Class Talk Fall 2016

Funnily enough, a portion of my leadership project was concerning difficult airway situations!

I learned that a nurse can do the following to assist with intubation:

• Position the patient to elevate the head and align the ear with the sternal notch to improve respiratory mechanics
• use wedges, towels, or reverse trendelenberg

• Pre-oxygenating the patient before the intubation attempt and between attempts

• Be familiar with and prepare appropriate equipment
• (ETT and bougie pictured)

 

• Apply cricoid pressure if asked by the respiratory or anesthesia specialist
• This can help with visualization of the trachea

References

http://www.narcomed.com.au/g0.htm (picture)

Lutes, M., and Slawter, A. (2007) Focus on: Emergency management in the pregnant patient. American College of Emergency Physicians

Matshe, J. (2014) The Difficult Airway Management in Adult Critical Care. http://slideplayer.com/slide/4244922/ (picture)

Perioperative Care of Bariatric Patients. (2017) AORN Study Guide PDF

Seifert, P. & Wadlund, D. (2015). Crisis Management of Failed Airway in the OR. AORN Journal. https://doi.org/10.1016/j.aorn.2015.07.002

 

Acute respiratory distress syndrome can be life threatening and because of this it is important to use evidence-based practice in order to provide the patient with the best prognosis possible.

Pathophysiology: “ARDS has three phases: the acute exudative phase, proliferative phase and fibrotic phase” ( Schreiber, 2018). 1-7 days after the initial trauma a systemic immune response is truggered causing the pulmonary vsculature to become more permeable. As fluid infiltrates the lungs and alveoli begin to fill pulmonary edema occurs. This prevents blood from being oxygenated and hypoxemia results.

Patient Care: Nursing care includes maintainging pulmonary function. This includes frequent assessments to identify hypoxia including respiratory rate, oxygen saturation, and arterial blood gases. When maintaining the oxygen saturation above 90% it is important to titrate oxygen appropriately to prevent hyperoxygenation. In patients on ventilators it is also important to “adhere to strict infection control measures coupled with ventilator bundle protocols” (Schreiber, 2018). In addition medication therapy may include antibiotics, brochodilators, vasopressors, diuretics, anxiolytics, analgesics, sedatives, and neuro-muscular blockade agents.

This disease process can progress rapidly which is why it is important to provide evidence based practices. It is up to the nurse to use skill and critical thinking to achieve the most beneficial outcomes.

Reference: Schreiber, M. L. (2018). Evidence-Based Practice. Acute Respiratory Distress Syndrome. MEDSURG Nursing, 27(1), 59-65.

Acute respiratory distress syndrome can be life threatening and because of this it is important to use evidence-based practice in order to provide the patient with the best prognosis possible.

Pathophysiology: “ARDS has three phases: the acute exudative phase, proliferative phase and fibrotic phase” ( Schreiber, 2018). 1-7 days after the initial trauma a systemic immune response is truggered causing the pulmonary vsculature to become more permeable. As fluid infiltrates the lungs and alveoli begin to fill pulmonary edema occurs. This prevents blood from being oxygenated and hypoxemia results.

Patient Care: Nursing care includes maintainging pulmonary function. This includes frequent assessments to identify hypoxia including respiratory rate, oxygen saturation, and arterial blood gases. When maintaining the oxygen saturation above 90% it is important to titrate oxygen appropriately to prevent hyperoxygenation. In patients on ventilators it is also important to “adhere to strict infection control measures coupled with ventilator bundle protocols” (Schreiber, 2018). In addition medication therapy may include antibiotics, brochodilators, vasopressors, diuretics, anxiolytics, analgesics, sedatives, and neuro-muscular blockade agents.

This disease process can progress rapidly which is why it is important to provide evidence based practices. It is up to the nurse to use skill and critical thinking to achieve the most beneficial outcomes.

Reference: Schreiber, M. L. (2018). Evidence-Based Practice. Acute Respiratory Distress Syndrome. MEDSURG Nursing, 27(1), 59-65.

Acute respiratory distress syndrome can be life threatening and because of this it is important to use evidence-based practice in order to provide the patient with the best prognosis possible.

Pathophysiology: “ARDS has three phases: the acute exudative phase, proliferative phase and fibrotic phase” ( Schreiber, 2018). 1-7 days after the initial trauma a systemic immune response is truggered causing the pulmonary vsculature to become more permeable. As fluid infiltrates the lungs and alveoli begin to fill pulmonary edema occurs. This prevents blood from being oxygenated and hypoxemia results.

