We still use a 1:1 using a nurses aide or ortho tech.
Janice
Janice Delgiorno BSN, RN, CCRN, RRT
Trauma Program Coordinator
The Trauma Center at Atlantic City Medical Center
1921 Pacific Avenue
Atlantic City, NJ 08401
W: 609-441-8182
Fax: 609-441-8178
Janice.Delgiorno@Atlanticare.org
>>> Phyllis.Uribe@HealthONEcares.com 06/13/03 04:39PM >>>
Thanks, Tony. We, too, love Propofol. However, I should have been clearer
that the patients I seek ideas for have been transferred out of critical
care and are not in monitored beds....our neurotrauma unit is a step-down
type of unit for patients with brain and spinal cord injuries.
Phyllis Uribe
-----Original Message-----
From: Mitchell, Tony [mailto:tmitchel@stj.com]
Sent: Friday, June 13, 2003 2:35 PM
To: 'traumanurses@mailman.listserve.com'
Subject: [traumanurses] Re: Need some help with agitated neurotrauma patie
nts
Phyllis,
After trying every possible way we knew, we have found that if a family
member cannot stay with the patient, minimal doses of Propofol, Midazolam,
and soft restraints work the best on our agitated head injury patients. We
only use enough Propofol to prevent them from injuring themselves and that
dose is clearly patient specific. Usually the family member has minimal
involvement unless you can see an obvious positive response from the patient
but the family member can see how difficult it is to manage their loved one
and this is very important in other ways. The neurologists usually call or
have certain times they make rounds and ask that we shut the Propofol off
about ½ an hour before they arrive so they can assess the patients status.
Frequent attempts are made to decrease the Propofol and balance with
increased Midazolam until eventually you can get everything off. Hope this
helps.
Tony Mitchell RN, CCRN,
Trauma Coordinator
St. John's Regional Medical Center
Joplin, Missouri, 64804
Office- 417-627-8337
Pager- 888-665-1827
email- tmitchel@stj.com
-----Original Message-----
From: Uribe Phyllis [mailto:Phyllis.Uribe@HealthONEcares.com]
Sent: Friday, June 13, 2003 3:09 PM
To: 'traumanurses@mailman.listserve.com'
Subject: [traumanurses] Need some help with agitated neurotrauma patients
Greetings, all. As you head off into your weekend, our neurotrauma unit is
looking for some creative ideas on how to assure safety for agitated brain
injured patients. They often request an order for a "sitter" or "behavioral
attendant" to stay with the patient, but staffing and budget constraints
mean that is not always available. Any ideas you have used or policies for
deciding between drugs, restraints, and attendants would be welcomed. Thank
you in advance.
Phyllis Uribe RN BSN CCRN
Trauma Program Supervisor
303-788-5082 (office)
303-788-6928 (FAX)
Phyllis.Uribe@HealthONEcares.com
www.swedishhospital.com
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