Managing Patient Emergencies: Critical Care Skills Every Nurse Must Know

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Robin Gilbert, MSN, RN, CEN, CPEN Related seminars and products

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Robin Gilbert, MSN, RN, CEN, CPEN, has over 25 years’ experience in emergency nursing. She is both a certified emergency nurse and certified pediatric emergency nurse. Robin has extensive experience working in the emergency department, progressive care, intermediate care, transitional care, step-down and, currently, as the regional manager for staff development at Central Maine Medical Center. Robin draws on her expertise to teach her own hospital staff and experienced healthcare audiences throughout the country on a variety of critical care and emergency nursing topics.

She has been an item writer for the Board Certification of Emergency Nursing (BCEN), a former Chairperson of BCEN, and most recently a contributing writer for the current CEN Review Manual. Robin is an active member of the Emergency Nurses Association, the American Nurses Association, Society of Critical Care Medicine, Association for Nursing Professional Development, and is a reviewer for the ANCC’s Pathway to Excellence.

Speaker Disclosures:

Financial: Robin Gilbert has an employment relationship with Central Maine Medical Center and Rumford Hospital. She receives a speaking honorarium from PESI, Inc.

Non-financial: Robin Gilbert has no relevant non-financial relationship to disclose.

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Objectives

1. Distinguish 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. Assess care of the diabetic patient in diabetic ketoacidosis.
6. Determine patient populations who are at high-risk for bedside emergencies.
7. Propose how to integrate assessment data and critical lab findings into the plan of care for a patient experiencing a life-threatening emergency.

Outline

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

Target Audience

• Nurses
• Nurse Practitioners
• Clinical Nurse Specialists

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