1. RAD422
LECTURE(2)
The emergency trolley

2. LEARNING OBJECTIVES
By the end of this Lecture the student will be able to:
Define the emergency trolley its purpose in the radiology department
Identify the external contents of the emergency trolley and state the purpose of each content.
Classify the different drawers of the emergency trolley
List the various emergency drugs and state their action

3. Lecture .2
References
M.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 trolley
To begin addressing the emergency conditions while waiting the emergency team to arrive:
Compromised Airway
Respiratory Distress /Respiratory Arrest
Cardiac Arrest
Drug Overdose
Hypoglycemia
Anaphylactic 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 supply
Defibrillator with Monitor
Portable suction apparatus
Laryngoscope
Shuttle forceps
Sphygmomanometer
Stethoscope
Emergency Crash Cart Check Sheet
Check List of cart contents.
Emergency drug information sheet

7. Contents of the trolley
External Contents
Oxygen supply:
To arise alveolar oxygen tension.
To relieve hypoxemia or hypoxia.
Oxygen regulator with flow meter
a valve to adjust the rate of oxygen flow
Oxygen cylinder

8. Contents of the trolley
External Contents
Defibrillator:
Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmia as ventricular fibrillation usually by electrical shock.

9. Contents of the trolley
External Contents
Suction 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- Medications
Drawer 2- Breathing and Airway
Drawer 3- Circulation: IV supplies
Drawer 4- Circulation: I.V. solutions and tubing
Drawer 5- Cardiac, Chest Procedures
Drawer 6- Special Procedure Trays

11. Contents of the trolley
Drawer contents: Drawer 1- Medications

12. Contents of the trolley
Emergency medication List
Action
Drug
Increase cardiac output, constricts blood vessels, raises blood pressure, relaxes bronchioles, aids respiration
Adrenalin
Bronchodilator (Prevention of bronchial asthma )
Aminophylline
Reduce secretions, Dilate the bronchi
Atropine
Antihistamine drug used in the prevention of the symptoms of allergic conditions such as rhinitis and urticaria
Benadryl
Respiratory stimulant (increase activity) treat hypotension
Intropin
Increases cardiac output, for the treatment of various heart conditions, such as atrial fibrillation
Dioxin (Lanoxin)
an anti-epileptic (anticonvulsant)
Dilantin
For maintaining normal concentrations of glucose in blood, (having the opposite effect of insulin)
Glucagon

13. Contents of the trolley
Emergency medication List
Action
Drug
Diuretic , increase amount of urine
Lasix
Emetics (produce vomiting)
Apomorphine
Fluid replacement .
Sodium bicarbonate
For sever bronchospasm
Hydrocortisone
Anti arrhythmic drug For ventricular arrhythmias
Bretylol
sedative ,used in treatment of anxiety
Valium (Diazepam )
Anti Acid, Treat of hypertension
Calcium gluconate
Correct hemodynamic imbalance
Dopamine
Prevent & treat cardiac arrhythmia
potassium chloride
Anticoagulant (Inhibits blood coagulation)
Heparin

14. Legal consideration
It is important to radiologic technologist to make certain that all information is documented on the patient chart
If patient experiences any adverse side effects to the drug, make certain to document the details of the incident
Errors 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 Airway
Examples:-
Oropharyngeal Airways
Nasopharyngeal Airways
Endotracheal tubes
Tracheostomy tubes
Face mask
Pocket mask
Suction tube
Tracheostomy mask
Nasal cannula
Laryngoscope
Tongue blades
Suction catheter

16. Contents of the trolley
Breathing and Airway
Laryngoscope:
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 to
provide ventilation to a patient
who is not breathing or who is
breathing inadequately 

17. Contents of the trolley
Breathing and Airway
Tracheostomy 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 Airway
Ventilation Devices:
Pocket mask
Designed 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 Airway
Airway 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 supplies
Examples:-
Needles different sizes
Syringes different sizes
Butterflies
Sterile water vials
IV cannulas
Tourniquet
Alcohol swabs
Cotton balls
Blood tubes
Tape

22. Contents of the trolley
Drawer contents: Drawer 4- I.V. solutions and tubing
Examples:-
0.9% sodium chloride 500ml)5%
Dextrose (500ml)
10% dextrose (500ml)
Hase-steril 6% (500ml)
Ringer lactate (500ml)
Blood pump tubing
I.V. Tubing

23. Contents of the trolley
Drawer contents:
Drawer 5- Cardiac, Chest Procedures
Examples:-
ECG electrodes
Sterile gloves
Sutures
Cardiac needle
Sterile towels
Cut down tray
Catheter kit
Chest tubes
Scalpels with blades
Dressings
sutures
(knife)
Scalpels

24. Contents of the trolley
Drawer contents: Drawer 6- Special Procedure Trays

25. Contents of the trolley
Sample supplies
I.V Cannula
Butterfly
Syringe
Tourniquet
Tourniquet

26. Contents of the trolley
Sample supplies
masks
Protective gowns
Tongue blades
Kidney bowel
Scissors
Thermometer

27. assignment (1) First assignment
Write about the principles of drug administration
(The golden rules of drug administration)
Total marks = 5
maximum time = 2 weeks

28. The End