Donation after Cardiac Death DCD o Type of donor that you have to withdrawal

Donation after cardiac death dcd o type of donor that

This preview shows page 9 - 13 out of 15 pages.

Donation after Cardiac Death (DCD) o Type of donor that you have to withdrawal care from pt o 60 minutes or 90 minutes to pass away & heart completely stopped & can ONLY donate kidneys Living Donors o Kidneys, portions of liver (regenerative) PICU Appearance can be overwhelming o Lots of machines – red power outlets = generator o IV pumps – labels, compatibility & multiple lines o Intraosseous if cannot get IV Placed in lower leg – top of shin Boluses & rescue meds until get better IV Family education o Touch baby – even if cant hold Visitation hours – none on PICU, sometimes can have no restrictions – withdrawal of care Child life – involved if older & awake, reduce chances of PTSD Nursing considerations o Strict I&O, assess hourly, check temp frequently, vent, VS continuous, lab draws ½ mL blood tubes (bullet) Peds STAT Drugs: o Epinephrine – vasoconstricts o Atropine – bradycardia issues o Lidocaine -anti arrythmics o Vasopressin - antiarrythmics o Amiodarone - antiarrhythmics o Adenosine – SVT chemical defibrillation Actions: o Physician has talking job – sometimes calm, sometimes not
Image of page 9
o Code Nurse – PI charge nurse (most experienced) o Med nurse – Draws meds from CPR card o Documentation nurse – should not have ANY other job at all o Compressor - RT o Respirations - RT o Cart/Defib nurse o Clerk o Other nurses on unit o Brand new nurse on unit  you won’t get experience or know how to do jobs if you aren’t ever a part of it – you don’t have experience or skills enough to monitor all other pts or know how to deal with issues… Documentation nurse on code sheet, med nurse, Pediatric Rhythms Review cardiac rhythms at: Cardiac Rhythms Sinus tach – pain, activity, anxiety, illness/fever, electrolyte imbalances, dehydration Asystole – flat line on monitor – LOOK at pt, like to pull off monitors Peds Arrhythmias Vagal maneuvers – get Ziploc bag of ice & place on neck o Coffee straw – have them blow through while you block end SVT wolff-parkinson-white – preexcitation  delta wave in strip( hill vs sudden incline going into QRS) Long QT syndrome –possible issue in SIDS Most kids wont see heart block, if have surgeries
Image of page 10
Child’s experience in PICU Pain Sleep disruption Stress o Developmental level o Past experiences o Type of illness o Coping mechanisms o Available emotional support Child PTSD risk factors Severity of illness Invasive procedures Restricted to bed Attached to equipment Sedation and analgesia – switch pt rooms if been there for a long time Coping Regression – thumb sucking Denial Repression Postponement Bargaining Helping children cope Promote sense of control Facilitate use of play Encourage routines Encourage privacy Diversion Parent stressors
Image of page 11
Loss of parenting role Risk for PTSD Cannot support child if their own needs are not met o Accident with child, on medication, sick from accident o Support parent needs
Image of page 12
Image of page 13

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture