Suctioning in Head Injury Care

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Questions and Answers

What is the primary function of an antidote?

To induce vomiting as a first response

To provide immediate surgery to the affected area

To neutralize poison and mitigate its effects (correct)

To remove the entire poison from the body

Which of the following is considered an alkaline poison?

Toilet bowl cleaner

Pool cleaner (correct)

Battery acid

Metal cleaner

What symptom is commonly associated with the ingestion of corrosive poisons?

Euphoria

Increased appetite

Excessive tiredness

Burning pain in mouth or throat (correct)

When managing poisoning, which goal is NOT typically included?

Incur only supportive care without treatment Signup and view all the answers

Which of the following substances would NOT be classified as an acid poison?

Oven cleaner Signup and view all the answers

What is the recommended storage temperature range for vaccines?

+2 to +8 °C Signup and view all the answers

In which injection sites are vaccines administered to infants?

Anterolateral thigh and deltoid Signup and view all the answers

How long can reconstituted vaccines be stored in the refrigerator before use?

8 hours Signup and view all the answers

Which injection area should never be used for vaccine administration due to unpredictable absorption?

Gluteal area Signup and view all the answers

What type of bite wound would require vaccination according to the guidelines?

All frankly infected wounds Signup and view all the answers

What is the set dosage of the PCEV administered on Day 0?

1.0 ml Signup and view all the answers

Which of the following describes the Zagreb Regimen Schedule?

2-0-1-0-1 Signup and view all the answers

On Day 21, what is the site of injection for the PCEV?

One deltoid or anterolateral thigh Signup and view all the answers

What is a recommended practice to reduce the risk of hypoxemia during suctioning?

Administer 100% oxygen pre-suction and post-suction Signup and view all the answers

Which suctioning technique is suggested for patients on high FIO2 or PEEP?

Closed suction technique Signup and view all the answers

What should NOT be routinely performed prior to endotracheal suction?

Administering normal saline instillation Signup and view all the answers

Why is shallow suction preferred over deep suction?

Evidence from infant and pediatric studies supports its use Signup and view all the answers

What is the effect of suctioning on patients with head injuries?

It can cause elevations in intracranial pressure (ICP) Signup and view all the answers

Which parameter is NOT recommended to monitor during suctioning?

Patient's hair color Signup and view all the answers

What should be considered if the patient experiences a clinically important reduction in oxygen saturation during suctioning?

Consider pre-oxygenation Signup and view all the answers

What is a possible complication that can arise from the use of central catheters?

Infection from the catheter insertion Signup and view all the answers

What is a key benefit of using the closed suction technique?

It allows for continuous mechanical ventilation and oxygenation Signup and view all the answers

What is one of the recommended care practices for an AV fistula?

Avoid sleeping on the side with the fistula Signup and view all the answers

Which of the following is necessary for the proper care of intrajugular or central line access?

Clear labeling of fluid bags and lines Signup and view all the answers

What can result from air entering the bloodstream through a catheter?

Air embolism Signup and view all the answers

How should healthcare providers manage potential complications with central catheters?

Follow hospital protocols and regularly inspect the site Signup and view all the answers

What is an important step to take when caring for an intrajugular catheter or central venous access device?

Identify when each line was last changed and label it Signup and view all the answers

What is a common misconception about central catheter use?

Once inserted, central catheters require no monitoring Signup and view all the answers

Which practice is recommended for daily inspection of an AV fistula?

Check for signs of infection or bleeding Signup and view all the answers

What should be checked at the site of an arteriovenous fistula (AVF) immediately following surgery?

Signs of excessive bleeding and swelling Signup and view all the answers

What is a key indication for the use of an arteriovenous graft?

For chronic dialysis clients without adequate blood vessels for a fistula Signup and view all the answers

How long after insertion can a mature arteriovenous fistula (AVF) typically be used?

After 2 weeks to 4 months Signup and view all the answers

What is a potential complication of an arteriovenous graft?

Clotting and infection Signup and view all the answers

What should be done to care for an arteriovenous graft site after surgery?

Keep the dressing dry for the first 2 days Signup and view all the answers

What should be avoided at the site of an arteriovenous graft to prevent injury?

Applying pressure during blood sampling Signup and view all the answers

When can bathing or showering be resumed after arteriovenous graft surgery?

After the dressing is removed Signup and view all the answers

What is a sign that may indicate infection at the site of an arteriovenous graft?

Pain and tenderness at the site Signup and view all the answers

Study Notes

Suctioning Guidelines

Suctioning can raise intracranial pressure (ICP) in patients with head injuries.
Endotracheal suctioning should be performed only when secretions are present.
The closed-suction technique is preferred, allowing continuous mechanical ventilation during suctioning.
Administering 100% oxygen before and after suctioning helps reduce hypoxemia.
Monitoring during suctioning should include breath sounds, oxygen saturation, skin color, pulse oximeter readings, respiratory rates, hemodynamic parameters, and sputum characteristics.
Normal saline instillation before suctioning is not recommended.
Closed suction is advised for adults on high FIO2, PEEP, or neonates at risk for lung derecruitment.

Vaccination Protocol

Vaccines must be stored in a refrigerator at +2 to +8 °C, avoiding the freezer.
Once reconstituted, vaccines should be refrigerated and used within 8 hours.
Injection sites for adults are the deltoids, while infants receive injections in the anterolateral thigh.
The gluteal area is not recommended for injections due to unpredictable absorption.
Recommended schedules include Day 0, Day 7, and Day 21 for vaccine administration.

Central Venous Catheter Care

Intrajugular or central line access is for temporary or emergency dialysis.
Daily inspection of access sites should occur for signs of infection, bleeding, or hematoma.
Each line and its corresponding medication should be clearly labeled.
Complications of central catheters include infections, blood clots, pneumothorax, air embolism, and compatibility issues with medications.

Arteriovenous Fistula (AVF) and Graft Management

Daily inspection of AVF sites is crucial for detecting complications like excessive bleeding, hematoma, and signs of infection.
Blood flow should be assessed by checking pulses, color, and temperature of the limb.
A mature AV fistula can be used between 2 weeks to 4 months post-insertion.
Common complications include clotting, aneurysms, and infection.
Avoid blood pressure measurements or blood tests near the graft.

Poison Management

Poisons are substances causing injury through ingestion, inhalation, absorption, or contact.
Alkaline poisons include drain cleaners and bleach, while acid poisons include toilet bowl cleaners and rust removers.
Goals in poison management are to remove/inactivate the poison, provide supportive care, neutralize the poison, and expedite elimination.
Clinical manifestations of poisoning can include burning pain, difficulty swallowing, drooling, vomiting, and altered levels of consciousness.

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Description

This quiz focuses on the recommendations and techniques of suctioning in patients with head injuries. Participants will learn about the effects of suctioning on intracranial pressure and best practices, including when to perform suctioning. Understanding the closed-suction technique and pre-oxygenation will be emphasized.