Assessment of Critically Ill Patient

hospital-critical-care

Admission Protocol
–    Patients with Respiratory failure.
–    Post successful CPR.
–    Post neurosurgery (Brain surgery).
–    Fluids and electrolytes imbalance.
–    D.I.C. (Disseminated intravascular co-agulopathy.
–    Pneumothorax and hemothorax affecting respiration.
–    Shock.
–    Chest trauma (Flail chest).
–    Poisoning.
–    Post major surgery.
–    Coma with unknown cause.
–    Acute renal failure

Assessment of Critically Ill Patient
FANCAP

 

 

–    F: Fluid: movement of fluid and electrolytes among body compartment.
“ Electrolyte imbalance, Dehydration, hypervolemia,
hemodynamic stability (V/S)”
–    A: Aeration: assess the patient clinically and laboratory.
“ Type of respiration, normal and extrabreathing sounds, color of skin & mucous membrane, rate of respiration, ABGs determination is the best indicator for the patient condition.
–    N: Nutrition: assess the patient through physical examination and lab. Investigation and ask the following question:
“ Can we use the normal GI tract, what about the GI system condition, does the patient need biologic nutrition (TPN), what about vitamins and minerals supplementation”.
–    C: Communication: Assess neurological function (GCS), look at the patient eyes, does he cooperative, does he oriented.
–    Activity: bed rest with mild activity (ADL), complete bed rest,
– Up with help—-need assistant.
– Up in chair —— cannot walk.
–    P: Pain: Physiological pain from the disease process, psychological pain from lone less, hopelessness‘, fear.
P.Q.R.S.T. criteria for assessment of pain
–    P:  (Precipitating & palliating factors).
–    Q:  (Quality of pain) how would describe the pain “burning, stabbing, squeezing” description may indicate the cause.
–    R:  (Region & radiation) where is the pain, as; the patient to point the area of pain, does it travel any where.
–    S:  (Severity) does it make you stop what you are doing, double over.
–    T:  (Time factor) how often does the pain occur, how long does it lasts, when did you first experience the pain.

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