3 D's
This condition is an acute confusional state and a medical emergency with a fluctuating course. It can be caused by many physiological factors such as dehydration or infection.
What is DELIRIUM?
Delirium can be reversed by treating the underlying cause such as providing oxygen for a hypoxic person.
This type of pain is persistent over several months or years and does not necessarily have an identifiable cause.
What is CHRONIC PAIN?
Acute pain is sudden and can usually be easily attributed to a specific cause such as a recent injury. The cause of chronic pain is often difficult to determine even after many investigations.
These are products that need to be applied to the skin in a thin layer by someone wearing gloves.
What are CREAMS & TOPICALS?
Creams and topicals must be monitored and their effectiveness documented so that it can be decided if the cream can be stopped, continued, or should be changed to a different treatment.
This condition is usually treated initially with 24 hours of increased fluids but may require antibiotics if symptoms persist.
What is a URINARY TRACT INFECTION?
Symptoms of a UTI can be: frequency, urgency, burning, foul smelling urine, cloudy urine, fever, suprapubic or flank pain/tenderness, hematuria, rigors, delirium.
These two acronyms are an essential part of the Code Red protocol.
What are REACT and PASS?
REACT stands for: Remove those in immediate danger, Ensure doors and windows are closed, Activate fire alarm, Call 911, Try and extinguish the fire
PASS is about how to use a fire extinguisher and it stands for: Pull the pin, Aim nozzle at the base of the fire, Squeeze trigger, Sweep nozzle from side to side
SIG E CAPS is an acronym that can be used to help identify this mental health condition.
What is DEPRESSION?
SIG E CAPS stands for: Sleep disturbed, Interest decreased, Guilty feelings, Energy lower, Concentration poor, Appetite disturbed, Psychomotor retardation or agitation, Suicidal ideation
This type of pain is caused by nerve damage or dysfunction and can be difficult to manage.
What is NEUROPATHIC PAIN?
There are many types of pain. Other types can include: phantom, inflammatory, nociceptive, bone, cancer, soft tissue, emotional, arthritic
This pressure sore stage is characterized by a red closed area.
What is a STAGE 1 ULCER?
This is the least severe stage of pressure ulcers. The other stages go from 2-4 and get progressively more severe as the ulcer gets deeper and affects more underlying layers and structures of the skin
A resident would be promptly isolated for this if they were to present with acute onset of new cough or change in an existing cough PLUS one or more of the following: fever, sore throat, arthralgia (joint pain) myalgia (muscle aches), prostration, (severe exhaustion)
What is INFLUENZA-LIKE ILLNESS?
Residents with ILI must be isolated for contact & droplet precautions. An order should be obtained for an NP (nasopharyngeal) swab which would then be sent to the Provincial Laboratory to determine if the illness is Influenza. An outbreak occurs when there are 2 or more linked ILI cases (same area, same caregivers, etc.) within 7 days and at least one case is confirmed by laboratory to be Influenza.
In a Code Blue situation, chest compressions are only given to those at this level of Goals of Care.
What is R1?
R1, 2, and 3 are all resuscitative, but chest compressions are only performed for someone who has chosen to be at the R1 level. R1 is the level where all possible measures are taken to resuscitate a person so if GOC have not been set for a person and they experience a cardiac emergency, they would be R1 by default.
Vascular and Frontotemporal are part of this broad category of chronic diseases affecting the brain.
What is DEMENTIA?
Some types of dementia include: Alzheimer's, Lewy Body, Vascular, Frontotemporal, Parkinson's associated, Corticobasal degeneration, and Progressive supranuclear.
For a typical adult, the maximum amount of Acetaminophen that can be given each day is this.
What is 4000 mg?
Remember that Acetaminophen is not only given on its own but can be included in many other commonly given drugs such as Tramacet or T3s. Make sure you are adding up the Acetaminophen from ALL sources when calculating how much someone has had in one day
This component of the Braden Scale references an essential building block for the healing of wounds.
What is NUTRITION?
Eating satisfying meals high in protein throughout the day will provide the building blocks the body needs to repair the wound.
This respiratory illness can be caused by a variety of pathogens such as bacteria, viruses, or fungi but can also be the result of an episode of choking.
