The document outlines 45 standards of care for critical care nurses, including requirements such as having a nurse in attendance for each patient at all times, taking full responsibility for patient care coordination, conducting frequent patient assessments and monitoring, and communicating changes in patient condition to physicians. The standards are intended to ensure optimal patient safety, monitoring, treatment and family support in the intensive care unit.
The document discusses adjustment disorder in children, specifically related to starting school. It defines adjustment disorder and notes it is a time-limited condition caused by stressors. Symptoms include agitation, conduct issues, depression, and physical complaints. Diagnosis requires a stressor, disproportionate response, and no underlying illness. Treatment includes behavior therapy, individual therapy, family therapy, and self-help groups. Prognosis is usually good with symptoms resolving without lasting effects.
Current principles, practices and trends in pediatricGnana Jyothi
Evolution of pediatrics, Pediatrics in India, Evolution of Pediatric Nursing in relationship to Child health, Historical background on the care of the child, Factors influencing the care of the child.........
Anatamical and physiological basis of critically ill childmohanasundariskrose
The document discusses the anatomical and physiological differences between infants/children and adults that are important for critical care. Key points include:
- Infants have proportionally larger heads, shorter necks, and smaller airways making them more vulnerable to respiratory issues.
- Their lungs are less developed with lower compliance. Heart rates and respiratory rates are higher in infants for metabolic reasons.
- Immature gut muscles and bacterial flora make infants more prone to gastrointestinal issues like trapped gas.
- Anatomical differences in the central nervous, renal, and gastrointestinal systems also exist compared to adults. Understanding these differences is vital for appropriate critical care of infants and children.
The document provides an overview of a seminar on staff development presented by Ms. Binsy Cherian. It defines staff development and discusses the need for programs to support ongoing learning and skill development for healthcare workers. The seminar covers topics such as the objectives, types (e.g. continuing education, in-service training), and standards of effective staff development programs, as well as some common barriers to implementation.
This document discusses the metabolic response and nutritional needs of critically ill children. It notes that critical illness leads to increased caloric and protein needs due to catabolism. Early enteral nutrition within 24 hours is recommended where possible to provide nutrients and prevent wasting, though total parenteral nutrition may be needed if enteral is not feasible. The document outlines the administration, types, indications, and complications of both enteral and parenteral nutrition in critical illness. It also discusses using immunonutrition formulas to help modulate the immune response.
This document discusses the nutritional needs of critically ill children in the pediatric intensive care unit (PICU). It notes that malnutrition is common upon admission to the PICU and nutrition may deteriorate without attention. Resting energy expenditure estimates range from 37-62 kcal/kg/day but can be lower with organ failure. Ventilated children typically need 45 kcal/kg/day while requirements increase from 42 kcal/kg/day on day 1 to 50 kcal/kg/day on day 5 and 69 kcal/kg/day on day 12. The combination of enteral and parenteral nutrition has advantages like improved coverage of energy targets and protein-energy balance as well as presumed benefits such as maintaining gut function
The document discusses adjustment disorder in children, specifically related to starting school. It defines adjustment disorder and notes it is a time-limited condition caused by stressors. Symptoms include agitation, conduct issues, depression, and physical complaints. Diagnosis requires a stressor, disproportionate response, and no underlying illness. Treatment includes behavior therapy, individual therapy, family therapy, and self-help groups. Prognosis is usually good with symptoms resolving without lasting effects.
Current principles, practices and trends in pediatricGnana Jyothi
Evolution of pediatrics, Pediatrics in India, Evolution of Pediatric Nursing in relationship to Child health, Historical background on the care of the child, Factors influencing the care of the child.........
Anatamical and physiological basis of critically ill childmohanasundariskrose
The document discusses the anatomical and physiological differences between infants/children and adults that are important for critical care. Key points include:
- Infants have proportionally larger heads, shorter necks, and smaller airways making them more vulnerable to respiratory issues.
- Their lungs are less developed with lower compliance. Heart rates and respiratory rates are higher in infants for metabolic reasons.
- Immature gut muscles and bacterial flora make infants more prone to gastrointestinal issues like trapped gas.
- Anatomical differences in the central nervous, renal, and gastrointestinal systems also exist compared to adults. Understanding these differences is vital for appropriate critical care of infants and children.
The document provides an overview of a seminar on staff development presented by Ms. Binsy Cherian. It defines staff development and discusses the need for programs to support ongoing learning and skill development for healthcare workers. The seminar covers topics such as the objectives, types (e.g. continuing education, in-service training), and standards of effective staff development programs, as well as some common barriers to implementation.
This document discusses the metabolic response and nutritional needs of critically ill children. It notes that critical illness leads to increased caloric and protein needs due to catabolism. Early enteral nutrition within 24 hours is recommended where possible to provide nutrients and prevent wasting, though total parenteral nutrition may be needed if enteral is not feasible. The document outlines the administration, types, indications, and complications of both enteral and parenteral nutrition in critical illness. It also discusses using immunonutrition formulas to help modulate the immune response.
This document discusses the nutritional needs of critically ill children in the pediatric intensive care unit (PICU). It notes that malnutrition is common upon admission to the PICU and nutrition may deteriorate without attention. Resting energy expenditure estimates range from 37-62 kcal/kg/day but can be lower with organ failure. Ventilated children typically need 45 kcal/kg/day while requirements increase from 42 kcal/kg/day on day 1 to 50 kcal/kg/day on day 5 and 69 kcal/kg/day on day 12. The combination of enteral and parenteral nutrition has advantages like improved coverage of energy targets and protein-energy balance as well as presumed benefits such as maintaining gut function
Terminal illness and death during childhoodNEHA MALIK
A terminally ill child is a child who has no expectation of a cure for his or her disease or illness. this study material will help the medical professionals to learn more about caring for a terminally ill child.
