Besides CPR, what other situations/procedures require you to act fast..

RNKPCE · Mar 10, 2012

..and think critically?
And what do you have to do step-by-step to resolve the problem?

Probably a lot. You want to avoid the CPR situation. That is one of the reasons they have Rapid Response Teams at most hospitals.

The ones I can think of off the top of my head

1. Pulmonary edema

2. STEMI

3. CVA-both ischemic and hemorrhagic

4. GI Bleed

5. Bradycardia

6. Sepsis

7. Pulmonary Embolism

8. Anaphylaxis

9. DIC

10. Rupture of aneurysm

11. Hypoglycemia

12. Seizures

....... and many more, my area is adult medical.

Assessment is your most important skill. Remember your ABC's or now it is CAB's

Can't list what you would do step by step because each situation would vary and may even vary between hospitals based on protocols.

KelRN215, BSN, RN · Mar 10, 2012

In my area:

-Seizures (most common)

-Increased ICP/Shunt Malfunctions/Impending herniation

-Stroke

-Respiratory distress

-Sepsis

-Anaphylaxis

There are more, but these are the most common that I deal with. In the past few shifts that I've worked, I've encountered the first 4, the first 2 more than once.

As the previous poster said, it's not possible to give you a step-by-step guide because every situation is different and even patients with the same situation are different. How you react to one patient's seizure is not the same way that you react to his roommate's seizure.

tokmom, BSN, RN · Mar 10, 2012

Is this homework?

Multicollinearity, BSN, RN · Mar 10, 2012

How about this one: your patient is unconscious. What do you do first? How do you figure out what is wrong, so you can act quickly before CPR might be needed?

CelticGoddess, BSN, RN · Mar 11, 2012

Head trauma, after your resident stands up and face plants onto the floor.

diligent-trooper · Mar 11, 2012

The patient is in the process of falling, what do you do?:barf01:

MPKH, BSN, RN · Mar 11, 2012

I would say nursing in itself requires critical thinking, no matter the situation. As for the intervention, start with the basics and check with the hospital's policies and protocols

beckster_01, BSN, RN · Mar 11, 2012

Where I work, the most common emergency situations are CVA's and respiratory distress (for various reasons), and occasionally sepsis.

The most important thing you can possibly do is USE your resources, and think outside of the box. Last night I had a patient who was troubling me. Decreased UOP, hypotension, O2 in the mid 80's at rest, nausea/hypoactive bowel sounds, and a symptomatic 12-beat run of VT. The only response I got from the resident on call was to give her a fluid bolus, she didn't even come see the patient. After I called RT for some better O2 delivery I walked myself to the CVICU that she came from the day before and presented my case. The NP there very kindly put in some orders for me and gave the resident a nudge to pay a little more attention to my patient.

sunnycalifRN · Mar 11, 2012

I would say nursing in itself requires critical thinking, no matter the situation. As for the intervention, start with the basics and check with the hospital's policies and protocols

Agree! When you first meet your patient, you're using critical thinking, why is the pt here? What interventions are needed? What may go wrong? Etc. . .

nurseprnRN, BSN, RN · Mar 11, 2012

spontaneous pneumo is one of my faves. then things like surprise exsanguination, inappropriate extubation, or violence.

agree with tokmom: homework assignment? can you tell us how to respond to each of these? any?

RNperdiem, RN · Mar 12, 2012

Common ones where I work in surgery ICU:

Respiratory distress

dropping blood pressures

bleeding out, especially GI bleed

dangerous heart rhythms

critically low or high electrolytes

major agitation that can lead to injury/self-extubation on a ventilator

increasing intracranial pressures