Patient Care: Nursing care includes maintainging pulmonary function. This includes frequent assessments to identify hypoxia including respiratory rate, oxygen saturation, and arterial blood gases. When maintaining the oxygen saturation above 90% it is important to titrate oxygen appropriately to prevent hyperoxygenation. In patients on ventilators it is also important to “adhere to strict infection control measures coupled with ventilator bundle protocols” (Schreiber, 2018). In addition medication therapy may include antibiotics, brochodilators, vasopressors, diuretics, anxiolytics, analgesics, sedatives, and neuro-muscular blockade agents.

This disease process can progress rapidly which is why it is important to provide evidence based practices. It is up to the nurse to use skill and critical thinking to achieve the most beneficial outcomes.

Reference: Schreiber, M. L. (2018). Evidence-Based Practice. Acute Respiratory Distress Syndrome. MEDSURG Nursing, 27(1), 59-65.

Acute respiratory distress syndrome can be life threatening and because of this it is important to use evidence-based practice in order to provide the patient with the best prognosis possible.

Pathophysiology: “ARDS has three phases: the acute exudative phase, proliferative phase and fibrotic phase” ( Schreiber, 2018). 1-7 days after the initial trauma a systemic immune response is truggered causing the pulmonary vsculature to become more permeable. As fluid infiltrates the lungs and alveoli begin to fill pulmonary edema occurs. This prevents blood from being oxygenated and hypoxemia results.

Patient Care: Nursing care includes maintainging pulmonary function. This includes frequent assessments to identify hypoxia including respiratory rate, oxygen saturation, and arterial blood gases. When maintaining the oxygen saturation above 90% it is important to titrate oxygen appropriately to prevent hyperoxygenation. In patients on ventilators it is also important to “adhere to strict infection control measures coupled with ventilator bundle protocols” (Schreiber, 2018). In addition medication therapy may include antibiotics, brochodilators, vasopressors, diuretics, anxiolytics, analgesics, sedatives, and neuro-muscular blockade agents.

This disease process can progress rapidly which is why it is important to provide evidence based practices. It is up to the nurse to use skill and critical thinking to achieve the most beneficial outcomes.

Reference: Schreiber, M. L. (2018). Evidence-Based Practice. Acute Respiratory Distress Syndrome. MEDSURG Nursing, 27(1), 59-65.

The first friend I interviewed didn’t know what cardiopulmonary arrest meant. After I explained it to him he said it means there’s an emergency. When asking if he knew the term “MI”, he reported he didn’t know what that word meant either. I educated him that this is a medical term for a heart attack. Finally, when I asked his perception of CPR he described it as one person helping another person come back to life by pushing fluid where it needs to go to sustain life.

The next friend I interviewed guessed that cardiopulmonary arrest meant failure of the heart and lungs. I told him yes, the heart stops beating ,leading to lack of oxygen, and eventual death. He didn’t know what an MI was. I educated him by stating an “MI” stands for a myocardial infarction and is the medical term for a heart attack. Lastly, he perceives CPR as compression of the heart to pump blood to get the heart beating again.

The final friend I interviewed thought cardiopulmonary arrest is when the lungs stop. I gave him the same education I gave to my second friend. He guessed that an “MI” was a minor injury. I gave him the same education that I gave to my second friend. Finally he perceives CPR as a person trying to save a life of another who has drowned or choked on food.

With the friends I interviewed, it was clear that the big medical words and abbreviations aren’t everyday language and common terminology non-medical professions hear. When reflecting on my own thoughts before pursuing the medical world, I didn’t have a grasp on these terms either. Although, hearing that they know CPR is a means of saving one’s life made me very happy to hear. I believe it’s important for everyone to learn about CPR because you never know what situation you could be faced with and have an opportunity to sustain someone’s life.

What does Cardiopulmonary Arrest mean to you?

Brother: When your heart stops pumping. One of the chambers bro, something in your heart stops.

Cousin: It means cardiac arrest.

Do you know what MI means?

Brother: No, nah.

Cousin: Nope.

What happens during CPR?

Brother: You are pumping blood. You are doing the pumping of the heart and pushing air in the lungs to get the heart pumping again.

Cousin: You are pumping blood to restore oxygen to the heart during cardiac arrest.

 

For some background, both my brother and cousin taking college classes at the community college. My brother has had some health care experience working in an assisted living setting, while my cousin has worked long term in at a grocery store.