YOUTUBE CHANNEL LINK :- https://www.youtube.com/results?search_query=medic+o+mania
This document outlines stressors children experience during hospitalization and methods for providing atraumatic care. The three main stressors are separation anxiety, loss of control, and fear of bodily injury/pain. Atraumatic care aims to minimize these stressors through preventing separation from family, promoting a sense of control, and properly managing pain. Assessment tools like the Oucher scale help caregivers understand and address a child's pain. Play is also recommended to help reduce stress.
The document discusses the impact of hospitalization on children of different ages and strategies to help prepare them. It notes that hospitalization can cause emotional trauma in children and outlines ways to prepare infants, toddlers, preschoolers, school-aged children, and adolescents for their hospital stay. These include explaining what to expect in an age-appropriate manner, encouraging questions, allowing favorite toys, maintaining routines, and using play and recreational activities.
Ethical and cultural issues in pediatrics sukh randhawa
This document discusses ethical and cultural issues in pediatric nursing. It begins by defining ethics and explaining how ethics are influenced by laws, religion, science, philosophy and moral principles. It then discusses the principles of medical ethics including autonomy, beneficence, non-maleficence and justice. The rest of the document outlines some specific ethical issues pediatric nurses may face, such as refusing immunizations, withholding or withdrawing treatment, informed consent, restraining children, and accepting medical realities. It also discusses how to address ethical dilemmas and the pediatric code of ethics.
The document discusses the recommended staffing for a pediatric intensive care unit (PICU). It recommends that the PICU be led by a medical director with special training in pediatric critical care who is available full-time. Residents should provide 24-hour in-house coverage and be trained in resuscitation. The ideal nurse to patient ratio is 1:1 but no less than 1:3. Other recommended staff include respiratory therapists, technicians, clerks, physiotherapists, nutritionists, and social workers to properly care for critically ill children.
This document discusses crisis and nursing intervention for hospitalized children. It begins with definitions of crisis and crisis intervention. It then discusses types of crises including maturational, situational, and adventitious crises. Crisis theory is explained, outlining the work of Erich Lindemann and Gerald Caplan. Four phases of the crisis process are defined. The document then focuses on hospitalized children, discussing functions of hospitalization, principles of hospitalization, modern concepts, visiting policies, rooming-in, care by parent units, parent support groups, and encouraging self-care. Reactions to hospitalization for different age groups are examined, along with preparation for hospitalization, guidelines for admission, and stressors and implications
Stress & reactions related to developmental stagesGnana Jyothi
This document discusses stress and reactions related to developmental stages and play activities for hospitalized children. It begins by defining stress, stressors, and illness. It then discusses the stressors of hospitalization and how a child's reaction depends on their developmental level. Specific stressors include separation from parents, loss of control, and physical harm. The document outlines expected behaviors for infants, toddlers, preschoolers, school-aged children, adolescents, and parents based on their developmental needs. These include crying, temper tantrums, withdrawal, and dependence. The role of nurses is to help children and families cope with stress through minimizing separation, preparation, explanations, and play. Suggested play activities are diversional activities, toys
This document discusses the history, philosophy, and principles of child health nursing. It outlines the evolution of pediatric nursing from ancient practices of child rearing to modern specialized nursing care. Key developments include the establishment of the first pediatric hospital in 1855, the inclusion of pediatric nursing education in 1917, and research in the mid-20th century highlighting the importance of family-centered care. The history of pediatric nursing in India incorporated it as a course in nursing programs from the 1950s onward.
Organization of neonatal care, services,transport,nicu,organization and manag...PRANATI PATRA
This document discusses the organization and management of neonatal intensive care units (NICUs). It outlines three levels of neonatal care from normal to intensive care and describes the personnel, physical facilities, equipment, and neonatal transfer services needed for properly functioning NICUs. The goal is to provide specialized care to sick newborns to reduce infant mortality rates in India.
This document outlines the expanded and extended role of pediatric nurses. It discusses that pediatric nursing involves preventive, promotive, curative and rehabilitative care for children from conception through adolescence. The roles of pediatric nurses have grown beyond direct caregiving and now include primary caregiver, health educator, nurse counselor, social worker, team coordinator, manager, child advocate, recreationalist, nurse consultant, researcher, and more. Pediatric nurses work in hospitals, clinics, schools, communities and more to support the holistic health of children. Advanced practice roles like pediatric nurse practitioners and clinical nurse specialists provide specialized care for acute, chronic, or critically ill children.
Hospitalization can be stressful for children of all ages due to separation from parents and familiar routines. Younger children may experience separation anxiety while older children worry about missing school or peer activities. Providing family-centered care, frequent family visits, play activities, and explaining medical procedures can help lessen children's stress during hospitalization. Therapeutic play tailored to children's developmental stages allows them to express feelings, learn coping skills, and feel a sense of normalcy and independence despite illness.
Norms are defined as fundamental concepts in the social sciences. They are rules and regulations that are enforced in an area for proper function in any field.
This document outlines a clinical teaching program in obstetrics and gynecology (OBG) nursing. It discusses various teaching methods used in clinical education such as bedside teaching, nursing rounds, demonstrations, and nursing care studies. It also covers the responsibilities of clinical preceptors such as setting objectives, evaluating students, demonstrating procedures, analyzing difficulties, and maintaining student records. The document provides guidelines for selecting teaching materials and the qualities of effective clinical preceptors such as competence, respect, organization, and limiting content. Common clinical teaching models like one minute preceptor, SNAPPS, and pattern recognition are also summarized.
The document discusses the care of hospitalized children. It emphasizes that children require specialized pediatric care due to anatomical, physiological, immunological, psychosocial and cognitive differences compared to adults. The hospital environment can impact children in various ways depending on their developmental stage. Nursing care aims to minimize stressors like separation from parents, loss of control, and pain/injury through measures like parental involvement, developmentally-appropriate activities, and clear communication. The goal is to help children benefit from hospitalization and cope with the experience in a healthy manner.
