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Fluid Management of hypovolemic Whenever a pt is hemorrhaging—whether externally
Shock? or internally—a loss of circulating blood results in a
fluid volume deficit & decreased cardiac output.
Therefore, fluid replacement is imperative to maintain
circulation.
Typically, two large-gauge IV catheters are inserted,
preferably in an uninjured extremity, to provide a
means for fluid & blood replacement.
Fluid Management of hypovolemic · Replacement fluids may include isotonic electrolyte
Shock? solutions (e.g., lactated Ringer's, normal saline),
colloids, & blood component therapy.
Packed RBC are infused when there is massive blood
loss, which may also necessitate transfusion of other
blood components, including platelets & clotting
factors.
Violence in the ED Precautions to take in order to avoid injury include:
· For prisoners, the hand or ankle restraint (handcuff)
is never released, & a guard is always present in the
room.
· Nonrestraint techniques should be tried when
possible—e.g., talking w/ the pt, minimizing
environmental stimulation.
·
Pts from prison & those who are under guard need to
be handcuffed to the bed & appropriately assessed
to ensure the safety of hospital staff & other pts.
, Family Focused Interventions Allow family to be present!
The family is kept informed about where the pt is,
how he or she is doing, & the care that is being given.
Encouraging family members to stay w/ the pt, when
possible, also helps allay their anxieties.
Reversal agents of anticoagulants? Protamine sulfate is an antidote for standard heparin
and LMWHs.
· A single dose should not exceed 50 mg
· The drug is given by slow IV infusion over at least 10
min
Heat Exhaustion Treatment Most importantly, immediate ingestion and eventually
IV replacement of large quantities of water, and
placement in a cool environment is helpful as well.
Heat Exhaustion prevention Preventing Heat-Induced Illnesses
· Maintain adequate fluid intake, wear loose clothing,
and reduce activity in hot weather.
· Monitor fluid losses and weight loss during workout
activities or exercise and replace fluids and
electrolytes.
Plan outdoor activities to avoid the hottest part of
the day (between 10 AM and 2 PM