VSIM Steps for Jackson Weber

VSIM Steps for Jackson Weber Feedback Log 0:00 You arrived at the child. 0:00 You reviewed the patient information. 0:00 You introduced yourself. 0:03 You washed your hands. To maintain patient safety, it is important to wash your hands as soon as you enter the room. 0:10 Child status - ECG: Sinus rhythm. Heart rate: 99. Pulse: Present. Blood pressure: 118/79 mm Hg. Respiration: 13. Conscious state: Appropriate. SpO2: 99%. Temp: 98.2 °F (36.8 °C) 0:23 You identified the relatives. This is important, as the patient is below 18 years of age. 0:27 You reviewed the patient log. 0:44 You identified the child. To maintain patient safety it is important that you quickly identify the child. 0:48 You asked the parent: Does he have any known allergies? The parent replied: 'No. I don't think so.' 1:05 You looked for normal breathing. He is breathing at 14 breaths per minute. The chest is moving equally. 1:10 Child status - ECG: Sinus rhythm. Heart rate: 99. Pulse: Present. Blood pressure: 119/80 mm Hg. Respiration: 14. Conscious state: Appropriate. SpO2: 99%. Temp: 98.1 °F (36.7 °C) 1:22 You checked the radial pulse. The pulse is strong, 100 per minute, and regular. 1:40 You checked the temperature at the ear. The temperature was 98.1 °F (36.7 °C). 2:01 You attached the automatic noninvasive blood pressure (NIBP) measurement cuff. This will allow you to reassess the child continuously. 2:10 Child status - ECG: Sinus rhythm. Heart rate: 100. Pulse: Present. Blood pressure: 121/81 mm Hg. Respiration: 14. Conscious state: Appropriate. SpO2: 99%. Temp: 98.1 °F (36.7 °C) 2:30 You assessed the pain level using the FACES scale. The child answered 0 on the FACES pain scale with a range of 0 to 10. 2:53 You assessed the child's neurological status. This is reasonable. 3:10 Child status - ECG: Sinus rhythm. Heart rate: 100. Pulse: Present. Blood pressure: 118/80 mm Hg. Respiration: 14. Conscious state: Appropriate. SpO2: 98%. Temp: 98.1 °F (36.7 °C) 3:28 You assessed the child's IV. The site had no redness, swelling, infiltration, bleeding, or drainage. The dressing was dry and intact. This is correct. Assessing any IVs the child has is always important. 4:10 Child status - ECG: Sinus rhythm. Heart rate: 100. Pulse: Present. Blood pressure: 118/79 mm Hg. Respiration: 14. Conscious state: Appropriate. SpO2: 98%. Temp: 98.1 °F (36.7 °C) 4:38 A 60 mg dose of phenobarbital was given orally. The child should be sitting up when doing this. It is important to use the basic rights of medication administration to ensure proper drug therapy. This was indicated by order. 5:10 Child status - ECG: Sinus rhythm. Heart rate: 100. Pulse: Present. Blood pressure: 119/80 mm Hg. Respiration: 14. Conscious state: Appropriate. SpO2: 98%. Temp: 98.1 °F (36.7 °C) 6:10 The child had a seizure. 6:10 Child status - ECG: Sinus rhythm. Heart rate: 101. Pulse: Present. Blood pressure: 117/79 mm Hg. Respiration: 14. Conscious state: Unconscious. SpO2: 89%. Temp: 98.1 °F (36.7 °C) 6:20 Child status - ECG: Sinus rhythm. Heart rate: 123. Pulse: Present. Blood pressure: 130/87 mm Hg. Respiration: 4. Conscious state: Unconscious. SpO2: 88%. Temp: 98.1 °F (36.7 °C) 6:21 You secured the patient to avoid injuries during seizures This is correct. 6:33 You put up seizure pads on the bed. This was indicated by order. 6:47 You gave the child 100% oxygen from a nonrebreathing mask. This was part of your orders. 6:50 You turned the oxygen on. 7:10 The child's seizure stopped. 7:10 Child status - ECG: Sinus rhythm. Heart rate: 129. Pulse: Present. Blood pressure: 134/90 mm Hg. Respiration: 14. Conscious state: Unconscious. SpO2: 85%. Temp: 98.1 °F (36.7 °C) 7:20 Child status - ECG: Sinus rhythm. Heart rate: 121. Pulse: Present. Blood pressure: 126/85 mm Hg. Respiration: 27. Conscious state: Somnolent. SpO2: 86%. Temp: 98.1 °F (36.7 °C) 7:29 You phoned the provider in order to discuss the patient. 7:51 Child status - ECG: Sinus rhythm. Heart rate: 113. Pulse: Present. Blood pressure: 127/85 mm Hg. Respiration: 22. Conscious state: Somnolent. SpO2: 90%. Temp: 98.1 °F (36.7 °C) 8:00 You listened to the lungs of the child. The breath sounds are clear and equal bilaterally. In the clinical situation, you should auscultate the lungs both anteriorly and posteriorly. 8:15 You listened to the heart of the child. There were regular heart sounds without murmurs. 8:37 You checked the child's pupils and they were 4 mm and reactive. It is reasonable to check the pupils here. 8:51 Child status - ECG: Sinus rhythm. Heart rate: 108. Pulse: Present. Blood pressure: 119/80 mm Hg. Respiration: 18. Conscious state: Somnolent. SpO2: 95%. Temp: 98.1 °F (36.7 °C) 8:53 You checked the carotid pulse. The pulse is strong, 110 per minute, and regular. 9:04 You looked for normal breathing. He is breathing at 17 breaths per minute. The chest is moving equally. 9:28 You provided education to the relative regarding the child's condition. This is correct. It is important to use every opportunity to provide education. 9:29 A patient handoff was performed. Seizures occur as a result of abnormal, excessive electrical activity within the brain. While some seizures are idiopathic, others occur as a result of trauma, infection, hypoglycemia, endocrine dysfunction, toxins, or tumors. Accompanying signs and symptoms can include loss of consciousness, jerking movements, loss of bowel and bladder control, and altered breathing pattern. Management of seizures includes antiepileptic medications, safety precautions, and family education. During a seizure, care of the patient includes: maintaining airway patency, ensuring safety including the use of seizure pads according to local recommendations, avoiding risk of aspiration, administering medications, and providing emotional support to the family. Some patients needs help from social work for optimal treatment. Medical alert bracelets should be worn by all children with a history of seizures. A history of seizures should not confine a child to a sedentary life, but extra supervision is needed while swimming and during activities such as rock climbing, and it is essential that helmets and padding be worn while riding bicycles. Risk factors for exacerbations include noncompliance with medication regimen, nontherapeutic drug levels, infection, head injury, electrolyte imbalances, and metabolic disorders. You got 100%