This document discusses mechanical ventilation and care of children requiring long-term ventilation. It covers the physiology of ventilation, indications for mechanical ventilation, types of ventilators including transport, ICU, neonatal and PAP ventilators. It describes various ventilation modes like PC, VC, PRVC, SIMV and their applications. Factors in weaning from ventilation are discussed along with complications and troubleshooting. Non-invasive ventilation options like CPAP, BiPAP and protocols for safe weaning are also summarized.
The document discusses the role of the pediatric nurse in child care. It outlines that the role is constantly changing due to expanding medical practice, emerging challenges in child care, consumer demands, and technology. The core responsibilities of a pediatric nurse include being a primary caregiver, coordinator and collaborator, advocate, health educator, consultant, counselor, case manager, recreationist, social worker, and researcher. The document then provides more details on each of these roles and how the pediatric nurse supports children's health at the primary, secondary, and tertiary levels of care. It also discusses old and new concepts in pediatric nursing.
Ethical and cultural issues in Pediatric Nursingrittikadas7
This document discusses ethical and cultural issues in pediatric nursing. It defines pediatric nursing as dealing with children from conception to adolescence, focusing on holistic and preventative care. Key principles that govern ethical decisions are discussed, including non-maleficence (do no harm), beneficence (advocate for patients), parental autonomy, providing correct medical facts, and justice (equal treatment). Issues that can present ethical dilemmas are also covered, such as refusing immunization or treatment, genetic therapy, and withdrawing life support. The document stresses the importance of cultural considerations like socioeconomic factors, customs, and the needs of migrant families.
A Tracheoesophageal fistula is a congenital disease. It is a acquired communication between the trachea and esophagus. Most of the patient with TEF are diagnosed immediately following after birth.TEF are often associated with life threatening complications.
This document outlines national goals and plans related to health, population issues, and socioeconomic development in India. It discusses reducing mortality rates for infants and children, addressing communicable and non-communicable diseases, improving environmental sanitation and access to healthcare. Specific targets are identified around reducing infant, child, and maternal mortality. National policies and plans such as the National Health Policy, National Policy for Children, and various Five Year Plans are mentioned as frameworks for addressing these issues through improving primary healthcare, nutrition, education, rural development, poverty alleviation, and overall quality of life.
The document discusses various common behavioral disorders seen in children and adolescents. It defines behavioral disorders as deviations from socially acceptable behaviors due to multiple factors such as faulty parenting, family environment, illness, social influences, and media influences. Some common behavioral disorders mentioned include feeding problems, habit disorders, speech problems, sleep problems, educational difficulties, adjustment problems, emotional problems, and sexual problems. Specific disorders discussed in more detail include temper tantrums, breath holding spells, thumb sucking, nail biting, enuresis, pica, tics, school phobia, attention deficit hyperactivity disorder, masturbation, juvenile delinquency, anorexia nervosa, and learning disorders. Causes and management strategies for each are also summarized
Nursing management of critically ill patient in intensive care unitsANILKUMAR BR
Critical care nursing: it is the field of nursing with a focus on the utmost care of the critically ill (or) unstable patients.
Critically ill patients : critically ill patients are those who are at risk for actual (or) potential life threatening health problems.
Admission QGeneral appearance (consciousness)
Airway: Patency Position of artificial airway (if present)
Breathing: Quantity and quality of respirations (rate, depth, pattern, symmetry, effort, use of accessory muscles) Breath sounds Presence of spontaneous breathing.
Circulation and Cerebral Perfusion: ECG (rate, rhythm, and presence of ectopy) Blood pressure Peripheral pulses and capillary refill Skin, color, temperature, moisture Presence of bleeding Level of consciousness, responsiveness.
quick Check Assessment in CCU.
Terminal illness and death during childhoodNEHA MALIK
A terminally ill child is a child who has no expectation of a cure for his or her disease or illness. this study material will help the medical professionals to learn more about caring for a terminally ill child.
YOUTUBE CHANNEL LINK :- https://www.youtube.com/results?search_query=medic+o+mania
This document outlines stressors children experience during hospitalization and methods for providing atraumatic care. The three main stressors are separation anxiety, loss of control, and fear of bodily injury/pain. Atraumatic care aims to minimize these stressors through preventing separation from family, promoting a sense of control, and properly managing pain. Assessment tools like the Oucher scale help caregivers understand and address a child's pain. Play is also recommended to help reduce stress.
The document discusses the impact of hospitalization on children of different ages and strategies to help prepare them. It notes that hospitalization can cause emotional trauma in children and outlines ways to prepare infants, toddlers, preschoolers, school-aged children, and adolescents for their hospital stay. These include explaining what to expect in an age-appropriate manner, encouraging questions, allowing favorite toys, maintaining routines, and using play and recreational activities.
Ethical and cultural issues in pediatrics sukh randhawa
This document discusses ethical and cultural issues in pediatric nursing. It begins by defining ethics and explaining how ethics are influenced by laws, religion, science, philosophy and moral principles. It then discusses the principles of medical ethics including autonomy, beneficence, non-maleficence and justice. The rest of the document outlines some specific ethical issues pediatric nurses may face, such as refusing immunizations, withholding or withdrawing treatment, informed consent, restraining children, and accepting medical realities. It also discusses how to address ethical dilemmas and the pediatric code of ethics.
The document discusses the recommended staffing for a pediatric intensive care unit (PICU). It recommends that the PICU be led by a medical director with special training in pediatric critical care who is available full-time. Residents should provide 24-hour in-house coverage and be trained in resuscitation. The ideal nurse to patient ratio is 1:1 but no less than 1:3. Other recommended staff include respiratory therapists, technicians, clerks, physiotherapists, nutritionists, and social workers to properly care for critically ill children.
