PE/DVT
Definitions of pulmonary embolism and DVT
What is a blood clot that causes a blockage in the pulmonary arteries.
What is a condition in which a blood clot forms in deep veins in the body, usually the legs. Clot can travel to the lungs and cause a PE.
Purpose/role of the RACE Team
What is improving patient morbidity and mortality by working collaboratively with hospital staff to identify, assess, and treat the needs of patients with changes in deterioration or HEWS of 6 or greater. Intervene before there is a medical emergency.
Early Warning Scores are good or excellent predictors of
What is short-term mortality
top cause of injury related hospitalization in adults 65+
What is falls
effects of early mobilization
What are:
shorter length of stay, lower post-op complications, lower pain, increase walking ability, increase QOL, decrease rate of readmission, decrease mortality rate, lower hospitalization cost, higher number of physiotherapy sessions prior to discharge, increase in satisfaction, no fracture displacement or implant failure
The signs and symptoms of PE
What are:
Sudden shortness of breath
Chest pain
Coughing or coughing up blood
Dizziness, lightheadedness, fainting
Irregular heartbeat
Palpitations
Sweating
Anxiety
Low blood pressure
Do not call the RACE Team for these events
What is cardiac arrests and other life threatening emergencies - call Code Blue
This stage of the clinical reasoning cycle is where you interpret the cues that have been collected and identify abnormalities. Cues are clustered, clinical patterns identified, inferences, and hypotheses are made.
What is process information
Ways to prevent falls
What is promoting physical activity and exercise, keeping hands free when walking, non-slip socks, etc.
Examples of effective communication
What are:
clear messages, close loop communication, mutual respect, and confidentiality
Diagnosing a pulmonary embolism
What are:
Chest x-ray
Ventilation-perfusion Scan
Pulmonary Angiogram
CT Scan
MRI
Duplex Ultrasound
Lab Tests - D-dimer levels
EKG
3 interprofessional members on the RACE Team
What is the RACE registered nurse, RACE respiratory therapist, and RACE physician
Clinical judgement of healthcare providers was significantly better (compared to risk-stratification models) at predicting ______
What is the need for ICU admission and severe adverse events
mental health challenges older adults face
What is isolation, loneliness, depression, etc.
two main components of communication system in medical emergencies
What is community TO healthcare facilities and communication WITHIN healthcare facilities
Treatment options for a pulmonary embolism
What is:
Drug therapy - fibrinolytic drugs, anticoagulant therapies
Surgical therapy - in severe obstructions → embolectomy
The role of CCRT and what it stands for
What is Critical Care Response Team.
What is the team that assess and and stabilizes the patient’s condition, shares information with physician, transfer patient to higher level of care, follow-up assessments.
Definition of clinical reasoning
What is a systematic and cyclical process that guides clinical decision making, particularly in unpredictable, emergent, and non-routine situations, and leads to accurate and informed clinical judgements.
Biologic and intrinsic factors for falls
What are acute illness, balance and gait deficits, chronic conditions and disabilities, cognitive impairments, low vision, muscle weakness and reduced physical fitness
safe intermediate level of care between ICU and ward/home
What is step down units
Nursing roles in the treatment of a pulmonary embolism
What are any of the following:
Position patient in semi-fowler’s to support breathing
Maintain IV line for medications and fluid therapy
Administer oxygen as ordered
Monitoring of vital signs, SPO2, cardiac rhythm
Monitor lab results - INR, aPTT
Assess for complications of anticoagulant therapy
3 situations where RACE can be initiated
What are any of the following:
Airway - threatened airway, stridor, excessive secretions
Breathing - respiratory rate less than or equal to 8 or greater than or equal to 30, distressed breathing, saturations less than 90% or greater than or equal to 50% O2
Circulation - SBP less than or equal to 90 mmHg or greater than or equal to 200 mmHg or decrease greater than 40 mmHg
Decreased LOC - decreased LOC (GCS decrease greater than or equal to 2 points)
Other - urine output less than or equal to 100mL over 4 hrs, if the healthcare professional or family member is worried about the patient's clinical state
This can occur if the identification of subtle changes in a patient's clinical status occurs at the expense of increased trigger alerts per shift
What is alert fatigue
The ability to understand, analyze, and communicate information necessary to make informed decisions
What is health literacy
Role of step down bed
What is providing intermediate level of care, still require frequent monitoring, may have minimal organ support requirement, nurse ratio 1:2 to 1:4