Intervention Rational Flashcards
Why do we check the airway?
To ensure airway patency and confirm there is no obstruction or abnormal sounds or movement. Untreated airway obstructions can result in reduced air entry, which can impair other systems within the body, cause hypoxia and prevent gas exchange from occurring.
Rationale for oxygen
I administered 15L of oxygen via a non rebreath mask as per the APLS Guidelines to supply the body with oxygen, maintain saturations and homeostasis and prevent hypoxia which can cause respiratory arrest, whilst averting secondary injuries to tissues and organs.
I used a non rebreathe mask as it administers between 90-100% oxygen to the patient, and inflated the reservoir bag prior to administration to prevent the inhalation of carbon dioxide.
Rationale for IV access
I obtained IV/IO access in order to administer…
The APLS guidelines recommends trying for 90 seconds before moving onto IO access, whereas the Surviving Sepsis guidelines recommends going straight to IO. In a child with sepsis, peripheral circulation is compromised, so IO access is more likely. The IO needle goes in a long, flat bone.
Rationale for resus fluids
20ml/kg of 0.9% sodium chloride via IV/IO according to the APLS Guidelines
Less likely to generate an allergic response, cheap and readily available.
Replaces circulating losses which therefore increases and maintains delivery of oxygen to the cells and the removal of waste products.
Rationale for IV antibiotics
NICE recommendation, IV broad spectrum antibiotics within one hour: to treat any sources of bacterial infection. Once the blood cultures are returned, the antibiotic dose can be altered to treat the specific bacteria
Rationale for taking blood cultures
The UK Sepsis Trust and the NICE Guidelines recommends taking blood cultures prior to the dose of antibiotics to improve the ease of identifying the cause of infection
Rationale for suctioning
I suctioned using a soft tip suction catheter at a pressure of between 12-20 Kpa as per the AOPCT guidelines, and suctioned gently in the sides of the cheeks and in the tip of the nostrils to ensure the airway was patent. Untreated airway obstructions can result in reduced air entry, which can impair other systems within the body, cause hypoxia and prevent gas exchange from occurring.
Rationale for checking blood glucose
I took a blood glucose sample to assess the patient’s glucose levels; abnormal glucose levels can further reduce conscious levels, which can cause complications in maintaining airway patency.
Rationale for bronchodilators
British Thoracic Society and BNFC
The NICE Guidelines recommend 10 puffs back to back or nebulisers given in 6L of oxygen.
Beta-2 agonists act on and stimulate the beta-2 receptors in the muscles that line the airways, causing the smooth muscles to relax and dilate, widening the airways.
Rationale for corticosteroids
British Thoracic Society and BNFC
Corticosteroids, such as oral prednisolone, are anti-inflammatory, and act on the immune system to reduce inflammation, swelling and mucus production in the airways by mimicking the effects of hormones produced in the adrenal glands in order to suppress inflammation.
Rationale for positioning
I have confirmation that my patients blood pressure is stable, so I would sit them up to aid with their breathing.
Why do we assess the patients breathing?
We assess the patients breathing to detect signs of respiratory distress or poor ventilation
Why do we assess the patients circulation?
Assessing the patients circulation allows us to understand the effectiveness of their heart, and the cardiac output
Why do we assess disability?
Assessing a patients disability allows us to undrestand their level of consciousness. Reduced consciousness can cause complications in maintaining airway patency, and may require intervention.
Why do we assess the patients exposure?
Checking the patients skin for rashes, bruises and wounds may give us a further understanding into the patients condition.