This document discusses crisis and nursing intervention for hospitalized children. It begins with definitions of crisis and crisis intervention. It then discusses types of crises including maturational, situational, and adventitious crises. Crisis theory is explained, outlining the work of Erich Lindemann and Gerald Caplan. Four phases of the crisis process are defined. The document then focuses on hospitalized children, discussing functions of hospitalization, principles of hospitalization, modern concepts, visiting policies, rooming-in, care by parent units, parent support groups, and encouraging self-care. Reactions to hospitalization for different age groups are examined, along with preparation for hospitalization, guidelines for admission, and stressors and implications
Stress & reactions related to developmental stagesGnana Jyothi
This document discusses stress and reactions related to developmental stages and play activities for hospitalized children. It begins by defining stress, stressors, and illness. It then discusses the stressors of hospitalization and how a child's reaction depends on their developmental level. Specific stressors include separation from parents, loss of control, and physical harm. The document outlines expected behaviors for infants, toddlers, preschoolers, school-aged children, adolescents, and parents based on their developmental needs. These include crying, temper tantrums, withdrawal, and dependence. The role of nurses is to help children and families cope with stress through minimizing separation, preparation, explanations, and play. Suggested play activities are diversional activities, toys
This document discusses the history, philosophy, and principles of child health nursing. It outlines the evolution of pediatric nursing from ancient practices of child rearing to modern specialized nursing care. Key developments include the establishment of the first pediatric hospital in 1855, the inclusion of pediatric nursing education in 1917, and research in the mid-20th century highlighting the importance of family-centered care. The history of pediatric nursing in India incorporated it as a course in nursing programs from the 1950s onward.
Organization of neonatal care, services,transport,nicu,organization and manag...PRANATI PATRA
This document discusses the organization and management of neonatal intensive care units (NICUs). It outlines three levels of neonatal care from normal to intensive care and describes the personnel, physical facilities, equipment, and neonatal transfer services needed for properly functioning NICUs. The goal is to provide specialized care to sick newborns to reduce infant mortality rates in India.
This document outlines the expanded and extended role of pediatric nurses. It discusses that pediatric nursing involves preventive, promotive, curative and rehabilitative care for children from conception through adolescence. The roles of pediatric nurses have grown beyond direct caregiving and now include primary caregiver, health educator, nurse counselor, social worker, team coordinator, manager, child advocate, recreationalist, nurse consultant, researcher, and more. Pediatric nurses work in hospitals, clinics, schools, communities and more to support the holistic health of children. Advanced practice roles like pediatric nurse practitioners and clinical nurse specialists provide specialized care for acute, chronic, or critically ill children.
Hospitalization can be stressful for children of all ages due to separation from parents and familiar routines. Younger children may experience separation anxiety while older children worry about missing school or peer activities. Providing family-centered care, frequent family visits, play activities, and explaining medical procedures can help lessen children's stress during hospitalization. Therapeutic play tailored to children's developmental stages allows them to express feelings, learn coping skills, and feel a sense of normalcy and independence despite illness.
Norms are defined as fundamental concepts in the social sciences. They are rules and regulations that are enforced in an area for proper function in any field.
This document outlines a clinical teaching program in obstetrics and gynecology (OBG) nursing. It discusses various teaching methods used in clinical education such as bedside teaching, nursing rounds, demonstrations, and nursing care studies. It also covers the responsibilities of clinical preceptors such as setting objectives, evaluating students, demonstrating procedures, analyzing difficulties, and maintaining student records. The document provides guidelines for selecting teaching materials and the qualities of effective clinical preceptors such as competence, respect, organization, and limiting content. Common clinical teaching models like one minute preceptor, SNAPPS, and pattern recognition are also summarized.
The document discusses the care of hospitalized children. It emphasizes that children require specialized pediatric care due to anatomical, physiological, immunological, psychosocial and cognitive differences compared to adults. The hospital environment can impact children in various ways depending on their developmental stage. Nursing care aims to minimize stressors like separation from parents, loss of control, and pain/injury through measures like parental involvement, developmentally-appropriate activities, and clear communication. The goal is to help children benefit from hospitalization and cope with the experience in a healthy manner.
This document discusses mechanical ventilation and care of children requiring long-term ventilation. It covers the physiology of ventilation, indications for mechanical ventilation, types of ventilators including transport, ICU, neonatal and PAP ventilators. It describes various ventilation modes like PC, VC, PRVC, SIMV and their applications. Factors in weaning from ventilation are discussed along with complications and troubleshooting. Non-invasive ventilation options like CPAP, BiPAP and protocols for safe weaning are also summarized.
The document discusses the role of the pediatric nurse in child care. It outlines that the role is constantly changing due to expanding medical practice, emerging challenges in child care, consumer demands, and technology. The core responsibilities of a pediatric nurse include being a primary caregiver, coordinator and collaborator, advocate, health educator, consultant, counselor, case manager, recreationist, social worker, and researcher. The document then provides more details on each of these roles and how the pediatric nurse supports children's health at the primary, secondary, and tertiary levels of care. It also discusses old and new concepts in pediatric nursing.
Ethical and cultural issues in Pediatric Nursingrittikadas7
This document discusses ethical and cultural issues in pediatric nursing. It defines pediatric nursing as dealing with children from conception to adolescence, focusing on holistic and preventative care. Key principles that govern ethical decisions are discussed, including non-maleficence (do no harm), beneficence (advocate for patients), parental autonomy, providing correct medical facts, and justice (equal treatment). Issues that can present ethical dilemmas are also covered, such as refusing immunization or treatment, genetic therapy, and withdrawing life support. The document stresses the importance of cultural considerations like socioeconomic factors, customs, and the needs of migrant families.
A Tracheoesophageal fistula is a congenital disease. It is a acquired communication between the trachea and esophagus. Most of the patient with TEF are diagnosed immediately following after birth.TEF are often associated with life threatening complications.
This document outlines national goals and plans related to health, population issues, and socioeconomic development in India. It discusses reducing mortality rates for infants and children, addressing communicable and non-communicable diseases, improving environmental sanitation and access to healthcare. Specific targets are identified around reducing infant, child, and maternal mortality. National policies and plans such as the National Health Policy, National Policy for Children, and various Five Year Plans are mentioned as frameworks for addressing these issues through improving primary healthcare, nutrition, education, rural development, poverty alleviation, and overall quality of life.
