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A Nurse's Survival Guide to Acute Medical Emergencies Updated Edition

Richard N. Harrison (Author), Lynda Daly (Author)

9780702076664

Paperback, published 10 December 2018

464 pages, 54 illustrations (54 in full color)
22.9 x 15.2 x 2.9 cm, 0.74 kg

Are you a nurse, a physician’s associate or a medical student in an acute or emergency unit?

This is your indispensable primer of acute medical care – a pocket guide to caring for patients with acute medical conditions.

This book will help you to

  • care for patients in the first critical 24 hours of admission
  • manage patients using the most up-to-date evidence based approach
  • understand the most common emergency medical conditions and their underlying disease mechanisms
  • handle the patient’s assessment , understand the observations and manage their disease
  • easily obtain clear practical advice
  • know what to tell the patient and relatives using jargon-free language
  • access information on SARS, avian influenza and bio-terrorism

This updated edition

  • contains improved sections on stroke care, diabetes and sepsis,
  • introduces the NEWS 2 observation chart
  • has revised its case histories in line with current practice

This updated edition:

contains improved sections on stroke care, diabetes and sepsis,

introduces the NEWS 2 observation chart

has revised its case histories in line with current practice

Abbreviations

  1. Introduction: Immediate assessment of the critically ill
  2. ABCDE: Immediate assessment and intervention

    Early warning: Track and Trigger

    National Early Warning Score

    Communication – NEWS and SBAR

  3. Cardiology
  4. Acute severe breathlessness

    Cardiac failure

    Heart muscle damage

    Valvular disease

    Rhythm disturbance

    Types of heart failure

    Left heart failure

    Right heart failure

    Congestive cardiac failure

    Right heart failure and COPD

    Diastolic heart failure

    Clinical features and management of cardiac failure

    Acute left ventricular failure

    Acute on chronic congestive cardiac failure

    Ischaemic heart disease

    Chest pain

    Acute coronary syndromes, NSTEMIs and Unstable Angina

    Sudden cardiac death

    Atrial fibrillation and arterial emboli

    Causes of atrial fibrillation

    Importance of atrial fibrillation

    Complications of atrial fibrillation

    Diagnosis of atrial fibrillation

    Management of atrial fibrillation

    Infective endocarditis

    Drugs in the management of acute heart disease

  5. Respiratory medicine
  6. The breathless patient: the general approach

    Respiratory failure

    Type I and Type II respiratory failure

    Principles of treatment

    Acute severe asthma

    Mechanisms

    Assessment of acute severe asthma

    Management of acute severe asthma

    Chronic obstructive pulmonary disease

    Mechanisms

    Management of acute exacerbations of COPD

    Non-invasive ventilation

    Pneumonia

    Assessment

    The severity score in pneumonia: CURB-65

    Management of pneumonia

    Antibiotics

    Spontaneous pneumothorax

    Nursing the patient with a chest drain

  7. Acute neurological problems
  8. Ensuring the safety of the patient

    Prioritising the initial management: GCS and ABCDE

    Managing ‘medical’ and ‘neurological’ coma

    Responding to neurological deterioration

    Stroke and stroke-like emergencies

    Cerebral infarction

    Transient ischaemic attacks

    Intracerebral haemorrhage

    Subarachnoid haemorrhage

    Subdural haemorrhage

    Extradural haemorrhage

    Nursing the patient with a stroke: the first 24 h

    Meningococcal meningitis

    Acute severe headache

    Subarachnoid haemorrhage

    Lumbar puncture

    Sudden loss of consciousness: faints and fits

    The basic mechanisms: syncope

    The basic mechanisms: epileptic seizures

    Pseudoseizures (non-epileptic seizures)

