Tag: patient
Question of Week (QoW) #2
Remeber, there are not necessarily any right or wrong answers.
But, it is important to venture a guess.
Evoking Epiphany : What’s Your Opinion?
We are going to start posting questions or statements to start a significant discussion group.
Our goals are to :
- Start a wide berth of discussions.
- establish synergies of thought.
- improve patient care.
- improve interdisciplinary communications.
- introduce varied approaches to healthcare.
- decrease length of intubation.
- decrease length of time to liberation from mechanical ventilation.
- decrease length of hospital stay.
- decrease the cost of health care.
- introduce new or variant concepts of ICU care.
Here is the first 2 of many thought provoking statements.
Evoking Epipheny – 2019-05-001
https://www.linkedin.com/pulse/respiratory-therapists-friends-foes-melissa-allen-rrt-ms-ches?trk=related_artice_Respiratory%20Therapists%3A%20Friends%20or%20Foes%3F_article-card_title
The ICU patient – evaluating the patient in 2 minutes
Why would you want to evaluate a patient in 2 minutes?
>> To be able to answer anyone who asks : “How’s my patient doing?”
> answer quick and BE READY to defend your stance!
>> Why you think the patient is faring well vs. why you think the patient is decompensating.
>> if they like your answer over the course of 1 to 2 patients (and you were correct),
they will trust you for the rest of your life with anything respiratory related and
patient related as well.
How do you evaluate the patient in 2 minutes?
>> 7 zones to focus on : 2 min = 120 seconds
>> patient. 10 sec
>> patient monitor. 10 sec
>> IV pumps. 30 sec
>> ventilator. 10 sec
>> chest tube. 10 sec
>> urine collection bag. 10 sec
>> any other unusual device in room. 10 sec
>> conclusion and defense thesis. 30 sec
PATIENT : 10 seconds
cyanosis / pale / normal
MONITOR : 10 seconds
HR : hi / lo / normal
BP : hi / lo / normal
PA : hi / lo / normal
CVP : hi / lo / normal
SpO2 : hi / lo / normal
IV PUMPS : 30 seconds
Vasoactives : constrictors vs. dilators
Cardiotonics : inotropes vs. chronotropes
Sedation :
Analgesics :
Paralytics :
Epi / Levo / Neo / Vaso / Milrinone
Diprivan / Ativan / Versed / Fentanyl
VENTILATOR : 10 seconds
Type & Mode of Ventilation : VCV vs. PCV ; AC vs. SIMV vs. PSV
PEEP : hi / lo / normal
FiO2 : hi / lo / normal
P/F ratio : hi / lo / normal
Lung compliance : hi / lo / normal
CHEST TUBE : 10 seconds
Qualitative analysis :
Quantitative analysis : hi / lo / normal
URINE COLLECTION BAG : 10 seconds
Qualitative analysis : clear / yellow / pink / red / green / blue
Quantitaive analysis : hi / lo / normal
UNUSUAL DEVICES : 10 seconds
EEG / Hypothermia Induction Device / IAB / VAD / ECMO, CVVH, hemodialysis, wound VAC, compression stockings, external pacing device, cardio-defibrillator, video monitor, patient escape alert device.
CONCLUSION : immediate
Rationale : 30 seconds
(MORE TO FOLLOW next week)