The document discusses various common behavioral disorders seen in children and adolescents. It defines behavioral disorders as deviations from socially acceptable behaviors due to multiple factors such as faulty parenting, family environment, illness, social influences, and media influences. Some common behavioral disorders mentioned include feeding problems, habit disorders, speech problems, sleep problems, educational difficulties, adjustment problems, emotional problems, and sexual problems. Specific disorders discussed in more detail include temper tantrums, breath holding spells, thumb sucking, nail biting, enuresis, pica, tics, school phobia, attention deficit hyperactivity disorder, masturbation, juvenile delinquency, anorexia nervosa, and learning disorders. Causes and management strategies for each are also summarized
Nursing management of critically ill patient in intensive care unitsANILKUMAR BR
Critical care nursing: it is the field of nursing with a focus on the utmost care of the critically ill (or) unstable patients.
Critically ill patients : critically ill patients are those who are at risk for actual (or) potential life threatening health problems.
Admission QGeneral appearance (consciousness)
Airway: Patency Position of artificial airway (if present)
Breathing: Quantity and quality of respirations (rate, depth, pattern, symmetry, effort, use of accessory muscles) Breath sounds Presence of spontaneous breathing.
Circulation and Cerebral Perfusion: ECG (rate, rhythm, and presence of ectopy) Blood pressure Peripheral pulses and capillary refill Skin, color, temperature, moisture Presence of bleeding Level of consciousness, responsiveness.
quick Check Assessment in CCU.
Anesthesia carries risks that can lead to patient death or injury. Several factors contribute to risks in the operating room including equipment issues, patient health factors, human performance errors, and system failures. Some key errors that can cause severe harm are airway issues, medication errors, and procedure mistakes. Maintaining vigilance, checklists, standards, training, and learning from adverse events can help improve safety. Thorough documentation and review of incidents is important for quality assurance.
2018 ATLS PROTOCOL
FOCUSING ON THE PRIMORDIAL MANAGEMENT OF PT IN THE APPROACH OF IMPROVING TRAUMA PT MANAGEMENT AND REDUCING MORTALITY OF TRAUMA PT AT OUR RESPECTIVE HEALTH FACILITIES AS DOCTORS AND CLINICIANS WORKING IN THE EMERGENCY DEPARTMENT.
GIVEN THE NECESSARY EQUIPMENT AND FAVOURABLE AMBIENT WORKING ENVIRONMENT WE SHOULD BE ABLE TO OFFER OUR HUMANITY RACE QUALITY SERVICES BEARING IN MIND THAT LIFE COME FIRST AND ALL THE OTHER ATTRIBUTES IN LIFE FOLLOWS
The document discusses preoperative, intraoperative, and postoperative care for a patient undergoing surgery. In the preoperative stage, patients undergo assessments of their medical history and comorbidities, labs and tests are ordered to optimize the patient's health status, and the surgical plan is arranged. Intraoperatively, strict infection control protocols are followed and checklists are used to ensure safety. Postoperatively, patients are monitored, complications are prevented, and care is documented before discharge. The overall goal is to safely prepare the patient for surgery, perform the procedure, and provide care during recovery.
Mr. R should be evaluated hourly as his MEWS score is 7 which is considered high. He needs urgent medical attention and critical care monitoring due to his unstable vital signs.
Anesthetic risk, quality improvement and liability●๋•αηкιтα madan
This document discusses anesthesia risk and mortality. It provides estimates from various studies that anesthesia-related mortality rates range from less than 1 per 10,000 anesthetics to 1 per 1,560 anesthetics historically. Common complications discussed include nerve injuries, awareness during general anesthesia, eye/dental injuries, and postoperative cognitive dysfunction in elderly patients. Risk management strategies to minimize liability like adherence to standards of care, vigilance, documentation, and informed consent are also outlined.
This document summarizes guidelines for oxygen therapy in post-operative care. It recommends that oxygen therapy is an important part of recovery and can reduce post-operative complications. The summary outlines standards for best practice, such as all patients in recovery receiving oxygen according to local guidelines, and all high-risk patients who could benefit from post-operative oxygen being prescribed it and using it correctly. Audit indicators are proposed to measure adherence to these standards.
This document presents an evaluation of trauma by Dr. Amr Shaddad. It discusses the objectives of understanding types of trauma, the ATLS protocol, and signs of urological injury. The ATLS protocol is described in detail, outlining the primary and secondary surveys with their respective components of cABCDE and a head-to-toe evaluation. Signs of potential urological injuries from trauma to the kidneys, ureters, bladder, and urethra are also summarized. The presentation aims to educate on proper trauma evaluation and management according to established guidelines.
This document discusses guidelines and considerations for providing anaesthesia services in non-operating room areas (NORA) such as for MRI/CT scans. It notes special challenges in NORA including limited space, equipment issues, and unfamiliar environments. Key guidelines are outlined such as having proper patient monitoring, emergency equipment, and following pre-procedure evaluations. Specific anaesthetic drugs that can be used for moderate sedation are discussed, including propofol, benzodiazepines, dexmedetomidine, and ketamine. Hazards in the MRI environment like magnetic fields, acoustic noise, and restricted access are summarized. The document stresses the importance of patient safety, standards of care, and proper planning for NORA cases.
This document discusses postoperative complications and nursing management. It begins by outlining the objectives of identifying common postoperative complications and providing appropriate nursing care. It then describes various surgical classifications and methods. The main types and causes of postoperative complications are explained, including both minor and major complications involving different body systems. Finally, the document outlines the nursing assessment, planning, implementation and evaluation that should be conducted to manage postoperative patients, including monitoring vital signs, wound care, pain management, and health teaching.
