What to do when you don’t know what to do…

Slides:

Advertisements

Similar presentations

ITU Post Operative Monitoring – Up to 4 hours

Advertisements

Shock.

Recognising the Deteriorating Patient

Phase 2; Year 2; G-I Block Acute Patient Assessment Acute Care Theme Topic Prof J A W Wildsmith.

A Dyspnoeic Lady Author Dr Tang Chung Leung Dec 2013.

Principles of Trauma Symphony of Surgery

Postoperative Care: Shock in the Surgical Patient Stuart Forman MD, FAAFP Contra Costa Regional Medical Center June 2006.

Lesson 3: Secondary Assessment Emergency Reference Guide p

Chapter 38 Acute Care. Measures to Promote Optimal Functional Independence Careful assessment to identify problems and risks Early discharge planning.

ICU Housekeeping Nov Outline  The daily review  Good practice points  Paperwork  Discharge planning.

Chest Pain and Cardiac Emergencies Chest Pain and Cardiac Emergencies WelcomeChest PainCertaintySimulation.

Focused History and Physical Examination for Medical Patients CHAPTER 11.

Pneumonia and Sepsis By Oliver Putt and Priyanca Patel For WMS Peer Support – 11 th November 2014.

3. Documentation and Monitoring of Dengue Patients

RET 1024 Introduction to Respiratory Therapy

Pre and Postoperative Care Dept of Surgery Yong Loo Lin School of Medicine National University of Singapore.

Monitoring of Patients during Anesthesia and Surgery Haim Berkenstadt MD Director, Department of Anesthesiology Deputy Director, The Israel Center for.

Pages LEQ: When caring for a shock victim, how does the type of shock determine the treatment?

Shock Part 3: Chapter 9.

Acute care Assessment and Management. Airway Obstruction because of…  CNS depression  Blood, vomit, foreign body  Trauma  Infection, inflammation.

Inova Loudoun Hospital ICU SAMANTHA MENDIGUREN. Critical Care Nurse ▪ Assigned one to two patients in the ICU. ▪ Checks on patients overall well being,

 Triage is from a French word meaning to sort. Emergency services regularly face patient loads that overwhelm resources. To better serve patients and.

First Aid What are the Emergency Actions Principles? a ______________________________ b ______________________________ c ______________________________.

 Primary Survey (D,R,C,A©,B,C?)  Help organised  Dealt with life-threatening conditions.

Hemorraghic Shock Sara Parker MD VCU Trauma Conference STICU Fellow

SHOCK Sudden collapse of circulation is called shock and is one of the most formidable conditions in clinical practice Sudden collapse of circulation is.

Life Support in Haemorrhage and Fluid Loss H.Gee MD, FRCOG.

Case Report 95/06/11 Intern 張偉德. Patient ’ s Profile  Name ：郭 ○ 玲  Age ： 40 y/o  Sex ： female  Chart no. ：  95/6/25, 12:04 入 ER.

 Mr Micheal Reilly  57 year old previously well car salesman  Fall from ladder, admitted with fractured femur  Day 3 post op: agitated, visual hallucinations,

Penetrating Neck Trauma Algorithm

Paediatric Emergencies

Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children,

“When in danger, when in doubt, run in circles, scream and shout.”

DR TOM HARDY SHO GENERAL SURGERY ???. 85 yo male Patient referred from GP – concerned about this gentleman’s pain, ?appendicitis 4/7 increasing RIF Over.

1 Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

1 Shock. 2 Shock refers to an abnormality of the circulatory system in which there is inadequate tissue perfusion due to a relatively or absolutely inadequate.

Confusion et al. = Confusion Corner 20 female fever episode of confusion Asleep 40 yr old Eastern Creek, fully geared up, off 120kph Amnesic.

By: Katie Helms, April Greene, Erin Mosher & Wyatt Withers.

Assessment in a systematic way

Objectives  To understand the structured approach to circulation problems  To recognise and manage shock.

Dr Nikhilesh Jain CHL Hospitals,Indore. Objectives  Explain what is meant by assessment of the acutely ill patient.  Describe the process of assessing.

Dilawaiz Nadeem MCh Orth, MD, FRCS (Ed) Trauma & Orth Professor /Consultant Orthopaedic Surgeon SIMS / Services Hospital, Lahore Find Online Presentations.

