By Rahul Jandial
Embarking at the first scientific rotation in a health facility is a frightening event for clinicians, as textbook wisdom doesn't inevitably correlate with the knowledge that's valuable ''''in the trenches'''' on the hospital.Whether you're a nurse tending to a significant venous line or an intern putting that line, Code Blue is an necessary addition for your arsenal of emergency care wisdom. positioned this instruction manual in your lab coat pocket and position the subsequent info at your fingertips: fundamentals on physique platforms, ailments, and drugsCritical in. Read more...
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Additional info for Code Blue: Bedside Procedures and Critical Information
POSTPROCEDURE CHECK Chest radiographs should be taken to confirm proper placement of the ETT (with the end at 1 cm above the carina). Tracheostomy tubes should be securely sewn into the neck skin. See Appendix B for additional helpful information. 09_Jandial-r5_033-038:Layout 1 8/2/12 3:24 PM Page 33 PART III CARDIOTHORACIC 09_Jandial-r5_033-038:Layout 1 8/2/12 3:24 PM Page 34 09_Jandial-r5_033-038:Layout 1 8/2/12 3:24 PM Page 35 9 PERICARDIOCENTESIS A 54-year-old man presents after a recent myocardial infarction with jugular venous distention, hypotension, tachycardia, and pulsus paradoxus.
Treat with serial chest radiographs to evaluate for absorption, or consider placing a central line and withdrawing the air. POSTPROCEDURE CHECK The patient should receive cardiac monitoring. See Appendix C for additional helpful information. 10_Jandial-r6_039-044:Layout 1 8/2/12 3:22 PM Page 39 10 THORACENTESIS A 61-year-old female smoker with a right pulmonary nodule presents with dyspnea and orthopnea. A chest radiograph reveals opacification of the right costophrenic recess. INDICATIONS • Pleural effusion leading to dyspnea (Fig.
9-5 Negative deflection of the QRS complex. 09_Jandial-r5_033-038:Layout 1 38 8/2/12 3:24 PM Page 38 Cardiothoracic PEARLS • Pericardiocentesis should be performed in a monitored setting. • For continuous drainage of fluid, a 16-gauge catheter can be inserted into the pericardial space using the Seldinger technique. The Seldinger technique uses the temporary insertion of a J-tip wire through the insertion needle to maintain a pathway into the pericardial space or vessel lumen. The insertion needle is removed and exchanged with the 16-gauge catheter over the J-tip wire, and the wire is subsequently removed.