Fainting - Definition昏迷的定义.pptVIP

Fainting and AnaphylaxisNeedlestick Injuries Bryna Warshawsky, MDCM, FRCPC Associate Medical Officer of Health Middlesex-London Health Unit Fainting - Definition Weak, lightheaded, pale, nauseated Falls on floor Brief seizure activity Fainting Study VAERS - 1990- October 1995 697 syncopal episodes reported Peak age 10-19 year olds - 45.4% Females 57.5% 80% occurred within 15 minutes of vaccine 27% had tonic or clonic movements 6 serious head injuries - 5 were male Fainting Prevention Stress free clinics - limit standing and waiting Watch for people who look anxious, pale, sweaty, trembling or complain of dizziness, numbness or tingling Vaccinate them when seated Escort them to mat or chair after vaccination Fainting Management Elevate feet Fan Cold cloth Seizures - avoid injury Vomits - recovery position, watch neck Prolonged - proceed as per anaphylaxis Serious injury - 911 Post Fainting Management Get up slowly Check vitals Offer juice Keep in clinic for a half hour or longer Leave with an adult to continue to observe Avoid driving Post Fainting Management Advise client to contact doctor if head injury or seizure activity Document incident Follow-up with client later if seizure activity, injury or prolonged fainting episode Anaphylaxis - Definition Occurs in .11 to .31 per 100,000 vaccines Progresses over several minutes from mild to severe Usually evident within 15 to 30 minutes Symptoms: hives, swelling of face and mouth, itchiness, tearing, nasal congestion, facial flushing, sneezing, coughing, wheezing, laboured breathing, hypotension, shock, collapse Anaphylaxis - Prevention Screen for allergy to egg or egg products Screen for allergy to past influenza vaccine Screen for allergy to other components of the vaccine Screen for allergy to other vaccines which may contain the same components Anaphylaxis - Management Two nurses Call ambulance Lay down and raise feet Assess airway, breathing, circulation Anaphylaxis - Adrenaline 0.01 ml/kg of 1:1000 adrenalin