Outline of Case and Objectives
43 year old male
Previous laparotomy about 10 years ago due to gunshot abdomen
Presenting now with a single stab wound to the right epigastric region, pericardial effusion confirmed by ultrasound. Explorative laparotomy done- patient has right ventricular injury and right sided diaphragmatic injury
The patient was intubated and ventilated
The patient had the following devices in place:
o Right Intercostal Chest Drain (ICD) for a haemothorax which drained 150ml.
o Right sided mediastinal drain
o Left sided pericardial drain
o Left sided peripheral intravenous (IV) line
o Right sided central venous line
o Right radial Arterial line (A. line)
Before this case I had not previously come across an A. line in hospital or prehospitally which is why I will be focusing on arterial line care and maintenance during interhospital transfers. I have extended my search to in hospital care as there is very little literature focusing specifically on prehospital care of A. lines.
As an Emergency Care Practitioner (ECP) you are often required to do interfacility transfers of critically ill patients. These patients oftentimes have devices in place that an ECP would not routinely come…
the crash course on how to read EKGs was very helpful.
During my second shift in the SINU, one of my patients was intubated and communicated to me by writing notes on a clipboard. I discontinued the arterial line and two infiltrated IV catheters on this patient. I also established an IV access on the first attempt. I had the opportunity to observe this patient’s extubation; I was surprised how quick this process was. My other patient had a fungal infection covering the entire body. I…
The innovation is a cover for the catheter stand used in hospital and short suspensor pocket for suprapubic catheter leg bag that will not restrict movement when attached. The proposed innovation is chosen to improve the use of urinary catheterisation that will enable nurses and other healthcare professionals to maintain patient dignity, respect, their right to privacy and confidentiality in managing urinary incontinence in all aspects of care as outlined by the Nursing and Midwifery Council…
The PSI is a cover for the catheter stand used in hospital and shorts with suspensor pocket for suprapubic catheter leg bag that will not restrict movement when attached. The proposed innovation is chosen to improve the use of urinary catheterisation that will enable nurses and other healthcare professionals to maintain patient dignity, respect their right to privacy and confidentiality in managing urinary incontinence in all aspects of care as (NMC, 2015). More so, it will minimise the…
Research Question: How will education on the importance and use of the nurse-driven indwelling urinary catheter removal protocol affect knowledge of nurses taking care of patients with urinary catheters and the CAUTI rates in an acute care hospital in North Carolina ?
Project Significance: An indwelling catheter removal protocol is a recommended tool and is part of a bundle used to prevent CAUTI. The lack of knowledge of its use and its importance may be directly related to high CAUTI…
tear of the bladder neck, rectum or vagina;
Extravasation at injury site ± blood in the vaginal introitus.
Extravasation at bladder neck during suprapubic cystography ± rectal or vaginal ﬁlling with contrast.
Table 8: European Association of Urology (EAU) Classification of urethral injury (Martinez-Pineiro et al, 2010)
IV.e. Urethral Stricture Characteristics and Etiology:
Most urethral strictures were idiopathic (34%), iatrogenic (32%), inflammatory (20%) or traumatic (14%). Iatrogenic…
The aim of this study was to evaluate the efficacy of a seven step Evidence-Based Practice (EBP) on reducing catheter-associated urinary tract infections (CAUTI). This paper will discuss both the strengths and weaknesses about this study as well as the authors effectiveness in documenting the results. While the strengths of this study and article are the positive results and reduction in CAUTI, the author’s use of a verbose and complicated writing style left me struggling to…
it to do over? (Consider this as you plan for tomorrow).
I am a firm believer in growth; I retain a belief that no matter an individual’s level of education or training, he or she could always improve. Learning does not impede. Every clinical day I uncover a task that I wish I could have completed better, and this week, that wish came in the form of catheters, feeding tubes, and IV pumps. Throughout my time at this clinical facility, I never retained an opportunity to witness a nurse implement,…
exasperated breath. “You can’t even imagine. We’ve had a multi-car collision on Jefferson Avenue, a house fire that spread to a warehouse, and some sushi restaurant gave a bunch of their customers food poisoning. In short, we’ve been up to our elbows in burn victims and vomit all day.”
“Oh, and we got another gentleman from the geriatric high rise across the street with urinary catheter complications.” Stephanie made little quotation marks in the air when she spoke the last four…
American Urological Association Endourological Society Guideline Statement 2016 recommends Ureteroscopy as first line therapy in patients with mid or distal ureteral stones who require intervention (who were not candidates for or who failed Medical Expulsive Therapy) with Evidence Level Grade B.1 European Association of Urology Guideline 2016 also recommends Ureteroscopy over Shock Wave Lithotripsy for ureteral stones if indicated for active stone removal - Recommendation Grade A.2 Semirigid…