Ward-Based Critical Care

Description

This book aims to guide practitioners in the initial management of the critically ill patient within the ward setting. It is aimed at a range of healthcare professionals including junior doctors, registered nurses physiotherapists and students. It is also relevant to practitioners who are moving into a setting that cares for acutely ill patients. It is divided into sections according to the ABCDE approach, as routinely used and taught in critical care and resuscitation training, with the intention of promoting consistent and prompt management of patients, and to prevent further deterioration. Ward-based Critical Care contains many useful features such as clinical scenarios, hot tips and practical skills and the text is richly illustrated and cross-referenced throughout. Contents include: ABCDE approach throughout Up-to-date guidelines and policies Initial physiological observations at admission and assessment Treatment plans based on diagnosis and past medical history Guidance on frequency of physiological observations Use of track and trigger systems Graded response strategies Effective handover during patient transfer Physiological and psychosocial needs of the patient

Sujets

• Médecine

Informations

• Publié par: M&K Publishing
• Date de parution: 18 janvier 2010
• Nombre de lectures: 0
• EAN13: 9781907830037
• Langue: English

Extrait

Ward-Based Critical Care
A Guide for Health Professionals
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Ward-based Critical Care
A Guide for Health Professionals
Edited by
Sally A. Smith MSc DipHE Nursing ENB100 998 RN
Nurse Consultant in Critical Care Outreach, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, Kent, UK
Ann M. Price MSc PGCE BSc (Hons) ENB100 RN
Senior Lecturer, Canterbury Christ Church University, Canterbury, Kent, UK
Alistair Challiner FRCA FIMCRCSEd EDIC DCH
Consultant Intensivist, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Intensive Care Unit, Maidstone, Kent, UK
Ward-based Critical Care: a guide for health professionals Edited by Sally A. Smith, Ann M. Price and Dr Alistair Challiner ISBN: 978-1-905539-03-1 First published 2009
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP. Permissions may be sought directly from M K Publishing, phone: [phone], fax: [phone] or email: [e-mail]
Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
British Library Catalogue in Publication Data A catalogue record for this book is available from the British Library
Notice Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the Publisher. Neither the Publisher nor the author(s) assume any liability for any injury and/or damage to persons or property arising from this publication.
The Publisher To contact M K Publishing write to: M K Update Ltd The Old Bakery St. John s Street Keswick Cumbria CA12 5AS Tel: [phone] Fax: [phone] [e-mail] www.mkupdate.co.uk
Designed and typeset in 11/13 Candara by S. Maria Hampshire. Cover and graphics by Luke Kelsey. Printed in England by Ferguson Print (Keswick) Ltd.
Contents
Acknowledgements
About the contributors
Preface by Sally A. Smith, Ann M. Price and Alistair Challiner
Introduction
1 Critical care outreach Deborah Higgs
2 Overview of assessing and monitoring the acutely ill ward patient Alistair Challiner and Sally A. Smith
Airway Management

A
3 Assessing and managing the airway Alistair Challiner and Sally A. Smith
4 Temporary tracheostomies Philip Woodrow
Breathing

B
5 Asthma Simon Merritt
6 Left ventricular failure Simon Merritt
7 Chronic obstructive pulmonary disease Simon Merritt
8 Non-invasive ventilation in type 2 respiratory failure Jayne Fraser
9 Pulmonary embolism Gaurav Agarwal
10 Pneumonia Gaurav Agarwal
11 Neurological diseases affecting breathing Alistair Challiner
12 Physiotherapy in the acutely ill Sarah Elliott
Circulation

C
13 Sepsis Ann M. Price and Sally A. Smith
14 Hypovolaemic shock Tim Collins
15 Cardiogenic shock Russell Canavan
16 Management of critically ill patients with malignancy Angus Turner
17 Tachyarrhythmias in the acutely ill Kuno Budack
18 Chest pain Kuno Budack and Ann M. Price
19 Acute abdomen Russell Canavan and Ann M. Price
20 Oesophageal varices Russell Canavan
21 Electrolytes Philip Woodrow
22 Neurological compromise secondary to electrolyte imbalance Amanda Sudan and Sally A. Smith
23 Diabetic ketoacidosis Russell Canavan
24 Renal failure Russell Canavan
Disability

D
25 Severe acute pain in the acutely unwell patient Jane Donn
26 Compartment syndrome Ann M. Price
27 Altered level of consciousness and confusion Ann M. Price
28 Neurogenic shock Ann M. Price
Exposure and Environment