Here are the triage categories I would assign to each patient based on the information provided:
1. 30 year old male with a compound fracture of left femur, bleeding significantly. Resp. rate 24. Cap. refill less than 2 sec. Alert and oriented.
Category: DELAYED
2. 44 year old male sitting up with chest pain without obvious injury. Resp. rate 24. Cap. refill less than 2 sec. Alert and oriented.
Category: DELAYED
3. 28 year old female with fracture of left wrist. Resp. rate 22. Cap. refill less than 2 sec. Alert and oriented. Decides she can walk after all.
Category: MINOR
The document outlines several parameters for assessing quality of care in the intensive care unit (ICU). It discusses objective criteria for ICU admission including vital signs, laboratory values, imaging results, ECG findings, and physical exam findings. It also describes the roles and responsibilities of nurses in the ICU in monitoring patients, administering treatments, and advocating for patients. Key indicators of quality that are mentioned include mortality rates, complication rates, length of stay, adherence to best practices, rates of errors and infections, staff satisfaction, and patient satisfaction.
There are numerous types of brain surgery. The type used is based on the area of the brain and the condition being treated.
Brain surgery is a critical and complicated process. The type of brain surgery done depends highly on the condition being treated.
Intracranial surgery refers to various medical procedures that involve repairing structural problems in the brain.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Anesthesiologists must ensure patient safety during operations as anesthesia carries risks. Factors threatening safety include equipment issues, patient health conditions, and human factors like fatigue. Strategies to improve safety include thorough preoperative evaluations and planning, situational awareness during procedures, cross-checking observations, preparing for emergencies, enhancing teamwork, and learning from adverse events. Common errors involve airway issues, medication errors, and procedure mistakes, which can be avoided through vigilance, training, and following standards and guidelines. Quality assurance aims to improve care and minimize risks through documentation, safety training, and protocols for monitoring, handoffs, and responding to adverse events.
1.Mandatory guidelines for taking up the case of Exploratory laparotomy
2.What is the fluid of choice?
3. Is ABG mandatory?
4. What is sepsis? Septic shock? SIRS? Severe sepsis?
Antibiotic timming?
Co ordination among radio,surg and anesthesia
Can we keep normal saline?
Why RL preferred in ERAS
The document summarizes information and recommendations regarding the Covid-19 pandemic from the perspective of intensive care and critical care specialists. It provides worldwide case statistics and outlines anticipated critical care bed needs for a hospital. It also discusses ventilation strategies, the use of ECMO, guidelines from medical societies, PPE recommendations, management of shock, antibiotics, experimental drug treatments and ongoing clinical trials. The overall focus is on evaluating and treating critically ill Covid-19 patients from an intensive care perspective.
The document summarizes information and recommendations regarding the Covid-19 pandemic from the perspective of intensive care and critical care specialists. It provides worldwide case statistics and projections for hospital bed and ventilator needs in California. Guidelines are presented on testing, diagnosis, treatment strategies including ventilation, use of sedatives, ECMO, and experimental drugs. Risk stratification, PPE guidance, and management of complications like shock are also addressed. Clinical trials and the potential use of convalescent plasma are discussed.
The document summarizes information and recommendations regarding the Covid-19 pandemic from the perspective of intensive care and critical care specialists. It provides worldwide case statistics and projections for hospital bed and ventilator needs in California. Guidelines are presented on testing, diagnosis, treatment strategies including ventilation, use of sedatives, ECMO, and experimental drugs. Risk stratification, PPE guidance, and management of complications like shock are also addressed. Clinical trials and the potential use of convalescent plasma are discussed.
Equipment used in critical care areas in Child Careamaramon
The document is a list of equipment owned by Mr. Amar Alim Mulla, who has an M. Sc. (N) degree and is a PhD scholar. The equipment includes a radiant warmer, phototherapy unit, suction machine, ambu bag and mask, weight machine, pulse oximeter, and infusion pump.
The document outlines 32 standards for nursing care of intensive care patients, including requirements that no patient be left without a nurse in attendance, each nurse be responsible for the full care of their assigned patient, and breaks be arranged to ensure safe patient coverage. It also provides rationales for the standards, which aim to ensure intensive patients receive close monitoring and care.
The document discusses the design and layout of a paediatric unit. It notes that paediatric intensive care units (PICUs) admit critically ill children or those at risk of critical illness who need extra nursing care. Key considerations in establishing a PICU include documenting local need, availability of trained staff and resources, and access to paediatric specialties. An ideal PICU location is near emergency and other pediatric departments to minimize patient transport. Sufficient space per patient bed is important along with areas for staff, storage, and other functions. A variety of medical equipment is also needed.
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This document discusses neonatal resuscitation, post-resuscitation care, and the ethical issues involved. It begins by explaining what normally happens at birth to allow a baby to breathe and how problems can arise during transition. It then outlines the clinical findings of compromised babies and different types of post-resuscitation care. Potential post-resuscitation complications are listed for various organ systems. Ethical principles like benevolence, justice, autonomy and nonmaleficence are discussed. Situations where not initiating resuscitation may be ethical are presented.
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Ethical challenges in neonatal intensive careamaramon
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Picu norms
1. Standards for Critical Care Nurses
MR. AMAR MULLA, M. Sc. (N),
PhD SCHOLAR, SVBCON, DNH
1
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
2. The following are some general requirements
for nursing care of the intensive care patients
• 1. No critical care patient will be left without a nurse
in attendance.
Rationale: Critically ill patients may have life-
threatening changes in their condition; remove an
invasive line or self-extubate quickly.
• 2. Each nurse will be responsible for the entire care of
his/her patient, and acts to coordinate care with other
health team professionals.
Rationale: The caregiver, by assuming full
responsibility for monitoring the patient's condition and
care, can detect changes promptly.
