Medical Emergencies and Infection Control
Medical emergencies and infection control tests recognition, immediate action, and prevention. The exam expects you to distinguish common vasovagal events from true emergencies and to apply standard precautions consistently.
Core rules
- Syncope: pale, diaphoretic, bradycardic; supine, legs elevated, oxygen, monitor. Do not give epinephrine.
- Hypoglycemia: conscious patient gets oral glucose; unconscious patient gets nothing by mouth and requires emergency services/glucagon per protocol.
- Anaphylaxis: urticaria, bronchospasm, hypotension after exposure; intramuscular epinephrine is first-line, plus oxygen, airway support, and call for help.
- Angina/MI: stop treatment, sit upright, oxygen, nitroglycerin if prescribed and no contraindication, aspirin if not allergic, activate EMS.
- Infection control: hand hygiene, PPE, sharps safety, instrument cleaning before sterilization, sterilization monitoring, and post-exposure management.
- Emergency kit and staff training must be current; oxygen and suction are baseline.
Worked example
A patient becomes unresponsive minutes after a local anesthetic injection. The differential includes vasovagal syncope, LAST, and anaphylaxis. Check responsiveness, airway, breathing, and circulation; position supine, give oxygen, monitor vital signs. If wheeze, urticaria, or hypotension suggests anaphylaxis, give IM epinephrine; if seizures or cardiovascular collapse suggest LAST, stop injection and start lipid emulsion protocol.
Traps
- Giving IM epinephrine for simple syncope.
- Delaying BLS while looking for equipment.
- Skipping cleaning before sterilization.
- Recapping needles by hand.