Technical Operations
Working as a paramedic I have encountered patients that required the use of my critical thinking ability, help successfully set up proper equipment for team members to successfully establish an airway, assessing, intervening and stabilizing patients, and understanding ventilator management.
Establishing an airway
Proper equipment for team members to successfully establish an airway.
This task was done by gathering necessary equipment and medication for incoming patients that were intubated prior to arriving at Vanderbilt. o Medication that was prepared
• Ketamine
• Succinylcholine
• Rocuronium (In the event that succinylcholine was contraindicated.)
•
o Equipment that was prepared
• Oxygen o Making sure that the oxygen tank at the head of the bed is full in the event the patient need to be transported to CT, MRI, or to assigned room on the floor.
• Strozes o Making sure that the proper strozes blades where placed in the room for the physician to use for intubation.
• Alternative Devices o OPA o NPA o LMA o King Airway o BVM o Non-rebreather o Nasal cannula o CO2 detector for Philips monitor o End-tidal Co2
Ventilator Management
Managing complex ventilator patients require critical thinking to solve problems pertaining to ventilator issues. Even though I am a certified ventilator paramedic, ventilator management is managed an respiratory therapist. Having the ventilator certification was useful in which I was able to apply my knowledge to
Use at least two patient identifiers when providing care. Double checking of ID bands and ID/Driver’s license of patient if possible. Using labels to mark all materials /items needed for the procedures. A two person check off procedure must be implemented. Items requiring labeling include: patient records, signed consents, and all assessments, diagnostic tests and x-rays. Also included should be any item that is needed for the procedure (blood products, devices, and equipment). Using a matching system, so that all items in the procedure area are matched to the patient. The matching system must be completed by a minimum of two staff members. These staff members should include a qualified staff member, nursing staff involved in the procedure, recovery room staff, and discharge staff.
Our role is to make sure we are completing forms thourghly and submitting all required documentation, as well as codes regarding the patients diagnosis. This information is necessary in order to prove why the equipment is necessary for the
An appointed member of staff is responsible for checking the first aid boxes on a regular basis and for placing orders to replenish stock. All staff are
The physician needs to insert a chest tube. What are your responsibilities as the nurse?
Adequate qualified medical staff must be present in all critical care areas caring for mechanically ventilated
The only intervention identified within the scope of nursing practice is to use sterile technique. Central line insertion, intubation, and prescription are functions of the physician.
“They hold sterile instruments, anesthesia equipment, medicines, drapes, gowns, catheters, and a handheld unit allowing clinicians to obtain a hemogram and measure electrolytes or blood gases with a drop of blood. FSTs also carry a small ultrasound machine, portable monitors, transport ventilators, an oxygen concentrator providing up to 50 percent oxygen, 20 units of packed red cells, and six roll-up stretchers with their litter
ability of patients and assist them if needed to ensure the quality and hygiene of all patients. With
The goals that I hope to achieve through this shadowing is to fulfill a portion of the hours of shadowing required by t Virginia Commonwealth University for a student on the Pre-Medicine track. In addition to that, I believe this experience will allow me to understand if a healthcare related career would be a proper choice for me, it has been my lifelong dream to become a doctor and to be of service to the world from a very young age.
New Zealand is an ongoing developing country, with the population continue to grow. This means that the health sector must improve to keep on top of the amount required to establish the care to the patients. In New Zealand, Paramedics respond to over 450,000 jobs a year (Tunnage, Swain, & Waters, 2015). A paramedic needs to carry out many assessments in different uncontrolled conditions in a minimal time to achieve the best results for the patient. Treating a vulnerable adult or a child in pre-hospital settings is always a possibility. Paramedics need to insure the keep an eye out for any signs like, bruises, fragile, lack of energy due to lack of food, etc (Phillips, 2013). Another study was conducted by Cohen, Levin, Gagin, & Friedman (2007) which indicates similar methods to identify different form of abuse, like emotional distress, low self-esteem, the feeling of not being believed when they speak.
The Material Flow Committee (MFC) knew that there were many problems associated with this process and that they had to change. The people involved in this group were Sridhar Seshardi, who was the vice president of Process Excellence; Nick Gaich, who was the vice president for Materials Management; Candace Reed, who was the director of the Sterile Processing Department (SPD); and Joan Rickley, who was the director of the OR. The first step that was taken by this committee was a pilot project called the “Early Morning Instrument Prep.” This development would involve a neurosurgery nurse coming to the hospital in the early mornings to make sure that all supplies and instruments were where they would be required for neurosurgery. Another aspect of this project was to “Provide early data into possible sources of problems” (p. 5). Once the MFC had reviewed the data that came back from the “Early Morning Instrument Prep,” they decided the Hospital would greatly benefit from hiring an Implementation Specialist for Healthcare (ISH). The ISH is a firm that has a specialization in
Respiratory therapists have one of the most exciting and gratifying careers within the medical field. Unfortunately as with any other job or career, it doesn’t come without having challenging times. Respiratory therapists work along-side physicians and are highly trained to treat patients with any sort of lung concern or breathing complications. This job requires hands on care, and deals with life and death daily. One specific scope of this field involves caring for patients (of all ages) attached to mechanical ventilation. It is the respiratory therapists’ responsibility to remove assistive ventilation to patients with written order from the doctor; which ultimately results in death of the patient (Keene, Samples, Masini, Byington).
The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT
We then load trolleys with the necessary paperwork and go from patient to patient, checking which paperwork needs replenishing and noting down what time physiological measurements etc. need doing and tidying the bed areas.
The moderate sedation policy will be revised to require one on one nursing staff to monitor patient from admission until discharge criteria is met. Patient vital sign parameters will be included along with frequency of monitoring. All staff who assist or perform moderate sedation will complete required training as described in the policy. Annual recertification will be completed by all practitioners and registered nurses through continued education, observation, and implementation.