    Acute paralysis of the lower limbs

    Spinal cord compression

    Guillain–Barré syndrome

  9. Gastroenterology
  10. Nausea and vomiting underlying mechanisms

    Nausea and vomiting in acute medical conditions

    Acute upper gastrointestinal haemorrhage

    Management of upper gastrointestinal haemorrhage

    Portal hypertension and the management of oesophageal varices

    Acute liver failure and hepatic encephalopathy

    Acute jaundice

    Acute abdominal pain

    Acute diarrhoea: sources and courses

    Infective diarrhoea

    Clostridium difficile diarrhoea

    Infective diarrhoea versus acute ulcerative colitis

    Medical conditions presenting with gastrointestinal symptoms

  11. Diabetic complications
  12. Diabetes on the Acute Medical Unit: the general approach

    Normal blood sugar control and the nature of diabetes

    An overview of Type I and Type II diabetes

    Acute medical conditions associated with diabetes

    Diabetic renal disease

    Diabetic neuropathy

    Cardiovascular disease

    Cerebrovascular disease

    Peripheral vascular disease

    Blood sugar control in adverse medical situations

    Variable Rate Intravenous Insulin Infusion (VRIII) or GKI

    DIGAMI regimen

    Diabetic Keto Acidosis (DKA)

    Hyperosmolar non-ketotic diabetic coma (HONK)

    Hypoglycaemia

    Infective complications in diabetes: the acute diabetic foot

  13. Thromboembolic disease
  14. Thrombosis and thromboembolisation

    Mechanisms

    Superficial thrombophlebitis

    Deep vein thrombosis

    Pulmonary thromboembolism

    Tests to identify thromboembolic disease

    Management of pulmonary thromboembolism

    Nursing the patient with a suspected DVT

    Other causes of a swollen painful leg

    Cellulitis

    Necrotising fasciitis

    Management of a DVT

    Anticoagulation therapy

  15. Deliberate self-harm, alcohol and substance abuse
  16. Deliberate self-harm

    General principles

    Care of the unconscious patient: ABCDE

    The patient who refuses treatment

    Specific overdoses

    Benzodiazepines

    Paracetamol poisoning

    Antidepressant overdose

    Carbon monoxide poisoning

    Alcohol abuse

    Acute alcohol-withdrawal syndrome

    Cocaine 303 Ecstasy

    Heroin abuse

    Needle stick injuries

    Hospital-acquired methicillin-resistant Staphylococcus aureus infections

    Violent incidents

  17. The ‘social admission’
  18. Common errors and omissions in the admission of elderly patients

    Taking a history from the patient

    Taking a history from a third party

    Falls

    The cause of falls

    Assessment after a fall

    Immobility

    Immediate safety of the patient: ABCDE

    Assessing the cause: establish the full history

    Delirium

    Dementia

    Nursing home admissions

    Ethical issues and the elderly sick

    The emergency admission of patients with a terminal disease

  19. Multisystem failure
  20. Shock: the basic mechanisms

    Cardiogenic shock

    Hypovolaemic shock

    Redistributive (low-resistance) shock

    Acute severe hypotensive collapse

    The importance of immediate resuscitation

    Ensuring adequate oxygen delivery to vital organs

    Oxygen therapy

    The blood pressure

    Inserting a CVP line

    Fluid challenge

    Surviving sepsis

    Anaphylactic reaction

    Emergency blood transfusion in shock

    Transfusion reactions

    Massive blood transfusion

    Acute kidney injury

    Management: resuscitation begin with ‘ABCDE’

    Emergency (acute renal failure) management of hyperkalaemia

    Establishing a management plan

    Sudden collapse and cardiac arrest

    Chain of survival

    Basic life support

    After basic life support

    Do not attempt resuscitation

    Bereavement on the Acute Medical Unit

  21. Emerging problems: outbreaks and deliberate releases – SARS, toxins and biological agents

How infection spreads

Severe acute respiratory syndrome

Case definition of SARS

Other emerging infections

Unusual illnesses – deliberate release of infectious and chemical agents

Deliberate release of infectious agents

General principles

Examples of potential pathogens and initial symptoms

Poisoning with nerve agents

Key nursing skills in outbreaks and deliberate releases

Index

Subject Areas: Accident & emergency nursing [MQCL1]

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