizational failings may contribute.
The basic principles are summarized in the ABC of resuscitating the acutely ill patient:
1. Airway – ensuring a patent airway
2. Breathing – providing supplemental oxygen and adequate ventilation
These early interventions should proceed in parallel with diagnosis and definitive treatment of the underlying cause. If cardiac arrest is suspected, the adult advanced life support algorithm in Figure 19.1 should be followed.
Figure 19.1 Adult advanced life support algorithm. Reproduced with the kind permission of the Resuscitation Council (UK).
Equipment
2. A positive pressure breathing device (Ambu bag) and mask
3. Supplemental oxygen and oxygen delivery devices
5. An intubation tray with airways, laryngoscopes and endotracheal tubes
6. Intravenous (i.v.) cannulas and i.v. fluids
(a) Sedative reversal drugs including naloxone and flumazenil
(b) Resuscitation drugs including adrenaline (epinephrine), atropine and hydrocortisone
9. Non-invasive blood pressure device and appropriately sized brachial cuffs
Respiratory emergencies
Respiratory depression
1. Decreased, shallow, laboured breathing
2. Decreased oxygen saturations
3. In partial airway obstruction; snoring and paradoxical chest wall movement.
The patient should immediately be placed in the supine position. If the airway is compromised it can be maintained by opening the mouth, tilting and extending the head, and lifting the chin. Supplemental oxygen must be provided. If respiratory depression is due to sedative drugs then reversal agents should be considered.