During clinical this week, the student nurse got the opportunity of an observational experience in a Specialty Care Unit. The student was directed to the Surgical Intensive Care Unit (SICU) to observe a patient that was critically ill and receiving extensive treatment. The student observed a nurse caring for a patient while administering therapeutic hypothermia after cardiac arrest.
The patient L.E. is a 73 year old male. The patient has no history of coronary artery disease or any problems with his heart. Yet, he suffered an event of ventricular fibrillation which he was shocked for followed by a massive heart attack while unaccompanied at a restaurant. Upon arrival to the Southcoast Hospital he went into ventricular tachycardia in the Emergency Room and was shocked a second time. According to the Southcoast critical care manual, these events are part of the inclusion criteria for therapeutic hypothermia after cardiac arrest. He fits the first inclusion criteria listed which is: cardiac arrest with return of spontaneous circulation (ROSC) with initial rhythm of ventricular fibrillation, pulseless ventricular tachycardia, pulseless electrical activity or asystole. The protocol has been provided at the end of the paper.
The Arctic Sun is an experimental study but has various supportive data. When a person such as L.E. experiences a heart attack, one of the body’s responses is increased body temperature. An increased body temperature contributes to ischemic brain damage post cardiac arrest. The Arctic Sun is a system that provides targeted temperature management in the neurologically impaired patient. Pads are placed on approximately 40% of the body and a temperature probe is inserted. L.E. had two temperatur...
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... and many nurses have not yet had the experience of implementing it. It is complex and challenging and the importance of a multidisciplinary approach is critical. The nurse has to rely or her own judgment while valuing and recognizing the expertise of other team members. The article summarizes article perfectly, “One life saved by means of successful implementation of the therapy, "Therapeutic Induced Hypothermia", is an example of science translated into practice on account of commitment, collaboration and achievement of the multidisciplinary team.
Works Cited
Voelzing, L., Willoughby, L., & Loree, K. (2008). Therapeutic induced hypothermia: when every minute counts -- a multidisciplinary team approach. Dynamics, 19(2), 43. Retrieved from EBSCOhost.
http://www.medivance.com/html/contributions_tempManagement.htm
There is high risk of death and poor neurological function with unconscious survivors in out of hospital cardiac arrest. Trails were undertaken with the patients after awakening from cardiac arrest, which was compared with Ther...
Hypothermia is a common problem in surgical patients. Up to 70% of patients experience some degree of hypothermia that is undergoing anesthetic surgery. Complications include but are not limited to wound infections, myocardial ischemia, and greater oxygen demands. The formal definition of hypothermia is when the patient’s core body temperature drops below 36 degrees Celsius or 98.6 degrees Fahrenheit. Thus, the purpose of the paper is to synthesize what studies reveal about the current state of knowledge on the effects of pre-operative warming of patient’s postoperative temperatures. I will discuss consistencies and contradictions in the literature, and offer possible explanations for the inconsistencies. Finally I will provide preliminary conclusions on whether the research provides strong evidence to support a change in practice, or whether further research is needed to adequately address your inquiry.
Many years from now, I will take this experience with me to better myself as a nurse. I know for the future that it is in my patient’s best interest, if I collaborate with other health care professionals. In order to maintain patient safety, I must always remember to work together with my fellow collogues to obtain a positive working environment. In order to be a good nurse, I need to always understand that I am part of a team to help those in need. I want to incorporate providing efficient care to each and every patient the best way I possibly
Turnock, C. (1994). Technology in Critical Care Nursing. In B. Millar, and P. Burnard. (Eds.) (1994). Critical Care Nursing. Caring for the Critically Ill Adult. London: Baillière Tindall.
Journal of Critical Care, 503.) The leading causes of most errors among stress and interruption are other factors such as: wrong dosage, dose omissi...
During nursing school, we learn a lot about physical conditions that affect people. In clinicals, the majority of our time is spent in a hospital setting. It is important for student nurses to learn about all things
Heat-to-To assessment, including focused assessment based on current diagnose and body systems that are indicating signs and/or symptoms that of concern and require nursing interventions.
