Thank You Hannah for clarifying the "X" on MAR charts. If I may ask, a pre-op patient that is scheduled for surgery, during assessment I'd verbalize the importance of maintaining NPO prior to surgery. My question is, how long should the patient be on NPO for? Is it 12 or 8 hours for food and clear fluids? Secondly, when a SDH pt is on Warfarin, do I confirm for active bleeding in the last 24hrs or 48hrs?
Hi for NBM this is very dependent on the local trust policy the current evidence-based advises against prolonged periods of being NMB and most places follow 2 hrs as patient outcomes are worst with long periods of NBM and the risk of aspiration does not appear to change with a short NBM time some places allow clear fluids up to surgery. I would advise against verbalising a set time. In relation to SDH yes you would withhold if the the SDH had happened in the last 48hrs
Thank you Hannah. I still have 2 questions. * What is really considered low pulse. Is it 50 or 60 . I have found many sites indicating that we code if pulse is less than 60. 2nd question is that Is it common to prescribe low or higher doses?
@@ivanlumu7842 the NEWS2 parameters for normal pulse are 51-90 so 50 and under scores so that's why I teach 50 it is also important to use clinical judgement and ask if that is normal for the patient. From experience it is not common for the doses to be prescribed incorrectly
@@Huda20248 you would code the same, you can give the 500mg to the 68kg patient, it is not unsafe it will just not be effective pain relief so you could give 500mg and verbalise that you would escalate so you can give the full dose once prescribed. I have never heard of this being a scenario in the exam
Thanks
❤❤
Thank You Hannah for clarifying the "X" on MAR charts.
If I may ask, a pre-op patient that is scheduled for surgery, during assessment I'd verbalize the importance of maintaining NPO prior to surgery. My question is, how long should the patient be on NPO for? Is it 12 or 8 hours for food and clear fluids?
Secondly, when a SDH pt is on Warfarin, do I confirm for active bleeding in the last 24hrs or 48hrs?
Hi for NBM this is very dependent on the local trust policy the current evidence-based advises against prolonged periods of being NMB and most places follow 2 hrs as patient outcomes are worst with long periods of NBM and the risk of aspiration does not appear to change with a short NBM time some places allow clear fluids up to surgery. I would advise against verbalising a set time.
In relation to SDH yes you would withhold if the the SDH had happened in the last 48hrs
@ You’re Amazing… Thank you Hannah 🙏🏾
Thank you Hannah. I still have 2 questions. * What is really considered low pulse. Is it 50 or 60 . I have found many sites indicating that we code if pulse is less than 60. 2nd question is that Is it common to prescribe low or higher doses?
@@ivanlumu7842 the NEWS2 parameters for normal pulse are 51-90 so 50 and under scores so that's why I teach 50 it is also important to use clinical judgement and ask if that is normal for the patient. From experience it is not common for the doses to be prescribed incorrectly
@HannahAmes24 , Thank you so much for your timely response. May the almighty continue blessing you
How about in once only medication. Do we code it as well. For example paracetamol 500mg but the patient is 68kg
@@Huda20248 you would code the same, you can give the 500mg to the 68kg patient, it is not unsafe it will just not be effective pain relief so you could give 500mg and verbalise that you would escalate so you can give the full dose once prescribed. I have never heard of this being a scenario in the exam
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