2
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
3. • 3. Breaks will be arranged according to unit need/safe
coverage by mutual agreement between each nurse and
his/her coworkers. The nurse must give a full report to
another staff nurse prior to leaving for a break. The
second nurse assumes responsibility for the patient and
interacts with family/other health team members in the
principal nurse's absence.
Rationale: When many people are involved in the care, a
principal caregiver reduces the assumption that someone
else did or did not complete a task, and helps to maximize
resources.
3
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
4. • 4. The staff nurse will report any changes in his/her
patient's condition directly to the physician. The charge
nurse may be utilized to report the information, e.g., on
nights. The nurse will ensure a physician is aware of all lab
reports. The staff nurse will keep the charge nurse informed
of changes in the patient's condition. The charge nurse will
be notified if the staff nurse needs any direction regarding
procedure, policy or physician interaction.
Rationale: The staff nurse is the one person who has
current and detailed information on the patient's condition.
4
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
5. • 5. All critical care patients will have continual ECG
monitoring.
Rationale: A critically ill patient requires intensive
monitoring
• 6. Alarms must be left on the ECG and arterial lines
at all times. Appropriate limits will be selected at the
nurse’s discretion according to institutional policy.
Rationale: To ensure rapid detection of heart rate or BP
changes. To reduce risk associated with leaving alarm
disabled.
5
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
6. • 7. An ECG strip will be obtained and analyzed
according to institutional policy. Generally, this is
every four hours and as needed for patients with a
cardiac disorder. The ECG strips are analyzed,
rhythm identified and taped to the back of the flow
sheet. Changes are reported to the consultant.
Rationale: Heart rate and rhythm are keys to
determining the hemodynamic stability of an intensive
care patient.
6
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
7. • 8. For a stable, non-acute patient without invasive monitoring
equipment, vital signs will be done at the staff nurse's discretion,
at least every hour.
Rationale: To ensure regular vital sign monitoring
• 9. Temperatures will be measured on all patients at least q4h by
other than axilla route. Patients having abnormal temperatures (<
36 or >37.5 C) will have temperature measured by a core method
(rectally, tympanic, pulmonary artery, esophageal).
Rationale: Temperature changes may indicate infection or other
disease states. Core represents a much more accurate value.
7
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
8. • 10. All patients admitted for neurological problems will
have hourly neurological assessments performed. All
patients will have a neurological assessment evaluated
and recorded on the flow sheet at least once per shift,
using the Glasgow Coma Scale.
Rationale: To quickly reference previous, function if
deterioration occurs. This will provide a clear understanding
of the patient's neurological status and avoid uncertainty
over assessments at shift change. Unconscious patients will
have neurological assessments done q.1-4h. At the nurse's
discretion.
8
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
9. • 11. The turning of all critically ill patients every
two hours around the clock is done unless
contraindicated, with skin assessment recorded as
part of the every four-hour assessment. If turning
is contraindicated, pressure points will be relieved
q2h. If pressure relieve is not possible, rationale
will be documented.
Rationale: This is to relieve pressure points and
allow for skin perfusion as well as provide reference
for comparison of skin care.
9
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
10. • 12. All intensive care patients will have chest PT q4h and PRN
unless contraindicated. The frequency will be recorded on the
flow sheet documented in progress note.
Rationale: Immobility increases the risk for the retention of
secretions and reduced ventilation.
• 13. All critical care patients will have range of motion exercises
q4h unless contraindicated (i.e. neuromuscular blockers). This
will be recorded on the flow sheet treatment section and in
clinical record.
Rationale: To reduce possible contracture formation, disuse
atrophy, "frozen joints", and to promote venous return.
10
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
11. • 14. Perineal care will be done every shift and
as needed PRN for all patients.
Rationale: To promote hygiene and comfort.
• 15. All Critical Care patients will have mouth
care done every four hours with inspection for
oral skin sores. Teeth will be brushed every
shift and as needed.
Rationale: Intubation increases risk for
developing mouth ulcers and/or infections.
11
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
12. • 16. The Critical Care nurse may restrain
patients at his/her discretion. Provided
documentation done according to hospital
policies and procedures.
Rationale: To ensure life-supporting tubes or
lines are not disconnected.
• 17. All restraints will be secured to allow rapid
lowering of bedside.
Rationale: For rapid access in a crisis.
12
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
13. • 18. Any patient who expires, that falls into the
classification of a coroner's case, or who is going to have a
autopsy must have all lines/airways/tubes left in place
unless the coroner confirms that they may be removed.
Rationale: Correct tube placement is occasionally evaluated
at post mortem.
• 19. All routine dressing changes, I.V. tubing changes and
catheter changes will be done on night shift. The Flow
sheet will be updated with the new date change, and the
procedure documented in the clinical record.
Rationale: To maintain consistency among all nurses.
13
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
14. • 20. Routine daily baths will be done on night shift. This will include total
skin care, fingernails and hair washing q. weekly and prn dressing
changes.
Rationale: The night shift is quieter and less hectic
• 21. All dressings unless otherwise indicated will be changed daily.
Rationale: To remove bacterial contaminates and replace with an aseptic
dressing
• 22. TED hose (anti-embolism stockings) and SCD’s (sequential
compressing device) will be removed for thirty minutes once per shift.
Rationale: To promote venous return and reduce thrombus formation and to
permit circulation and inspection of the limb.
14
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
15. • 23. Nursing care will be spaced out to allow
periods of rest.
Rationale: Sensory overload predisposes the
patient to disorientation.
• 24. All patients who have not had a bowel
movement will be checked for impaction
q.3. days and the flow sheet updated.
Rationale: To monitor bowel function
15
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
16. • 25. Procedures will be explained to patients; person, place and time
being repeatedly stated to the patient. Sensory stimulation, ie., radios,
tape recorders, will be provided for patients as indicated during the
day.
Rationale: It is not known how much an unconscious patient can hear or
comprehend. Sensory deprivation leads to disorientation. Anxiety
decreases with an awareness of one's surroundings. Maintain a normal
sleep/wake pattern.