The nursing discipline embodies a whole range of skills and abilities that are aimed at maximizing one’s wellness by minimizing harm. As one of the most trusted professions, we literally are some’s last hope and last chance to thrive in life; however, in some cases we may be the last person they see on earth. Many individuals dream of slipping away in a peaceful death, but many others leave this world abruptly at unexpected times. I feel that is a crucial part to pay attention to individuals during their most critical and even for some their last moments and that is why I have peaked an interest in the critical care field. It is hard to care for someone who many others have given up on and how critical care nurses go above and beyond the call
Nurses are an equally important part of each client’s life. Nurses provide stable care to each client, answers their questions, gives medications and treatments, and assists with medical procedures. They also have the responsibility to explain to clients and family members what they should and should not do as they go through treatment and recovery. Nurses must quickly respond to patients needs. Every individual nurse has his or her own unique way of caring. There are so many ways to show caring that the possibilities are never ending. Nurse’s support, comfort, and help allow the patients to recover to the best of their ability. Their experiences in dealing with different patients that have unique situations on a daily basis helps the nurses become better caregivers. Therefore, every nurse is capable of demonstrating care in their respective environments.
... sending signals from the brain to the other parts of the body so that the body can respond to its environment properly, but in this situation, all the systems, including the nervous system overworked to serve the requirements of the body, leading to heat exhaustion.
Thermoregulation has a significant role in regulation of homeostasis. Nevertheless, its heat production and heat conservation mechanisms of major thermoreceptors are unknown. In response to cooling, temperature (core and oral temperature, skin temperature), cardiovascular (blood pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, mean arterial pressure) and respiratory (minute ventilation, respiratory rate, oxygen consumption, metabolic rate and tidal volume) systems’ parameters are measured when we keep our subjects exposing to cold environmental temperature. Furthermore, to determine the dominant thermoreceptor when perceiving conflicting information, these temperature and cardiovascular parameters are measured repeatedly. Our studies showed that in response to cooling, core temperature was relatively constant. However, skin temperature dropped substantially due to vasoconstriction feedback.
While the respiratory and cardiovascular systems are most reliant on one another, all body systems require a functioning circulatory cycle in order to thrive. Blood circulation and consistent transfer of oxygen to cells is required to maintain cell and tissue life. Disturbances to this process will cause cells and tissues to die (Red Cross 48). This state of balance and functioning body systems is referred to as homeostasis, defined as a “condition of equilibrium in the body’s internal environment due to constant interaction of body’s many regulatory processes” (Tortura 8). Changes or disruptions to homeostasis are regulated by the Endocrine and Nervous systems of the body. The endocrine system is made up of glands placed throughout the body
There are many members of the inter-professional team, all of which are contributing to the healthcare of acute and critically ill patients. Every member of the team has had education and obtained a license of practice compatible to their level of knowledge (Prater, Fundamentals of Nursing, 2013). As a practical nurse you need to be mindful of your scope of practice in relation to registered nurses, certified nurses’ assistants and other healthcare professionals. With so many different people involved in the immediate care of a patient, there is always the possibility of a mix up. The purpose of this paper is to help differentiate between the roles of the healthcare staff, which will in turn help develop a knowledge base for prioritizing care;
The final stage is profound hypothermia, in this stage the body has effectively stopped trying to keep itself warm and some final steps are taken to avoid death. The heart rate and breathing slow so that they are hard to detect at all. Only one or two breaths per minuet may be taken. The skin is very pale and icy cold to the touch. The limbs are stiff, the pupils of the eyes dilate (open wide) and don’t react to light. To all intents and purpose the person appears to be dead. Metabolism has slowed so far that they are almost in a state of
For my clinical observation experience I went to the Emergency Department at JFK Medical Center. The first emergency nurse I was assigned to was responsible for six beds. When I first arrived the nurse explained to me that she prioritizes her care based on urgency and airway problem. Since the rest of her patients were stable, she went to perform a focused assessment on a new patient assigned to one of her beds. This patient came in because he had fallen in the bathroom. As soon as she was finished assessing this patient, she went to the