Pressure Injury
What song did we play before the quality huddle on pressure injuries?
Under Pressure, By David Bowie and Freddie Mercury
A patient could be still considered a candidate for tissue donation until _____hours after their death.
24 hours.
How is Epinephrine administered for an anaphylactic reaction? (i.e. dose, route & frequency)
0.3-0.5mg IM q5min
True or false: a nurse can shock a patient in cardiac arrest independently of a doctor or nurse practitioner.
True.
Citrate serves as an anticoagulant by binding which molecule?
Ionized Calcium - Free or ionized calcium is an important component of the coagulation pathway.
When should wound care be consulted for a pressure injury?
Stage III, IV, X or DTI
Your patient was on piptazo for a pneumosepsis. They could be a tissue donor: True or False.
True - Exclusion criteria for tissue donation includes an "active systemic infection and untreated".
Why do we favor IM over IV when administering Epinephrine for an anaphylactic reaction?
Higher risk of error: administering cardiac Epinephrine dose IV, which can lead to cardiac complications such as MI, CVA or potentially fatal arrhythmias.
What button should you press when shocking without the presence of a NP or MD?
"Analyze"
Citrate-calcium complex is primarily metabolized by which organ?
Liver
Name the symbol on the progressa bedrails with which you can align your patient's hips.
Arrows.
Contacting Hema Quebec to recommend a potential tissue donor is an act reserved for physicians. True or False?
False. Nurses can and should be contacting hema quebec to recommend patients. Nurses are responsible for answering the question "Is the patient a potential tissue donor?" and "Has the patient been recommended to Hema-Quebec" on the "Notification of Death Form".
What is the next step for epinephrine administration if a patient is unresponsive to IM epinephrine administration?
Start an epinephrine infusion.
A patient is POD 3 after a CABG. They go into VF. After you call for help, what is the first line intervention?
What are the byproducts of calcium-citrate metabolism?
Bicarbonate and Calcium - Monitor for metabolic alkalosis.
You patient is experiencing diarrhea. What product can be used underneath the critic aid to provide further protection?
"No sting skin prep" or "Cavilon No sting barrier film"
Name two locations in the ICU where you can find with the steps for recommending a potential tissue donor to hema-quebec.
2. On the white board next to the CSI office.
Your patient goes into cardiac arrest due to anaphylactic shock. What is recommended dose, route and frequency of epinephrine?
1mg, IV, q3 to 5 minutes
Attempt pacing.
Through which method of solute transport is citrate removed to the effluent fluid?
Diffusion - i.e. via dialysate. If a patient is having increased metabolic alkalosis, decreasing the citrate dose, OR increasing the dialysate would be methods of reducing the citrate in the patients body.
What is the treatment for a stage II pressure injury located on a patient's heel?
Duoderm, changed q72 hours.
One tissue donor can help up to 20 different people. The hema-quebec website lists 5 main types of tissue grafts and how they can help change lives. Name 2.
1. Cornea Transplant
2. Musculoskeletal tissues (i.e. ligament or tendon)
3. Skin grafts for burn victims
4. Vascular tissue for arterial bypass or AAA repair.
5. Heart valve graft.
Early intubation by the best intubator is the recommendation in anaphylaxis management. If the team is unable to get an airway, a cricothyrotomy kit can be used. Where is this located?
In the clean utility room - top shelf above the respiratory equipment.
For up to how long can CPR be delayed in favour of defibrillation or pacing for patient in cardiac arrest post cardiac surgery?
One minute. If defibrillation or pacing cannot be done within one minute, CPR should be initiated. The resternotomy cart should be brought over with the goal of opening the chest within 5 minutes if these interventions don't work.
How does increasing the BFR impact the amount of citrate the patient receives?
This will increase the citrate delivered to the patient. This is why we don't increase the BFR unless an MD says okay.