• 26. Information and emotional support needs for the family and
patient will be provided by the nurse/physician/social work/pastoral
care/palliative care, as required.
Rationale: The critical nature of the patient's illness places tremendous
strain on the patient and family unit.
16
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
17. • 27. The environment will be maintained in a mechanically safe
condition through: dry floors, good repair of furniture, proper
placement of machines and equipment, cleanliness, freedom from
clutter, and good repair of equipment.
Rationale: To reduce risks to patients, visitors, or staff.
• 28. Isolation technique will be followed as per infection control
manual.
Rationale: To minimize cross infection to patients, visitors, and staff.
• 29. Safety signs, such as, "isolation", "can hear", or
"neuromuscular blocking agent in use" will be posted when
indicated
Rationale: To communicate important information 17
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
18. • 30. Sharps and glass will be disposed of into point of
use sharps containers.
Rationale: To protect health care workers from
injury/contamination.
• 31. Any containers of body fluids (i.e. suction
canisters or chest drainage sets) must be disposed in
the appropriate biohazard bag or box.
Rationale: To reduce risk of contamination to health
care workers during handling.
18
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
19. • 32. All electrical equipment will: be grounded,
have 3-prong plugs, be used away from water or
wet floors, be protected from spillage of liquids, be
inspected by Biomedical Department. Any
equipment that malfunctions or appears damaged
will be reported to Biomedical Dept.
Rationale: Particularly with patients having
access catheters into the heart, electrical shocks could
pose serious risk for harm.
19
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
20. • 33. Labels will be affixed to: all bedside
medications, intravenous bags and bottles,
all wound or bladder irrigations, multidose
vials, multiple drainage bags/bottles,
hemodynamic transducers and monitors
(identifying waves and pressures).
Rationale: To reduce risk for errors.
20
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
21. • 34. All medications will be reviewed by the Critical
Care physicians (upon admission to Unit) and either
reordered or stopped. Nursing staff will ensure this
has been done prior to carrying out any medication,
treatment or investigative orders. Each
treatment/medication must be listed when reordered
(e.g., "Renew all preoperative meds" is NOT
acceptable.)
Rationale: To ensure optimal management.
21
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
22. • 35. Respiratory orders may only be carried out when
written by the patients physician. Ventilatory changes
will only be done upon receipt of written order.
Rationale: To maintain optimal and consistent respiratory
management
• 36. All orders written other than by the consultant/
treating doctor will be brought to the attention of the
Critical Care physician by the nurse prior to being
carried out. Rationale: To ensure all therapy is consistent
with goals for the patient's management
22
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
23. • 37. Narcotics MAY NOT be kept at the bedside. If use is
not immediate after withdrawal from the narcotic
cabinet, wastage as per narcotic protocol will be carried
out.
Rationale: To maintain narcotic control.
• 38. Visiting is negotiated between the nurse and family,
with consideration given to unit activity and institutional
policy. All exceptions should be reported nurse to nurse.
Rationale: It is important to communicate information to
oncoming nurse to avoid discrepancies. 23
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
24. • 39. The number of visitors will be limited to 2 at a
time; however, the nurse may use discretion based
on patient condition and room activity
Rationale: To promote privacy for other patients in the
bay and to accommodate space limitations.
• 40. The nurse/physician will notify families of
significant deteriorations in the patient's condition.
Rationale: The family has the right to determine when
they wish to attend their family member.
24
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
25. • 41. Support will be given to family’s that would
like children to visit. Special preparation of
the children MUST BE done.
Rationale: Research has shown that allowing
children to participate in the grieving process can
have a positive impact on subsequent adjustment
to family tragedy. Improper preparation can have
a negative and lasting impact.
25
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
26. • 42. A visitors handout will be given to one member of each patient's
family. Indicate on Nursing Note the date and family member who
received the booklet.
Rationale: To reduce the anxiety associated with visiting in the critical
care unit. To provide information regarding resources available to families.
• 43. All patients in Critical Care Unit, will be weighed daily and on
admission and recorded on the flow sheet. per week. For new hospital
admission, record weight on nursing admission database also.
• Rationale: To accurately measure Body Surface Area, for calculating
hemodynamic indexed values, to identify drug dosages, to assess
nutritional requirements, to assess adequacy of nutritional status, and to
evaluate fluid balance.
26
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
27. • 44. All patients in the critical care unit will have a minimum
IV access of two Heparin Locks.
Rationale: To ensure rapid resuscitation with IV drugs or fluid if
needed. Critical care patients are at sufficient risk to warrant
access. When a patient's illness has become chronic but stable,
they may not have an immediate need for an IV, and staff may be
unable to secure a peripheral site. If despite reasonable attempts by
a skilled individual a peripheral IV cannot be secured, the risk
associated with a central line insertion may be deemed greater than
the benefit of having an IV access. Appropriate documentation
must be included in the clinical record to justify this decision.
27
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
28. • 45. All change of shift reports will include a review of
all physician orders, lab results, medication
administration record, and joint review of neuron
status.
Rationale: To ensure communication between shifts and
reduce potential for medication or treatment
errors. Neuro status is jointly reviewed to ensure that
both incoming and out going shifts are clear on
interpretation of findings to be able to promptly detect a
change in patient condition.
28
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
29. • 46. All staff working at a bedside where an acute trauma or
actively bleeding patient is being managed will wear
protective goggles, masks and gloves. Protective gear is also
required anytime risk of splash from body fluids exists e.g.
suctioning.
Rationale: Current literature shows that it is during periods of
acute crisis when health care workers are at the highest risk for
disease transmission. This has also been shown to be the time
when health care workers are least compliant with universal
precautions. Masks, goggles and gloves in high risk situations are
a requirement as per Hospital Universal Precautions Policies.
29
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH
30. • Reference: AACN Standards for Critical
Care Nurses.
30
MR. AMAR MULLA, M. Sc. (N), PhD
SCHOLAR SVBCON, DNH