This exercise seems to highlight the confusion that can arise when we use medical terminology in front of patients. Although these words have become common knowledge to those working in the medical field, words like “cardiopulmonary arrest” and “myocardial infarction” bring confusion to the average individual. I know in the workforce, many healthcare jobs require some kind of CPR training but even then, the purpose and mechanism of it can get lost in translation. This shows the importance of educating patients in common terms and phrases they can understand. Doing this not only reduces anxiety and fear regarding their condition but also helps increase awareness can help the patient feel more in control of their ailment.

After I asked my brother and cousin these questions, I made sure to clear any misconceptions they had and explained the terms for them in a way they would understand.

 

What does Cardiopulmonary Arrest mean to you?

Brother: When your heart stops pumping. One of the chambers bro, something in your heart stops.

Cousin: It means cardiac arrest.

Do you know what MI means?

Brother: No, nah.

Cousin: Nope.

What happens during CPR?

Brother: You are pumping blood. You are doing the pumping of the heart and pushing air in the lungs to get the heart pumping again.

Cousin: You are pumping blood to restore oxygen to the heart during cardiac arrest.

 

For some background, both my brother and cousin taking college classes at the community college. My brother has had some health care experience working in an assisted living setting, while my cousin has worked long term in at a grocery store.

This exercise seems to highlight the confusion that can arise when we use medical terminology in front of patients. Although these words have become common knowledge to those working in the medical field, words like “cardiopulmonary arrest” and “myocardial infarction” bring confusion to the average individual. I know in the workforce, many healthcare jobs require some kind of CPR training but even then, the purpose and mechanism of it can get lost in translation. This shows the importance of educating patients in common terms and phrases they can understand. Doing this not only reduces anxiety and fear regarding their condition but also helps increase awareness can help the patient feel more in control of their ailment.

After I asked my brother and cousin these questions, I made sure to clear any misconceptions they had and explained the terms for them in a way they would understand.

 

What does Cardiopulmonary Arrest mean to you?

Brother: When your heart stops pumping. One of the chambers bro, something in your heart stops.

Cousin: It means cardiac arrest.

Do you know what MI means?

Brother: No, nah.

Cousin: Nope.

What happens during CPR?

Brother: You are pumping blood. You are doing the pumping of the heart and pushing air in the lungs to get the heart pumping again.

Cousin: You are pumping blood to restore oxygen to the heart during cardiac arrest.

 

For some background, both my brother and cousin taking college classes at the community college. My brother has had some health care experience working in an assisted living setting, while my cousin has worked long term in at a grocery store.

This exercise seems to highlight the confusion that can arise when we use medical terminology in front of patients. Although these words have become common knowledge to those working in the medical field, words like “cardiopulmonary arrest” and “myocardial infarction” bring confusion to the average individual. I know in the workforce, many healthcare jobs require some kind of CPR training but even then, the purpose and mechanism of it can get lost in translation. This shows the importance of educating patients in common terms and phrases they can understand. Doing this not only reduces anxiety and fear regarding their condition but also helps increase awareness can help the patient feel more in control of their ailment.

After I asked my brother and cousin these questions, I made sure to clear any misconceptions they had and explained the terms for them in a way they would understand.

 

What does Cardiopulmonary Arrest mean to you?

Brother: When your heart stops pumping. One of the chambers bro, something in your heart stops.

Cousin: It means cardiac arrest.

Do you know what MI means?

Brother: No, nah.

Cousin: Nope.

What happens during CPR?

Brother: You are pumping blood. You are doing the pumping of the heart and pushing air in the lungs to get the heart pumping again.

Cousin: You are pumping blood to restore oxygen to the heart during cardiac arrest.

 

For some background, both my brother and cousin taking college classes at the community college. My brother has had some health care experience working in an assisted living setting, while my cousin has worked long term in at a grocery store.

This exercise seems to highlight the confusion that can arise when we use medical terminology in front of patients. Although these words have become common knowledge to those working in the medical field, words like “cardiopulmonary arrest” and “myocardial infarction” bring confusion to the average individual. I know in the workforce, many healthcare jobs require some kind of CPR training but even then, the purpose and mechanism of it can get lost in translation. This shows the importance of educating patients in common terms and phrases they can understand. Doing this not only reduces anxiety and fear regarding their condition but also helps increase awareness can help the patient feel more in control of their ailment.

After I asked my brother and cousin these questions, I made sure to clear any misconceptions they had and explained the terms for them in a way they would understand.