The PGY2 managing the Wards After Hours


Acute & Emergency Care

• Management and escalation of acutely ill and/or deteriorating patient
• Running a MET/Code Blue call
• Basic & Advanced Life Support (+/- Paediatric LS) including use of automatic defibrillators
• Oxygen delivery/non-invasive ventilatory support (airways/Bi-PAP, CPAP)
• Circulatory support (fluids/drug therapy)
• Acute Patient Transfer (internal/external) including to ICU

Recognition of the deteriorating patientStandard 9 Recognising and Responding to Clinical Deterioration in Acute Health Care Icon on white J

During each year a number of education sessions are conducted at BHS

  • Clinical Review and Communications Tool  
  • Practice tip - please do not ask the nurse to complete the chart incorrectly beacuse you like the old way of doing things.  The evidence suggests that the new system provides a stronger visual cue to detect the deteriorating patient.

Did you know?
Recognition and response to clinical deterioration is one of the ten national standards as set by the AUSTRALIAN COMMISSION for QUALITY and SAFETY in HEALTHCARE.  It is standard nine, and there is a nice logo which you will see around the hospital. 

Standard 9 - Recognising and responding to Clinical Deterioration in Acute Health Care 

Recommended external resources
The following resource has materials - due to copyright restrictions cannot be reproduced here, however are freely available on the internet. It is really worth a look, although many busy clinicians might suggest the respiratory rate can be assessed in 15 seconds and not 60.
http://nswhealth.moodle.com.au/DOH/DETECT/content/

 How to run a MET

Regular face to face sessions are arranged by our resuscitation training officer Andrew Tongs

A number of resources are avaliable for pre reading and preparation

It would be fair to say that human factors and team leadership are essential in terms of running a MET response, however you need to know your resuscitation well.
 

The following is a series of videos on adult resuscitation – created by Rahul Patwwari 

ACLS 01 - Introduction
ACLS 02 - Airway 
ACLS 03 – Airway part 2
ACLS 04 – Cardiac Arrest VF/VT
ACLS 05 – Cardiac Arrest VF/VT – more details  
ACLS 06 – Cardiac Arrest (Asystole & PEA) 
ACLS 07 - Bradycardia
ACLS 08 Tachycardia 1
ACLS 09 Tachycardia 2
ACLS 10 Tachycardia 3
ACLS 11 Post resuscitation care

Paediatric Advanced Life support videos – Rahul Patwari
PALS 01 Introduction
PALS 02 Airway 
PALS 03 Monitoring and Access
PALS 04 Drugs part 1
PALS 05 Drugs part 2
PALS 06 Pulseless arrest  
PALS 07 Bradycardias
PALS 08 Tachycardias 

Oxygen delivery/non-invasive ventilatory support (airways/Bi-PAP, CPAP)
A number of resources will be available re oxygen delivery