Transcript Infection Control, Medical Emergencies, Vital Signs & Oxygen

Infection Control, Vital Signs,
Oxygen & Medical Emergencies
RTEC 93
Infection Control
• Microorganisms
• Infectious
Disease
• Chain of Infection
• Nosocomial
Infection
• Disease Control
• Environment
Standard Precautions
What do you think?
• What is the potential hazard to the patient
when strict aseptic techniques is not used
when administering intravenous
medication or contrast?
Microorganisms
that cause disease

Bacteria

Viruses

Fungi

Protozoa

Can grow in or on
an animal or plant
and cause diseases.

Host: animal or
plant that provides
life support to
another organism.
Disease
• Disease occurs
only when the
microorganism
causes injury to
the host
Pathogen

A disease producing microorganism.
 Multiply
in large numbers and cause an
obstruction
 Cause tissue damage
 Secrete substance that produce effects in
the body

Exotoxins ( high body temp, nausea, vomiting)
6 Steps of Infection

Encounter

Multiplication

Entry

Damage

Spread

Outcome
Chain of Infection
 Host
 Infectious
Microorganism
 Mode of
Transmission
 Vector/ Fomite
 Reservoir
Nosocomial Infections

Infections
originating in the
hospital; an
infection not
present before
admittance to
the hospital.
Nosocomial Infections
Iatrogenic
Infection
 Compromised
Patients
 Patient Flora
 Hospital
Environment
 Bloodborne
Pathogens

Types of Nosocomial Infections
Iatrogenic Infection – related to
physician activities
 Compromised Patients - weakened
resistance; immunosuppressed
 Patient Flora - microbes in healthy
people
 Contaminated Hospital Environment
 Bloodborne Pathogens – Hepatitis B
and HIV

Third Degree Burn
Who needs protection from infection if this is your patient?
Universal Precautions






Since there is no way you can know if a person
is infected, you should ALWAYS use universal
precautions:
Wash your hands
Wear gloves
Handle sharp objects carefully
Properly clean all spills
Wear mask, eye protection, and apron if
splashing is a possibility.
What are the 3 Transmission-based
Isolation Precautions?
 Contact
 Droplet
 Airborne
Airborne Precautions
Patients infected with pathogens that
remain suspended in air for long periods
on aerosol droplets or dust.
 TB, Chickenpox, Measles
 Respiratory protection must be worn when
entering pt room.
 Pt should wear mask.

Droplet Precautions
Patients infected with pathogens that
disseminate through large particulate
droplets expelled from coughing,
sneezing, or even talking.
 Rubella, Mumps, Influenza
 Surgical mask must be worn when within 3
feet of the pt.
 Pt should wear a mask.

Contact Precautions



Patients infected with pathogens that spread by
direct contact with the pt or by indirect contact
with a contaminated object (bedrail, pt dressing).
Methicillin-resistant staphylococcus aureus
(MRSA), Hepatitis A, Varicella, Flesh-eating
Virus
All PPE should be used and equipment must be
disinfected after use.
Controlling the spread of Disease
• Chemotherapy
• Immunization
• Asepsis
– Medical
– Surgical
• Disinfectants
Physical Methods of
Controlling Diseases
• Handwashing
• Standard
Precautions
– Gloving
– Gowns
– Face masks
– Eyewear
Hand washing



Single most important means of preventing the
spread of infection.
7 to 8 minutes of washing to remove the
microbes present, depending on the number
present. Per JCAHO =10-15 seconds
Most effective portion of hand washing is the
mechanical action of rubbing the hands together.
So What, and Who Cares?

Students and Techs are challenged both
physically and mentally by the microbial
world. In this world of newly found, lifethreatening diseases, education has
become the key to survival. Health care
providers must be committed to infection
control so that diseases can be
conquered!
Infection Control per JCAHO
Fingernail Compliance

No more than ¼ inch long

No artificial nails

No chips on nail polish
When do you wash your hands?
When hands are visibly soiled
 Before and after patient contact
 After removal of gloves
 After using the toilet
 After blowing or wiping the nose
 Upon leaving an isolation area

When do you wash your hands?

Before Eating

How long do you wash?
 10-15
Seconds
When should sharps boxes be
emptied?

When they are 2/3 full
What are some examples of proper
usage of gloves?




Wear gloves when you anticipate possible
contamination
When handling chemicals like disinfectants for
cleaning
Remove gloves immediately after performing
task and performing hand hygiene
Hallways should be considered a
“glove free zone”
When do you use disinfectant jell?
Before and after patient care when hands
are not visibly soiled
 Before performing invasive procedures for
hand decontamination
 To decontaminate hands after contact with
patient’s intact skin, i.e., after taking vital
signs

What can you use for cleaning
equipment and surfaces?

Disinfectant wipes
How do you know equipment is
clean?
Clean equipment is covered with plastic
 A clean bed or gurney is dressed
 Medical equipment is cleaned between
patients or when soiled
 Not sure ? Always clean and disinfect.

What are examples of
Standard
Precautions?
What are examples of Standard
Precautions?
Use of PPE (personal protective
equipment)
 Protective housekeeping
 Practicing good hygiene

Review








Microorganisms
Disease
Pathogen
Bacteria
Viruses
Fungi
Protozoan
6 Steps of Infection







Chain of Infection
Nosocomial Infection
Controlling Disease
Physical Methods of
Controlling Diseases
Handwashing
Standard Precautions
Universal Precautions
Questions?
• Infection Control
Vital Signs
 Vital Signs
 Oxygen Therapy
 Oxygen Devices
 Chest Tubes and
Lines
Vital Signs
 Indication of
 Physical assessment
Homeostasis
 Primary Mechanisms
include measurement
of vital signs
 Body Temperature
Pulse
Respiration
Blood Pressure
Mental Status





Heart beat
Blood pressure
Body temperature
Respiratory rate
Electrolyte
balance
Body Temperature
 Normal average body
 Measuring Body
temperature: 98.6 F
Humans can survive
between 106 F and
93.2 F.
Temperature
 Hypothermia
 Axillary
 Hyperthermia
 Tympanic
 Oral
 Rectal
Pulse
 Pulse rate: Adult = 60 to 100 beats per
minute
 Children under 10 = 70 to 120 beats per
minute
 Tachycardia
 Bradycardia
Respiratory Rate
 Breaths per minute: Adult = 12 to 20
 Children under 10 = 20 to 30 per min
 Tachypnea
 Bradypena
 Dyspnea
 Apnea
Pulse Oximeter
• Normal Pulse
Oximeter = 95%
to 100%
Blood Pressure
• Blood Pressure
• Systolic pressure =
95-140 mmHg
• Diastolic pressure =
60-90 mmHg
• Hypertension
• Hypotension
Oxygen
 Oxygen constitutes 21% of atmospheric
gases
 If O2 levels in the body drop below 21%
homeostasis is altered.
 Hypoxia: Inadequate amount of oxygen at
the cellular level.
Oxygen Devices
 Nasal Cannula
 Masks
 Nonrebreathing
mask
 Aerosol
mask
 Air-entrainment mask
Tent and Oxyhood
Chest Tubes and Lines
• Endotracheal
Tube (ET)
– Ventilator
• Chest Tubes
• Nasogastric tube
(NG)
• Central Lines
Central Line Injections by RT
• The California Law
does not address
arterial injection by
RT
• Employers policies
• Saline flush
Review
 Vital Signs
 Electrolyte balance
 Homeostasis
 Pulse Oximeter
 Body Temperature
 Oxygen
 Pulse
 Oxygen Devices
 Respiration
 Chest Tubes
 Blood Pressure
 Chest Lines
 Mental Status
Questions?
• Vital Signs
Medical Emergencies
Medical Emergencies
• Definitions
• What should the
RT know?
• Common
Radiology
Emergencies
Medical Emergencies

Definition: Sudden change in medical
status requiring immediate action.

For RT’s medical emergencies are
rare, however as medical personnel
we must be prepared to recognize
emergencies.
What an RT should know…..
How to…..
 Avoid additional harm to the patient
 Obtain appropriate medical assistance
quickly

 Recognize
emergency
situations

Remain calm and confident
Anaphylactic Reaction

An immune response to foreign material
Bronchospasm – wheezing and
edema in the throat and lungs
 Can lead to shock
 Requires prompt recognition and
treatment from the technologist
Why do RT’s care about Anaphylactoid
RXN’s….?
See Pg. 336

