Lab 5 code management Flashcards
What is code yellow
missing patient
what is code green
Evacuation
What is code orange
Mass casualty event has occurred alerts everyone to prepare for a lot of patients
what is a code brown
hazardous spill
what is a code grey
System failure ie water electricity
what is a code silver
means there is an active attacker in the hospital
what rate should you perform chest compressions at
100-120 bpm
to what depth should you compress an adults chest while performing compressions
compress at least 2 inches
what is the breaths to compression ratio
30 compressions: 2 breaths
What are the 5 rights of clinical reasoning
Right Cues
Right action
Right patient
Right reason
Right time
what are the steps of the clinical reasoning cycle
-Consider the patient situation
-Information collection
-Process information
-Identify the problem
-Establish goals
-Take action
-Evaluate outcomes
-Reflect on process and new learning
Consider the patient, take a good look,
Collect all the info, like reading a book.
Process the data, think what it shows,
Identify the problem, see where it goes.
Establish your goals, clear and precise,
Take action now, don’t think twice.
Evaluate outcomes, check what’s been done,
Reflect on your learning, improvement begun.
what is failure to rescue
The inability of clinicians to save a patient’s life by timely diagnosis and treatment when a complication develops
what are the 4 major causes of failure to rescue
-failure to recognize clinical deterioration
-Failure to communicate and escalate concerns
-Failure to physically assess the patient
-failure to diagnose and treat the patient appropriately
What are the 4 steps to preventing failure to rescue
-Surveillance/ assessment
-Timely identification of complications
-Taking action
-Activating a team response
What is usually the first sign of neurological deterioration
Restlessness
What is one of the earliest signs of instability?
Resp rate increase to above 20 per/min
How much oxygen can nasal cannula provide per minute
1-6 L/min
How much oxygen can a simple face mask provide per minute
6-10 L/min
How much oxygen can a non rebreather mask provide per minute
10-15 L/minute
what are two ways to improve ventilation in a patient that is experiencing acute respiratory failure
-create positive end expiratory pressure with a device during resp failure
-Endotracheal intubation
what 4 main elements are required for the heart to function properly
-oxygenation
-Perfusion
-electrolytes
-acid/base balance
what is the first sign of cardiac deterioration
heart rate increases to above 100 bpm
When would you call the MRP in regards to the patients resp rate
if they had resp rate greater than 25 or less than 8 or increased work of breathing
When would you call the MRP in regards to a patients blood pressure
if there is a systolic pressure less than 90 or a drop of more than 30
when would you call the MRP in regards to a patient’s heart rate
if they had a heart rate greater than 120 or less than 50
When would you call the MRP in regards to a patient’s LOC
if they had a sudden change in LOC or had a GCS score less than 10
When would you call the MRP in regards to a patient’s O2 saturation
if the have an SPO2 of less than 90% and the patient is on around 8L of O2 (50% FiO2)
When would you call the MRP in regards to a patient’s urine output
if they had a urine output of less the 80 mL over the last 4 hours
When would you call the MRP in regards to seizures
if they had new repeated or prolonged seizures
when would you call the MRP in regards to chest pain
if they had chest pain that wasn’t relieved by nitro spray as ordered
When would you call the MRP for things not related to the patient’s vital signs or output
-If they were exhibiting FAST VAN stroke symptoms
-If they had unexpected significant bleeding
-The patient is failing to respond to treatment ie BP not coming up after administering a fluid bolus
when would you start to suspect sepsis in a patient
If the patient had two of the following:
-HR greater than 90
-RR greater than 20
-Temp of 38 or greater or less than 36
-WBC greater than 12 or less than 4.0x10^9
-Change in LOC
AND confirmed or suspected source of infection
What is always the prefered method of communication
Always communicate with SBAR
What are the components of a primary survey during a code
-Rapid assessment of the patient and the environment
-ABC
-D (AVPU)
What are the 4 different levels of responsiveness in an AVPU assessment
-Alert
-Verbal stimuli
-Painful stimuli
-U-Unresponsive
What are the most common reversible causes of cardiac arrest
H’s
-Hypovolemia
-Hypoxia
-Hydrogen (acidosis)
-Hypo/hyperkalemia
-Hypothermia
T’s
-Tension pneumo
-Tamponade cardiac
-Toxins
-Thrombosis, pulmonary
-Thrombosis, coronary
Should the family be present during a code situation
Yes there is overwhelming evidence that it has the best outcomes if the family is present during the code
what is the emphasis of the post resuscitation period
-maintain optimal tissue oxygenation and perfusion
-identify the cause of the arrest
-initiate treatment
When should you call a code blue
-When your patient is in respiratory or cardiac arrest
-When your assessment suggests early warning signs of arrest
-When directed to do so
What health care staff compose CCOT
-Critically trained RN from ICU
-Respiratory therapist
What are the different stages in the respiratory bell curve
-20 RR
-24 RR
-30 RR
-Increasing through 40’s
-Decreases to 4-10
-Apnea
What are the different stages of neurological deterioration
-Restless
-Anxious
-Irritable
-Agitated
-Confused
-Combative
-Lethargic
-Unresponsive
when would you stop performing abdominal thrusts on a patient
when the item they are choking on becomes dislodged or the person loses consciousness
What are the three steps in performing CPR
-Chest compressions
-Airway
-Breaths
*remember CAB abbreviation (this is also kind of the priorities ie the #1 priority should be chest compressions)
What is the chest compression to ventilation ratio
30 compressions : for every 2 breaths
what technique is used to open the airway of an unresponsive patient
head tilt/chin lift
after delivering a shock with an AED how long should CPR be performed for until the next rhythm check
2 minutes
When would you stop CPR if a patient begins to breath on their own
when they start breathing on their own 10 times per min
is there any difference in the number of compressions or the rate at which you perform compressions for a child vs an adult
No all the same
