2.2 Safety and Emergency Flashcards
Developmental Safety
Pregnancy - Do not drink/smoke or use drugs
Infants - Prone to falls and accidental ingestion.
(Requires supervision
Child - Likely for injury during play
Teens - Begin of drugs, alcohol, sex and driving
Stressed Adult - Continue high risk behavior
Elderly - Lose cognitive abilities, balance, confusion, falls and inability for self care.
Occupational Safety
Toxins, infectious agents, noise pollution, air pollution.
Lifting heavy loads risk for musculoskeletal injury
Workplace Violence.
Social Behavior
Drugs, alcohol, risky sexual behavior.
Not wearing helmet/seatbelt, car seat for children.
Environment/Mobility/Sensory Perception
Living in high crime areas, or natural disaster area.
Locks/security cameras and alarms can help.
Unsteady gait can increase risk of falling.
Alteration in sight/smell/hearing/touch/taste can decrease awareness.
Knowledge/Communication/Healthstate
Lack of knowledge of medications or medical equipment and procedures increase risk
Fatigue, stress, speaking different language makes assessment and education difficult
Acute/chronic illness weaken people. They may not be able to prevent injury as well. Stress also leads to increased accidents, depression, and social isolation.
Physical Examination
- Mobility Status
- Ability to communicate
- Level of awareness/orientation
- Sensory perception
- Potential safety hazards
- Domestic violence
Infant Safety Tips
- Use car seat. Rear facing less than 2 years old
- Infants must sleep on their back
- Childproof ingesting poison, electrocution, matches and firearms.
- Assess for abuse, physical/emotional/psychological neglect, or trafficking.
School aged Safety Tips
- Wear helmet with chinstrap
- Assess for concussion after head injury during sports activity
- Car booster seat with lap belt
- Should not sit in front seat under 13
- Childproof poison, electrocution, matches, firearms
- Assess abuse and sexual/physical/emotional/psychological neglect
- Teach children AMBER alert and about abduction
Adolescent
- Motor Vehicle Safety and Distracted Drivers
- Drug/Alcohol/Tobacco/Vaping abuse
- Discuss risky sexual behavior/avoid catching STI
- Clean environment for tattoo and piercings.
- Safe gun and supervised gun use
- Internet Safety (Meeting strangers, information online may not be truthful.
- Signs of abuse or trafficking
Adult
- Reminder of effects of stress on lifestyle/health
- Assess for partner violence, safety of living with abuser, children at home, pregnancy safety, leaving relationships.
Older Adult
- Change in vision, reaction time, impaired thinking related to falls and MVC accidents
- Environmental factors that can lead to falls
- Assess smoke detectors and increased risk of fires
- How to take medications (overdosing)
- Elder abuse
Risk of Falls
- Patient will have armband and sign will be at door warning risk of falls.
- Lower body weakness, poor vision/balance/gait, use of psychoactive medications, dizziness when standing, and home hazards raise risk of falls.
How to prevent falls
- Identify at risk patients (including armbands)
- Assess history of falls
- Combine assessment tools with nurse care plan
- Use skid-proof socks
- Keep beds locked and as low as possible
- Sensor for at risk getting out of bed
Assessing Patient after Fall
SPLATT S - Symptoms at time of fall P - Previous Fall L - Location of Fall A - Activity at time of Fall T - Time of Fall T - Trauma after Fall
Restraints/Side Rails
Restraints - Last resort. Risk of falls, confused, removes medical devices. Assess patient during restraints and remove every 2 hours.
Side Rails - 2 rails is not restraint, all 4 is restraint. Prevents patients from falling out of bed. Mobility and bathroom every 2 hours or as needed.
Alternative to restraints
- Determine behavior pattern and assess pain, electrolyte, vitals, respiratory status, blood glucose and medications.
- Involve family members and keep patient occupied with favorite hobbies.
- Reduce stimulation, noise, and light in room.
Guidelines for restraint use
- Patient has the right to be free from unneeded restraints
- Family must be involved in plan of care
- Can only be considered after assessment, environmental, and situation.
- Alternatives have already been tried
- Benefits must outweigh risks
- Must be ordered by physician after in person assessment
Guidelines for Restraint Use
Less than 9 - released every hour
9-17 - Every 2 hours
18+- Every 8 hours.
Guidelines for restraint use
- Must be monitored every hour (15m at psych)
- Personal nutrition/elimination needs must be met
- Skin Integrity and ROM must be preformed
- Document why, how, where and for how long restraints are placed
Types of restraints
Mummy Restraint (Swaddle) - Used for infants (Examine head and neck care, short term) Hand Mitt - Used for pulling out tubes (Least restrictive) Wrist Restraint - Used pulling out tubes, hands tied to bedframe Waist Restraint - Used when disoriented and tries to get out of bed. (Use slipknot and tie to bedframe, or behind chair) Elbow Restraints - For children who pull out medical equipment Posey Bed - Full enclosure of patient who escape all other restraints.
Stages of Seizures
Aura Stage - Hallucination, Confusion, Dizzy, Disoriented, Numb
Tonic Stage - Epileptic Cry, Stiff Body, Back Arched
Clonic Stage - Jerky, Frothy Saliva, Blinking Eyes
Postical Stage - Weak Limbs, Exhaustion, Sleepy
Safety of Seizure
- Watchout for signs. Shallow breathing, cyanosis, loss of bladder control.
- Common to have amnesia, confusion, or falling into deep sleep.
Safety - Pad Side Rails
- All 4 Rails Up
- Suction must be set up.
- AMBU Bag Setup