Water Soluble Iodine
• High atomic # 53
• Radiopaque
• Used to radiograph
–
–
–
–
Vessels
Arteries
Veins
Function of internal
organs
Iodine Contrast Material
• Ionic Iodine Contrast
– Anion – Cation +
– More patient allergic
reactions
• Non-Ionic Contrast
– Less patient allergic
reactions
Patient Assessment Check List
• Information update !!
Medications containing metformin
 Glucophage
 Rosiglitazone
 Glucovance
 Metaglip
 Glyburide
 Avadment
 Glipizide
 Fortamet
Creatinine clearance vs Creatinine
 In general, creatinine clearance is the
removal of creatinine from the body.
 In renal physiology, creatinine clearance
(CCr) is the volume of blood plasma that is
cleared of creatinine per unit time.
 The result of this test is an important gauge
used in assessing excretory function of the
kidneys
Creatinine clearance vs Glomerular
filtration rate (GFR)
 Clinically, creatinine clearance is a useful
measure for estimating the glomerular
filtration rate (GFR) of the kidneys.
 creatinine clearance overestimates actual
GFR by 10-20%.
 This margin of error is acceptable considering
the ease with which creatinine clearance is
measured
Radiology Department
 Patients
are usually sent to
the radiology department
only after they have been
stabilized.
 However……
Become familiar with………..
• In your work environment:
– Emergency assistance protocol (how to
get help)
– Emergency Cart/Crash Cart Location
Important Conditions to be
Aware of……

Level of Consciousness: ALOC

Altered Level Of Consciousness

Anaphylatic Shock: vasogenic shock

Hypoglycemic/Hyperglycemia

NPO – Nothing by Mouth
Radiologic Technology
• You never know
when a medical
emergency may
occur.
• Helping your
patients depends
on your abilities to
stay calm and
perform you duties!
Questions?
• Infection Control
• Vital Signs
• Medical
Emergencies
Vascular System
Vascular access is legal for RT’s
where? upper or lower extremity ?
• What are characteristics of arteries?
• What are characteristics of veins?
• Rapid flow, Contain valves, Dark red
blood, Flows away from heart, Flows
toward the heart, Pulsating
Venipuncture Anatomy
• Most Common
sites for IV
introduction in
Radiology
– Anticubital space
– Anterior forearm
– Dorsum of the
hand
– Radial wrist (ouch)
Anticubital Space & Anterior
Forearm
• Cephalic Vein
– Accessory cephalic
•
•
•
•
Basilic Vein
Median veins
Antecubital Vein
Median cubital
– Most common site
for extravasation
– Pg. 316
Anticubital Space
• Are located over an area of joint flexion:
therefore any motion can dislodge the
cannula and cause infiltration.
• A flexible IV catheter is the needle of
choice for placement of a venous access
in the antecubital space.
Posterior Hand & Radial Wrist
• Cephalic Veins
• Basilic Veins
• Radial Vein
Pharmacology for the
Radiologic Technologist
Drug Classifications

Name – generic or brand

Action

Method of legal purchase (prescription
or non-prescription)
Classification by Name



Chemical name – actual chemical
structure
Generic name – when it becomes
commercially available (never
capitalized) – nonproprietary name
Brand name – give by a drug
manufacture – trademark, trade name,
proprietary name
Example

Chemical name – 7 chloro-1,3-dihydro1-methyl-5-phenyl-H-1,4benzodiazepin-2-one

Generic name – diazepam

Brand name - Valium
Drug Reactions

Anaphylaxis
– VS

Anaphylactoid
Principles of Drug
Administration





“The golden rules of drug
administration”
The five rights of drug administration
Right drug
Right patient
Right route
Right amount
Right time
Drug Routes



Oral – by mouth
Sublingual – under the tongue
Topical – directly onto the skin
– transdermal

Parenteral – by injection or other than
oral - intramuscular, subcutaneous,
intravenous
Charting Drug
Information


Any time a drug is administered to an
inpatient it must be charted
Information includes:
– Drug name
– Dose of the drug
– Route of administration (if parenterally,
then the side of injection)
– Date & Time
Legal Considerations


Errors with drug administration is the
most common legal problems for
radiologic technologists
Techs must follow charting protocols
and document all errors in drug
administration
Pg. 319
 Do
Not Use
– abbreviations
Questions?
 "The pessimist sees difficulty in every opportunity.
The optimist sees the opportunity in every
difficulty."
Winston Churchill