What is PNEUMONIA?
Pneumonia is an inflammatory disease of the lungs causing cough, purulent sputum, fever, and difficulty breathing. Aspiration pneumonia is caused when something that is not air is inhaled into the lungs which is why it is important to monitor residents in the dining room. If choking/suspected aspiration occurs, the resident needs to be monitored for onset of pneumonia and should possibly have their diet reassessed especially if the problem reoccurs. When assessing for pneumonia, ensure you are monitoring: the resident's vital signs, the quality of the sputum, ease of breathing, and lung sounds by auscultation. If fever spikes or breathing becomes difficult/O2 sats drop, notify the physician and the resident will likely need to be sent out to hospital.
Using active listening, calling for backup, not blocking exits, using release manoeuvres, and being aware of your escape route are all important tools to use during this code.
What is CODE WHITE?
Code White is violence or aggression. You want to speak calmly to the aggressor and make sure you always have an exit route available. If you or someone else becomes trapped by the aggressor, the situation can become a Code Purple - hostage situation.
While they may be disruptive, odd, or confusing these actions taken by persons with dementia are a way of communicating ideas and feelings.
What are RESPONSIVE BEHAVIOURS?
Persons with dementia use responsive behaviours to communicate a need such as hunger, fatigue, or a need to use the bathroom. Always try to understand why the behavior is occurring and then address the underlying issue
Pinpoint pupils, unresponsiveness, and decreased breathing rate/depth are indicators of this condition in an opioid user.
What is OPIOID OVERDOSE?
Opioid overdose must be recognized effectively and a physician's order for Naloxone must be urgently obtained. Without prompt treatment with Naloxone, the resident can quickly die from hypoxia.
This skin condition can be identified using the acronym NERDS which stands for: Non-healing, Exudate, Red friable tissue, Debris, and Smell.
What is a SUPERFICIAL SKIN INFECTION?
In persons 65 years of age and older, fever may not be prominent due to older adults having a lower basal body temperature. Also, ranges for 'normal' body temperatures can vary depending on the method used to obtain the temperature (oral, rectal, tympanic, etc.). Therefore, AHS uses this temperature deviation as the general standard for identifying fever in a resident.
What is A TEMPERATURE >1.5° CELSIUS ABOVE BASELINE?
Any infection in a resident can result in a fever. If a fever is occurring, that means the infection has progressed to a more serious level meaning that the physician should be informed and the resident should be monitored closely. A temperature can quickly spike and result in death.
The process for this code includes an escalating series of searches starting with checking the sign out record, doing an immediate search of your community with your colleagues, and then finally informing the incident commander who will organize a search of the building/site and may ultimately involve the police.
What is CODE YELLOW?
Code yellow is the code for a missing person.
Occurring in the late afternoon and into the evening, this common behavioural symptom of dementia can lead to aggression, anxiety, and wandering.
What is SUNDOWNING?
Other behavioural and psychological symptoms of dementia (BPSD) are: agitation, wandering, restlessness, pacing, hoarding, rummaging, depression, sleep disturbance
This pain scale can be used to assess pain in a non-verbal person.
What is PAINAD?
The PAINAD scale asks you to rate a person's: breathing, negative vocalization, facial expression, body language, and consolability as 0, 1, or 2 which add up to a score out of 10
This skin condition can be identified by the acronym STONES which stands for: Size increase, Temperature, Osteomyelitis probes to the bone, New breakdown, Exudate, and Smell.
What is a SPREADING or DEEP TISSUE INFECTION?
This diarrhea-causing bacteria is not killed by hand sanitizer and is the reason why hand hygiene with soap and water is the gold standard when providing care for a resident with diarrhea.
What is C. DIFF?
C. Diff, or Clostridium difficile, forms spores that cannot be killed by hand sanitizer. The only way to prevent transmission of these infectious spores from one person to another is to wash hands thoroughly with soap and water.
This kit, which is available on all units, is used in response to a Code Brown.
What is a SPILL KIT?
Code Brown is for a hazardous/chemical spill. Contact the incident commander and locate your unit's spill kit for containment and proper disposal of the spill. Depending on the nature of the spill, it may be necessary to contact maintenance or even the fire department