NEWS2 revision Flashcards
what does abcde stand for?
Airway
Breathing
Circulation
Disability
Exposure
things to asess; breathing
*depth
*chest movements
*RR
*effort
*sound
why might someone not breathe properly in relation to pain?
if someone is experiencing pain in their chest/abdomen, they may take more shallow breaths to ease the pain
effects of not breathing properly?
*reduced O2 sats
*inability to clear mucus in chest; risk of chest infection
*breathlessness/distress
spo2 scale 1
*95-99%
spo2 scale 2
*88-92%
*for those at risk of hypercapnia, e.g., COPD
*must be decided by doctor/ANP
RR
rate; 12-20
bradypnea; <12
tachypnea; >20
regularity of breaths
sound; should be almost silent. any wheezing? crackles? etc.
use of accessory muscles/effort used
both sides of chest rising/falling equally?
colour of patient; signs of hypoxia/hypoxaemia? cyanosis?
what to consider when checking pulse
rate; 60-100
bradycardia; <60
tachycardia; >100
ryhthm; pattern of beats, regulaur/irregular
amplitude (volume); strength of beats, strong and bounding or weaky and thready?
blood pressure
rate; 120/80
hypotensive; <70?
hypertensive; >130
what does AVCPU stand for?
Alert
[Acute] confusion
Voice
Pain
Unresponsive/unconscious
temperature
normothermia; 36-37.5C
hypothermia; <35C
pyrexia; >38*C
what to consider when managing pain?
Type of pain; visceral, somatic, neuropathical
Source/sight of pain ^; where?
Amount of pain; ‘from 1-10 with …’
What worsens the pain and what could help; e.g., walking, provide AO1 care and potential aid?
Reassure & listen to PT, aware that anxiety can worsen pain
Administer prescribed appropirate analgesia
Re-asses continually; is it effective? side-effects & their management? tolerance?
what is the cause of pain?
tissue damage & associated inflammatory response
examples of pain caused by musculoskeletal conditions
*osteoathritis; stiff & painful joints
*fractures
*soft tissue injuries; muscles/tissues/joints/sprains/strains
example of pain cause by surgery
*incision site; cut skin & tissue
*extent of tissue damage
*type of surgery
types of traumas
RTCs
stabbings
burns
fractures
head injuries
what is neuropathic pain & example
damage/dysfunction to the nerves of the NS
pain caused by lesion or disease of the somatosensory system
example; phantom pain experienced by amputees
two examples of neuropathic pain
diabetic neuroapthy; damage of the nerves caused by diabetes. progressively, hyperglycaemia can restrict bloodflow to damaged nerves causing pain
shingles; an infection which damages nerve fibres, interfering with informatiom transmission to the brain & therefore consumed/exaggerated messages = chronic pain
pain caused by diseases
cancer; tumours can release chemicals which damage nearby tissue causing pain
IBS; inflammation can damage tissues and cause pain
Appendicitis
appendicitis; a swollen and inflammed appendix can irritate the lining of the abdominal wall and cause localised, sharp pain in the lower right abdomen
what happens when you sit up a breathless PT
you allow their abdominal muscles to move downwards, provides the diaphragm with enough space to move up & down, allowing efficient air in/out the lungs
why is BM (blood sugar) documented on NEWS2?
this relates to their ACVPU scale; whether PT is known to be diabetic or not, hyper & hypo glycemia levels can effect someone’s neurological state
why is pain documented on NEWS2?
pain can affect the following;
HR; tachycardia
RR; tachynpnoea/hyperventilation
why is ‘?PT last pass urine’ on NEWS2?
can be relevant to;
BP; decreased blood volume & therefore pressure
HR; initially increase then decrease
why is GCS on NEWS2?
a PT’s neurological state can impact on all their vial signs & being alive
what can the blank box on NEWS2 be used for?
can be left blank or used to document relevant info to that specific pT; e.g., medication such as a sedative which would impact their vitals
what does escalation of care on NEWS2 mean?
if your PT’s NEWS2 score was alarming, you would put Y for yes, in that you were escalating, then do so, or N for no, and continue on normal hourly
how can pain relief be administered?
PO; orally
Topically; on the skin
Rectally
Vaginally
Bucal; under the tongue
IV; intravenously
IM; intramuscular
Epidural; spine
Subcut; subcutaneous tissue
Transdermal; skin patch
apnoea?
temporary absence or cessation of breathing
orthopnea?
difficultry breathing when lying down
dyspnoea
difficulty breathing in general
tachynpnoea
high RR
