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Telemedicine used in emergency rooms
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R.G. is a 74 year-old male, and was admitted on 3/16 with shortness of breath and cough, which had been going on for one week. He was previously discharged with aspiration pneumonia, but was readmitted with the same diagnosis for treatment. R.G. was taking Zosyn for antibiotic treatment. He was also diagnosed with acute kidney injury due to medication during his hospital stay. He is currently on hemodialysis with right internal jugular access. While on dialysis his hemoglobin was 6.4 and on 3/26 he received one unit of blood.
Since admission to the hospital he has had irregular heartbeats which have dropped down into the 40s and was asymptomatic. On 3/18, a telemetry was placed on him for monitoring, but it has since been removed.
Dr. Murray, the chief resident who arrived around 8:00pm, charted Lewis’ heart rate as normal and noteds a probable ileus; however, nursing documentation at the same time recorded a heart rate of 126 beats per minute (Monk, 2002). Subsequent heart rates at midnight and 4:00am arewere charted as 142 and 140 beats per minute respectively without documented intervention (Monk, 2002 ). On Monday morning Lewis noted that his pain suddenly stopped after being very constant and staff charted that they were unable to get a blood pressure recording in either arm or leg from 8:30-10:15am despite trying multiple machines (Monk, 2002; Solidline Media, 2010).
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
Cardiac monitoring has been available since the early 1960s (Henriques-Forsythe, Ivonye, Jamched, Kamuguisha, Olejeme & Onwuanyi, 2009). George, Walsh-Irwin, Queen, Vander Heuvel, Hawkins, & Roberts (2015) explain, “Remote telemetry monitoring is the monitoring of cardiac rhythms of acute care inpatients from a central locate by personnel who are not directly involved with patient care” (p. 11). Researchers and authors published a multitude of articles, best practices, and standards for hospital monitoring (Drew, 2004, Funk, 2010). A basic internet query reveals injuries and deaths related to remote telemetry monitoring. Guidelines, best practices, and research provide the best evidence in the delivery of safe quality care
Client Profile: Lane Bronson is a 55 year old male with a history of angina, hypertension, Type 2 diabetes, COPD, and sleep apnea. He comes to the physican’s office complaining of worsening shortness of breath. His skin tone is grey, and his angina is worsening. Previously stable, he now does not get relief from rest or nitroglycerin. The physician called 911 and had Mr. Bronson directly admitted to the hospital.
During my morning rounds I began my assessment of Mrs. M., and I noted that she had shortness of breath and she was making gurgling sounds. I immediately auscultated her lungs and noted bilateral wheezing throughout all fields, her heart was irregular and rapid and she had 2plus pitting pedal edema. I noticed she had an IV running at 125ml/hr, which I quickly stopped. The patient did not have orders for IV fluid there was only an order to KVO. I raised the head of the bed and paged respiratory to the floor.
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
The patient is a 55-year-old man admitted to the hospital for dehydration secondary to vomiting. The physical examination of the patient revealed dry mucous membranes and vital signs as follows: Pulse 110, blood pressure 100/60, and respirations of 20.
Glen Carver is a 56 year old male who was admitted unto the cardiovascular care unit 48 hours ago with the diagnosis of heart failure. Mr. Carver went to see his primary care provider with complaints of dyspnea on exertion, a nonproduction cough, decreased activity intolerance, and general fatigue all of which have been worsening over the past two months. The primary care provider found Mr. Carver to have lower extremity swelling, profound ...
“The Red Zone”, a term that in this case does not refer to the NFL, but sexual assault on college campuses across this country. Specifically, the red zone is referred to as the period of time between Labor Day and Thanksgiving where freshman are most susceptible to sexual assault. It is not secret that even here on our own campus, the first few weeks of school for incoming freshman are a lot of parties, a lot of underage drinking, and a lot of under reported cases of sexual assault, rape, and other crimes of this nature. Most of it is attributed to the use of alcohol and recreational drug use and the combination of the two. Mix that with the newness of the college experience and we have ourselves a problem.
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
Cardiovascular System: He does not experience any chest pain or palpitation. He does not have dyspnea or leg swelling.
GPS is a system of satellites radio-transmitters that orbit the planet in great numbers; their purpose is to be able to pinpoint the exact location of an individual or any type of vessel that is equipped with a receiver transmitter within a very small radius. GPS navigation has had a great impact upon society in general as well and its commercial and military applications. Global Positioning is made available at no cost to anyone who has a GPS receiver unit anywhere on the planet. A GPS unit is able to give the user longitude/latitude information as well as, altitude, traveling speed, distance traveled, distance remaining and time in any type of weather conditions imaginable.
He is basically paralyzed on his left side and has to use a cane to walk. He takes no medication for his stroke, but takes kidney dialysis three times a week and other medication for his kidneys and heart. “The one good side-effect of dialysis is that it cleans your blood so that I don’t have to take insulin for diabetes. As far as the kidney disease, the damage is done and I have to do dialysis to live. I do have heart problems and am forced to take meds for that.” He feels bad most of the time. “The dialysis has the side-effect of making me extremely tired and have low energy. I feel like I have the flu on the three days a week that I have
When electronic devices transfer information to another electronic device, the devices need to know when data flow is beginning and ending. This is done with signals for synchronization.i
People in the present society have turned from the use of the old means of communication to the more advanced and technological ways of communicating. Technology has made it easier for people to communicate in a faster, efficient, and cost saving means through the introduction of the communication channels. The world has turned out to be the centre for technology with different technologies emerging daily as the people continue to develop from time to time to cope with the growing technology. The benefits of adopting the communication technology are explained in this article which shows why people do not function without technology.