Acute Care

Medical emergency: Injury

Call for help → Do NOT leave alone

Prevent further injury to pt

Medical Emergency: Seizure

Call for help → do NOT leave patient alone, keep them safe (location, airway)

Convulsions stop → lie on side

Medical Emergency: Burns

Cold water over it

Cover it

Medical Emergency: Shock

Can be deadly → call for help, correct cause, monitor vitals, lie down with blanket

Signs of shock

Pale/cool skin, shallow breathing, dilated eyes, weak/rapid pulse, dizziness

Hypoglycemia

Decrease blood sugar, leads to insulin shock

Normal breath

Give sugar

Hyperglycemia

Increased blood sugar, leads to Ketoacidosis (diabetic coma)

Fruity breath → EMERGENCY

Medical Emergency: Choking

“Ask are you choking?” → let them try to help themselves

Can’t speak/breath → remove object from mouth → Heimlich

Unconscious → CPR → finger sweep, breaths → Heimlich

Standard Precautions

PPE when necessary; usually gloves

HIV and Hepatitis

Contract Precautions

Gloves and gown

“Contacronyms” → C-DIFF, MRSA, VRE

Airborne

Mask

“Put Air In Mea Rube Tube” → Measles, Rubella, Tuberculosis

Contact and Airborne

“With both, you’'ll be Vari Shingle” → Varicella, Shingles

Droplet

All PPE (gloves, gown, mask)

Influenza, Whooping Cough, Pneumonia

Magic Number for Oxygen Sat

90 % and higher

What do you do when a patient has a Oxygen Sat below 90%?

Pause Activity → pursed lip breathing and monitor

What do you do when a cardio patient has a low oxygen sat?

Notify staff and document

What do you do when a patient’s oxygen sat. is below 90% for 5 minutes

Rapid response team

Magic number for Heart Rate?

60-100 BPM

With activity: increase of 20 BPM

What should you do when HR decreases 20 BPM during activity?

Contact medical staff

Magic Numbers for BP

• 120/80 mmHg

• Systolic

  • With activity → <30

  • Position change → <20

• Diastolic

  • < 100

Pt’s systolic drops >20 during position change. What is this indicative of?

Orthostatic Hypotension

A patient’s diastolic is greater than 100. What should you do?

Rapid response

Contraindications for BP

Don’t measure BP on UE with vascular issues, edema, mastectomy, IV line, fistula

Hematocrit

• The higher the better

• Hema25 → 25% or higher

Hemoglobin

• The higher the better

• Hemog7obin → 7 and higher

INR

• High → bleeding risk

• below 5