Tranforming Practice Flashcards
What is track and trigger? NEWS2
The national early warning score used to identify 6 physiological parameters:
- respiration rate
- oxygen saturation
- systolic blood pressure
- pulse rate
- level of consciousness or new onset confusion
- temperature
NEW scores determine what level of critical care you receive and how often you are monitored.
What is the SOFA score?
Organ failure assessment tool
Clinical recognition tool for sepsis
Questions:
Is the patient in ICU?
Altered mentation
Respiratory rate
Systolic blood pressure
What is ICU acquired weakness?
Linked to failure to wean from mechanical ventilation, longer hospital length of stay, long term functional impairment and reduced quality of life.
What is the ABCDEF bundle?
Involves early mobilisation in the ICU.
Assess, prevent and manage pain; Both spontaneous awakening and spontaneous breathing trial; Choice of sedation and analgesia; Delerium: assess, prevent and manage; Early mobility and exercise; Family engagement and empowerment.
What is the Chelsea critical care physical assessment tool?
An outcome measured designed to assess 10 domain of physical ability:
Respiratory Function
Cough
Bed Mobility
Supine To Sitting On The Edge Of The Bed
Dynamic Sitting
Sit To Stand
Standing Balance
Transferring From Bed To Chair
Stepping
Grip Strength
Graded 0 (complete dependence) to 5 (complete independence).
Explain the use of pre habilitation for reducing risks post surgery?
Physical and inactivity and poor fitness
- inspiratory muscle training: a handheld device is used to support maximal inspiratory pressure
Smoking:
Risk factor affecting up to 25% of surgical patients.
Measurable reductions in postoperative complications require 4-6 weeks preoperative cessation.
Alcohol:
Weekly unitary intake should be established in all patients.
Nutrition:
Major surgery induces a profound catabolic state.
The malnutrition universal screening tool must be adapted for preoperative use.
Psychological support:
Depression and anxiety and low self efficacy must be managed.
What are some outcome measures for breathlessness?
Baseline dyspnea index and translational dyspnea index
Borg CR10
Breathlessness Castastrophising scale
Chronic questionnaire - dyspnea domain
Clinical COPD Questionnaire - Dyspnea
Disability related to COPD tool
What is myCOPD?
Digital therapeutic solution through digital pulmonary rehabilitation and education delivery.
6 week safety gated home rehabilitation.
- education course
- risk factor tracking
- lifestyle modification support
- a tailored self - management plan
- inhaler instructor to optimise technique
- weather and air quality forecasts and information
MyCOPD can lead to:
- improved inhaler technique
- improved rate of recovery, post exacerbation
- reduced risk if exacerbation
- reduced readmission rates
- improve diabetes control
What is ERAS?
Enhanced Recovery After Surgery
What are ACTs?
Airway Clearance Techniques
Tools assisting the removal of bronchial secretions
What are some technologies to support the critically ill adult?
Motored
Tilt tables
Inspiratory muscle training
ICU diaries
Follow up clinics with exercise rehab groups
What is the MRC Sum Score?
Assessment for ICU acquired weaknesses
Voluntary muscle strength assessment following a neurological examination.
What is the Glasgow Coma Score?
Used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients.
- eye opening
- motor response
- verbal response
What is cough peak flow?
Peak flow but with a cough
What is MI-E?
Mechanical insufflation-exsufflation
Aim is to enhance cough expiratory flow along with expiratory volumes
Enhanced secretion movement in central airways and facilitates secretions to be cleared from the mouth
Delivers a set positive pressure and cycling rapidly to negative pressure
