Deteriorating Patient Flashcards
Which demographic is most likely to look “well”?
Children and young people
In what order are children likely to arrest?
Respiratory arrest first then cardiac arrest
What can indicate detrioration?
- Measurable Parameters - e.g. NEWS
- Organ Function
Who is at risk of deterioration?
anyone
What does “deterioration” look like?
It can look like a well person- young and healthy people can compensate for a while before becoming ill
If patient has “sluggish” cap refill or cold peripherals where else should you measure cap refill?
The central part of the body e.g abdomen
When can deterioration occur in an ill patient?
at any point
What type of patients are most vulnerable to deterioration?
those following an emergency admission to hospital
after surgery
during recovery from critical illness
What 3 factors are need for a good team dynamic to assess the deteriorating patient?
Good Leadership
Team working
Situational awareness
What is the purpose of the NICE guidelines: The acutely ill patients in
hospital (2007) ?
improve patient safety by addressing shortcomings identified in the NCEPOD report (2005) that acutely ill patients in hospital receive
suboptimal care.
Ensure early identification of the acutely ill
patient and prevent deterioration of clinical
condition.
Reduce patient mortality, morbidity and length of
stay.
To reduce ICU admissions and re-admission.
What are the key components of physiological observation?
- Heart Rate – respiratory rate – systolic blood pressure – level of consciousness – oxygen saturation – temperature
In specific clinical circumstances what additional physiological monitoring should be considered?
- Hourly Urine Output
- Biochemical analysis
- Pain Assesment
What can happen to the heart rate of a patient who is in shock? why?
Heart rate increases
to get more oxygenated blood around the body
What can happen to the lactate levels of a patient who is in shock? why?
They increase
Patient begins to respire anaerobically to produce enough quick bursts of energy to the body which produces lactic acid as a bi-product
What can happen to the respiratory rate of a patient who is in shock? why?
RR can increase
Body needs to increase intake of oxygen but also remove more CO2 to prevent increased acidity of the blood.
