Identification and Management of a Crisis: Critical Care Skills Every Nurse Must Know – Sandy A Salicco

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Mrs. Kelp is admitted to your floor with pneumonia and an exacerbation of COPD. Twenty minutes after admission, she develops worsening dyspnea and hypotension.Mrs. Kelp is admitted to your floor with pneumonia and an exacerbation of COPD. Twenty minutes after admission, she develops worsening dyspnea and hypotension.

Are you prepared to manage her unstable condition?Are you prepared to manage her unstable condition?

Do you know what respiratory measures are necessary?Do you know what respiratory measures are necessary?

Do you know the best way to manage her hypotension?Do you know the best way to manage her hypotension?

The patients in our hospitals are sicker than ever before. It is not uncommon to find patients on regular medical floors with central lines, chest tubes, pacemakers and AICDs. Some nursing homes are accepting patients on ventilators, and patients are now being sent home on vasoactive drips such as dobutamine. Even though acuity levels are higher, you are still caring for many patients and don’t have the luxury of frequent, comprehensive assessments. Therefore, it is important to be able to rapidly assess and implement appropriate interventions. Attend this seminar to sharpen your skills and leave prepared to identify and manage your next patient emergency!The patients in our hospitals are sicker than ever before. It is not uncommon to find patients on regular medical floors with central lines, chest tubes, pacemakers and AICDs. Some nursing homes are accepting patients on ventilators, and patients are now being sent home on vasoactive drips such as dobutamine. Even though acuity levels are higher, you are still caring for many patients and don’t have the luxury of frequent, comprehensive assessments. Therefore, it is important to be able to rapidly assess and implement appropriate interventions. Attend this seminar to sharpen your skills and leave prepared to identify and manage your next patient emergency!

OUTLINEOUTLINE

IDENTIFYING THE RED FLAGSIDENTIFYING THE RED FLAGS

• Critical Thinking During a CrisisCritical Thinking During a Crisis
• Rapid Assessment TechniquesRapid Assessment Techniques
• ABCD in Less Than 10 SecondsABCD in Less Than 10 Seconds
• Critical Questions to Ask Your PatientCritical Questions to Ask Your Patient

CARDIOVASCULARCARDIOVASCULAR

Prevention, Presentation, Action for: “I’m Having Chest Pain”Prevention, Presentation, Action for: “I’m Having Chest Pain”

• Recognizing Arrhythmias Recognizing Arrhythmias
  • Stable, Unstable and LethalStable, Unstable and Lethal
• 12-Lead EKG: Just the Down and Dirty 12-Lead EKG: Just the Down and Dirty
  • Utilizing a Systematic ApproachUtilizing a Systematic Approach
  • Patterns of Ischemia, Injury & InfarctPatterns of Ischemia, Injury & Infarct
• Acute Myocardial Infarction: STEMI/NSTEMI Acute Myocardial Infarction: STEMI/NSTEMI
  • Key Assessments & InterventionsKey Assessments & Interventions
  • tPA GuidelinestPA Guidelines
  • Cath Lab InterventionCath Lab Intervention
• Heart Failure Heart Failure
  • Recent Advances in CareRecent Advances in Care
  • Medication ManagementMedication Management
  • Fluid RestrictionFluid Restriction

RESPIRATORYRESPIRATORY

Prevention, Presentation, Action for: “I Can’t Breathe”Prevention, Presentation, Action for: “I Can’t Breathe”

• Assessment & Intervention Assessment & Intervention
  • Anxiety vs. Respiratory SymptomsAnxiety vs. Respiratory Symptoms
  • The Patient Who Needs Assistance The Patient Who Needs Assistance
    • O2, CPAP, BiPAPO2, CPAP, BiPAP
  • Indications for IntubationIndications for Intubation
  • Positive Pressure VentilationPositive Pressure Ventilation
• Respiratory Syndromes Respiratory Syndromes
  • Spontaneous Pneumothorax Spontaneous Pneumothorax
    • Chest Tube ManagementChest Tube Management
  • COPD COPD
    • Presentation: Why the Pursed Lips & Barrel ChestPresentation: Why the Pursed Lips & Barrel Chest
    • PROACTIVE not Reactive InterventionsPROACTIVE not Reactive Interventions
  • Respiratory Failure Respiratory Failure
    • Ventilator Settings Every Nurse Must KnowVentilator Settings Every Nurse Must Know

NEUROLOGICALNEUROLOGICAL

Prevention, Presentation and Action for: “My Head Hurts!”Prevention, Presentation and Action for: “My Head Hurts!”

• Elevated Intracranial Pressure Elevated Intracranial Pressure
  • Clues When you Don’t have a MonitorClues When you Don’t have a Monitor
• Ischemic vs. Hemorrhagic Stroke Ischemic vs. Hemorrhagic Stroke
  • Inclusion/Exclusion for tPAInclusion/Exclusion for tPA
  • Essential Assessments post-tPAEssential Assessments post-tPA

MANAGING THE DECOMPENSATING PATIENTMANAGING THE DECOMPENSATING PATIENT

Prevention, Presentation and Action for: “The Crashing Patient”Prevention, Presentation and Action for: “The Crashing Patient”

• AnaphylaxisAnaphylaxis
• SepsisSepsis
• ShockShock
• Considerations for TransportConsiderations for Transport
• Activating the Rapid Response TeamActivating the Rapid Response Team

OBJECTIVESOBJECTIVES

1. Describe two types of rapid assessment techniques and how to employ them for the best results during a patient emergency.Describe two types of rapid assessment techniques and how to employ them for the best results during a patient emergency.
2. Evaluate techniques for getting critical information during a rapid patient assessment.Evaluate techniques for getting critical information during a rapid patient assessment.
3. Recognize EARLY assessment findings in clinical syndromes that may progress rapidly and cause life-threatening conditions.Recognize EARLY assessment findings in clinical syndromes that may progress rapidly and cause life-threatening conditions.
4. Prioritize nursing actions for specific neurological, cardiac, respiratory and endocrine emergencies.Prioritize nursing actions for specific neurological, cardiac, respiratory and endocrine emergencies.
5. Review care of the diabetic patient in diabetic ketoacidosis versus HHNK/HHS. Differentiate key differences in presentation, lab results and plan of care.Review care of the diabetic patient in diabetic ketoacidosis versus HHNK/HHS. Differentiate key differences in presentation, lab results and plan of care.
6. Define heat failure with regards to left- and right-sided failure; discuss treatment options, acute and follow-up care.Define heat failure with regards to left- and right-sided failure; discuss treatment options, acute and follow-up care.
7. Discuss critical interventions and review treatment options for Sepsis and Shock.Discuss critical interventions and review treatment options for Sepsis and Shock.

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