Post Anesthesia Care. Post Anesthesia Unit  Specialized critical care area  Also called recovery room or PACU, (post anesthesia care unit)  Usually.

SHOCK. What is shock? Shock is a life-threatening medical condition as a result of insufficient blood flow throughout the body. Shock often accompanies.

Joint Special Operations Medical Training Center Manage a Patient Under General Parenteral Anesthesia INSTRUCTOR SFC HILL.

Chapter 9 Shock.

Critical Care Outreach

Bleeding & Shock.

OSCE Questions Feb 2017 POH.

How Do We Comply with all the Rules and Regulations?

Serotonin syndrome – one minute read

or who have clinical observations outside normal limits.

Admission Avoidance Assessment of vital signs

SEPSIS – What is Sepsis? <insert date>

Dr F Hignett, September 2015 ST4 Paediatrics

Aortic Dissection Diagnosis & Missed Diagnosis Dr Ruth Large

How Do We Comply with all the Rules and Regulations?

Objectives of patients flow map

Fluids Dr Omar Mansour Consultant Colorectal & Laparoscopic

Larry Halem, MD, CPC VEP Regional Productivity Director

Nursing Care of Patients in Shock

Anaesthetic management of the Trauma Patient

Lesson 3 Secondary Assessment

Assessment of the trauma patient

Lesson 3: Secondary Assessment

Initial evaluation and treatment of DKA in the emergency department

Circulation and haemorrhage control

Unit 16 Primary Assessment.

Presentation transcript:

What to do when you don’t know what to do… Christopher D Mills Medical and Intensive Care Registrar Monash Health

D Danger

D Danger Don’t Panic

R Response

D Response Reminisce

A Airway Maintained? Own? Tubed? Can I Fix This?

Signs of respiratory compromise? B Breathing Can they talk to me? Signs of respiratory compromise? RR? SaO2? Chest Examination? Blood Gases? CXR? CT Chest? Can I Fix This?

C Circulation Can I Fix This? Pulse? Blood Pressure? Rhythm? Rate? ECG? Cardiac Sounds? Can I Fix This?

DON’T EVER FORGET GLUCOSE! Disability GCS? Moving all 4 limbs? Coherent / Oriented? CT Brain? LP? DON’T EVER FORGET GLUCOSE! Can I Fix This?

?

Electrolytes and Metabolic EUC? CMP? Can I Fix This?

F Fluid What? How much? Volume Status? Urine? Can I Fix This?

Abdominal Examination? G GIT Abdominal Examination? Surgery? Scars? Output? PR? CT Abdomen? LFT? Lactate? MOVE THE BED SHEETS! Can I Fix This?

H Hb / Clotting Can I Fix This? Hb? Platelets? INR / aPTT? D Dimer / Fibrinogen? Declotting Stuff? Can I Fix This?

I Infection IS THIS PERSON SEPTIC? Can I Fix This? Temperature? WCC? Ferritin? CRP? IS THIS PERSON SEPTIC? Can I Fix This?

J Juice (Drugs) Can I Fix This? Medications? Do I need anything now? What have we given? Can I Fix This?

Are they aware of what is going on? K (Next of) Kin Are they present? Are they aware of what is going on? Prognosis? Can I Fix This?

L Lines IF YOU CAN’T GET IT – ASK! Can I Fix This? What do I have? What do I need? IF YOU CAN’T GET IT – ASK! Can I Fix This?

Significant Injury (eg. NOF #) M Musculoskeletal Significant Injury (eg. NOF #) Bleeding into muscle? Can I Fix This?

Do they have a Toxidrome? N Narcotics / Toxins Have they had any? Do they have a Toxidrome? Have we checked? Can I Fix This?

Is there anything else unique to this patient that is important? Other Stuff Is there anything else unique to this patient that is important? Can I Fix This?

Will they have any with what I’m about to do? P Pain Do they have any? Will they have any with what I’m about to do? Can I Fix This?

Q Transfusion Have they had one? Do they need one? Can I Fix This?

Should we be doing what we are doing? Resus Status Documented? Should we be doing what we are doing? Can I Fix This?

Is there any other treatment? Skin and Wounds Documented? Is there any other treatment? Can I Fix This?

?