Patient's Comfort & Safety - SICU - Part 2

Please watch Part 1 prior to viewing Part 2
http://www.youtube.com/watch?v=6jI7XmjrjuA

Part 2 is a continuation of Part 1 and has two scenes.
First scene "MD Rounds - Two Hours Later"
RN coaches family about their role in rounds, target RASS, actual RASS, CAM assessment and meds for sedation by RN, patient is on precedex & propofol & neosynephrine, RN starts rounds, MD orders to not turn propofol back on and lesser dose of precedex for SBT, Physical Therapist evaluates patient.

Second scene "Next Shift"
Patient is done with sprint and back on vent and just
finished resting, secure ETT, re-do CAM med changed during the day, RN organizes lines etc as they are teaching & involving family, orthostatic BPs, patient has been OOB to chair previously, patient follows two step command, discussion, ambulate, document.

Category:

Education

Tags:

• Patient's Comfort Safety
• SICU
• ICU
• UCSD Medical Center
• Medical Education
• RN
• Registered Nurse
• Shift Changes
• Bedside Report
• Plan for the Day
• RASS
• Pain Score
• SAT
• SBT
• NVPS
• CAM Evaluation
• Physical Therapists
• Hypoactive Delirium
• STEER
• MD Rounds
• CAM Assessment
• precedex
• propofol
• neosynephrine
• ETT
• Orthostatic Blood Pressure

[johnsonb87]

An awake pt may or may not be able to breathe on their own due to lack of energy. Certain pt.s can be so tired of breathing thats all the physical activity they can perform. In this case it did seem slightly off to keep the pt on the ventilator when she had almost full strength in all extremities.