E
29 The post-ICU patient Catherine Plowright
30 Ethics of acute care Victor Nebbiolo and Sally A. Smith
31 Caring for the suddenly bereaved in the acute care setting Sally A. Smith and Catherine Plowright
32 Organ and tissue donation Tim Collins
33 Family care Catherine Plowright
34 Communication Julie Cook
35 Patient transport Alistair Challiner
Practical Skills
36 Changing a tracheostomy tube Alistair Challiner and Sally A. Smith
37 Suctioning a tracheostomy tube Sally A. Smith
38 Care of central venous catheters and measuring central venous pressure Sally A. Smith
39 Pleural chest drains Philip Woodrow
40 Radial artery puncture Sally A. Smith
41 Interpretation of blood gases Ann M. Price
42 Pulse oximetry Tim Collins
43 Placement of a nasogastric tube Catherine Plowright
44 Meeting nutritional requirements (MUST) Ann M. Price
45 Undertaking a Glasgow Coma Score properly Ann M. Price
46 Examination of the sick ward patient Alistair Challiner
Index
Acknowledgements
This book has been the result of collaboration between many contributors. The Editors thank each of them individually.
Thanks are also extended to The Practice Development Group of the Kent and Medway Critical Care Network for the use of the Tracheostomy Wall Chart; East Kent Hospitals NHS Trust and Philips Respironics for their advice and use of guidance with non-invasive ventilation information; The Kent and Medway Critical Care Network for their input into the book; and Dr Ron Daniels of Survive Sepsis at Good Hope Hospital for his specialist advice.
We would also like to thank Mike Roberts at M K Publishing and Maria Hampshire at Shoreline BioMedical for their support and help with this book.
Finally, we extend our gratitude to the many clients and patients we have worked with over the years.
Sally A. Smith, Ann M. Price and Alistair Challiner November 2009
List of contributors
Gaurav AGARWAL Specialist Registrar in Acute Medicine, Maidstone Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
Dr Kuno BUDACK Cardiology Staff Grade, Kent and Sussex Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
Dr Russell E. M. CANAVAN Consultant Gastroenterologist and General Internal Medicine, Bronglais Hospital, Caradog Road, Aberystwyth, Ceredigion, Wales, UK
Dr Alistair CHALLINER Consultant Intensivist, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Intensive Care Unit, Maidstone, Kent, UK
Tim COLLINS Clinical Nurse Educator, Intensive Care Unit, Maidstone Hospital, Maidstone, Kent, UK
Julie COOK Acute Pain Nurse Specialist, Kent and Sussex Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
Jane DONN Acute Pain Nurse Specialist, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Maidstone, Kent, UK
Sarah ELLIOT Physiotherapy Practitioner in Respiratory Care, Medway Maritime Hospital, Medway NHS Foundation Trust, UK
Jayne FRASER Senior Outreach Sister, Kent and Sussex Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
Deborah HIGGS Consultant Nurse in Critical Care, East Kent Hospitals University NHS Foundation Trust, Margate, Kent, UK
Dr Simon MERRITT Consultant, Respiratory and Sleep Medicine, Conquest Hospital, Hastings, UK
Victor NEBBIOLO Resuscitation Consultant, Victor Nebbiolo Ltd, East Sussex, UK
Catherine PLOWRIGHT Consultant Nurse Critical Care, Medway NHS Foundation Trust, Medway Maritime Hospital, Gillingham, Kent, UK
Ann M. PRICE Senior Lecturer, Canterbury Christ Church University, Canterbury, Kent, UK
Sally A. SMITH Nurse Consultant in Critical Care Outreach, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, Kent, UK
Amanda SUDAN Senior Sister, Critical Care Outreach, Kent and Sussex Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
Dr Angus TURNER Consultant in Anaesthesia and Intensive Care, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Kent, UK
Philip WOODROW Practice Development Nurse, Critical Care, East Kent Hospitals University NHS Foundation Trust, Kent, UK
Preface
Sally A. Smith, Ann M. Price and Alistair Challiner
This book is designed to guide a variety of healthcare professionals in the management of critically ill patients within the ward setting. It is particularly relevant for medical students, nursing and physiotherapy students and newly qualified staff in these areas. Its purpose is to be a handy reference for both studying and updating knowledge and skills as part of one s job. Healthcare professionals should find it useful for consolidating what they learn in lectures or clinical placements, as well as for understanding the rationale of care and practical help in acute care wards.
The book utilises the ABCDE approach for assessing and manag