Lecture 6: Unresponsive Patient

Question 1

Level of consciousness normal vs abnormal

Answer 1

Normal:
-alert
-awake
-oriented
-interaction

Abnormal:
-lethargic (drowsy, slow, sleeping)
-obtunded (difficult to arouse, confused, mumbling)
-Stupour or semi coma: (Spontaneously unconscious, reponds to pain.)
-Coma: completely unconscious, no response to pain
-Acute confusional state

Question 2

Causes of Unresponsiveness: neuro vs Cardiovascular vs resp vs endocrine

Answer 2

Neuro:
-Stroke
-Seizure
-Trauma

Cardio:
-myocardial infraction
-heart attack
- cardiac arrhythmia

Resp:
-Pulmonary embolism
-Respiratory arrest (chocking, Opiod arrest)

Endocrine:
-Hypoglycemia

Question 3

What does an opiod arrest cause?

Answer 3

Respiratory unresponsiveness

Question 4

ABC’s are now _____

Answer 4

CAB

Question 5

what’s CAB

Answer 5

C: Circulation (pulse)
A: Airway
B: breathing

Question 6

Steps of patient not responding (1-4)

Answer 6

1. Shake and shout
2. Pinch and squeeze
3. Sternal rub (no longer recommended)
4. CALL FOR HELP

Question 7

First step of unresponsive patient

Answer 7

Shake and shout

Question 8

what is not recommended for seeing patient unresponsive

Answer 8

Sternal rub

Question 9

Definite pulse but NO BREATHING. What do you do? You already checked circulation….

Answer 9

1. “A” Airway : OPEN it
2. “B” breathing: Bag -Valve-Mask

Question 10

how do you use bag valve mask?

Answer 10

1 breath every 5-6 seconds
Recheck pulse every 2 mins

Question 11

You checked circulation and there’s NO PULSE. What do you do?

Answer 11

IMMEDIATE CHEST COMPRESSION:
-push hard and fast
-100-120 compressions per min
-Depth 2 inches
-allow chest recoil after each compression
-minimize interruptions in compressions

Question 12

What’s some criteria for perfect CPR:

Answer 12

-push hard and fast
-100-120 compressions per min
-Depth 2 inches
-allow chest recoil after each compression
-minmize interruptions in compressions

Question 13

No pulse, No breathing. What do you do?

Answer 13

CALL CODE BLUE
-request crash cart
-give report code blue team
-Participate in code/ CPR if needed

Question 14

what’s the criteria to call race team?

Answer 14

Anything sus

Question 15

How do you report a medical emergency to Race team/Physician/RN:

Answer 15

SBAR:
Situation-What is going on
Background-what happened
Assessment-What I think is wrong
Recommendation- What needs to happen/suggestions

Question 16

what’s SBAR

Answer 16

Situation-What is going on
Background-what happened
Assessment-What I think is wrong
Recommendation- What needs to happen/suggestions

Question 17

Communication of SBAR: Non critical situation vs Critical situation

Answer 17

Non critical: Communication of concerns related to identified problems
-nurse to nurse

Critical situation: Communication of changes in patient’s condition
-Nurse student reporting to co assigned nurse
Nurse to physician
-Nurse reporting to anyone’s

Question 18

What’s a neurological re check

Answer 18

-LOC
-orientation x3
-pupillary response
-motor function
-vitals signs