​Managing Patient Emergencies - Dr. Paul Langlois

• NEVER Miss the Subtle Changes in Your Patient that Could Lead to BIG Trouble
• Rapid Assessment Skills that Improve Outcomes for Your MOST Critical Patients
• The BEST Interventions for Cardiac, Neurological, Endocrine & Respiratory Emergencies
• Tools to Sharpen Your Crisis Management Skills

Mrs. Kelp is admitted with pneumonia and right-sided heart failure. Twenty minutes after admission, she develops worsening dyspnea and hypotension.

• Are you prepared to manage her unstable condition?
• Do you know what respiratory measures are necessary?
• Do you know the best way to manage her hypotension?

The patients in our hospitals are sicker than ever before. It is not uncommon to find patients on regular medical floors with central lines, chest tubes, pacemakers and AICDs. Some nursing homes are accepting patients on ventilators, and patients are now being sent home on vasoactive drips such as dobutamine. Even though acuity levels are higher you are still caring for many patients and don’t have the luxury of frequent, comprehensive assessments. Therefore, it is important to be able to rapidly assess and implement appropriate interventions. Attend this seminar to sharpen your skills and leave prepared to identify and manage your next patient emergency!

1. Describe two types of rapid assessment techniques and how to employ them for the best results during a patient emergency.
2. Evaluate techniques for getting critical information during a rapid patient assessment.
3. Investigate EARLY assessment findings in clinical syndromes that may progress rapidly and cause life-threatening conditions.
4. Prioritize nursing actions for specific neurological, cardiac, respiratory and endocrine emergencies.
5. Review care of the diabetic patient in diabetic ketoacidosis.
6. Identify patient populations who are at high-risk for bedside emergencies.
7. Discuss how to integrate assessment data and critical lab findings into the plan of care for a patient experiencing a life-threatening emergency.

Identifying the RED Flags

• Critical Thinking During a Crisis
• Vital Signs & ABCDs
• Methods for Establishing and Maintaining Airway
  • Breathing: More Than a Rate Issue
  • Circulation & Perfusion
  • Rapid Assessment Techniques
  • Critical Questions to Ask Your Patient
  • Identifying High-Risk Populations
  • Sick or Not Sick…Who would you see first?

Cardiovascular

Prevention, Presentation, Action for: “I’m having chest pain”

• Recognizing Arrhythmias - Stable, Unstable and Lethal
• Rhythm Recognition & Treatment for: VT, VF, SVT, and Heart Blocks
• Acute Myocardial Infarction: STEMI/NSTEMI

• Key Assessments & Interventions
• tPA Guidelines
• Laboratory Parameters
• Recognizing Subtle Changes
• Hemodynamic Monitoring:
  • MAP, CO, SV, CI
  • Preload, Afterload, Contractility
• Skills Practice: EKG Interpretation

Respiratory

Prevention, Presentation, Action for: “I can’t breathe”

• Capnography Basics
• Assessment & Critical Interventions for:
• Pulmonary Embolism
• Respiratory Failure
• COPD
• ARDS
• The Patient Who Needs Assistance
• O2, CPAP, BiPAP
• Indications for Intubation
• Positive Pressure Ventilation
• Chest Tube Management
• Easy ABG Analysis…Really!

Endocrine

Prevention, Presentation, Action for: “I don’t feel right”

• The Differences of DKA and HHNK
• Early Recognition of Hypoglycemia
• Critical Lab Findings
• Differentiating the Diagnosis – Case Studies
  • Which Intervention Should you do FIRST
  • What is the Likely Problem
  • Anticipating the Solutions

Neurological

Prevention, Presentation and Action for: “My head hurts!”

• Elevated Intracranial Pressure
• Clues When you Don’t have a Monitor
• Ischemic vs. Hemorrhagic Stroke
• Inclusion/Exclusion for tPA
• Critical Labs
• Malignant Headache
• Delirium
• Autonomic Dysreflexia
• Simulation Lab Review
  • Interpreting the Patient’s Presentation

Fluid Imbalance/Circulatory Emergencies

• Sepsis
• Shock
• GI Bleed
• Abdominal Aortic Aneurysm
• Compartment Syndrome

Managing the Decompensating Patient

• No Pulse, No Blood Pressure, No Respirations...Now What?
  • Common Medications
  • Monitor/Defibrillator Review
  • Roles & Responsibilities During a Code

What’s New & Trending

• Ethical Considerations
• Documentation Pitfalls
• Staffing Considerations & High Acuity Patients

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