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ANSWER TO QUIZ OF THE WEEK 8

Anagogesic sedation is an approach of using analgesics first, and hopefully, analgesics only for sedation.The use of a single agent may reduce the risk for delirium in some patients. Brenda Morgan Clinical Nurse Specialist, CCTC Last Update: November 13, 2018

Answer: VAP Bundle Interventions Head of bed elevation Oral care routine with chlorhexidine mouth rince Appropriate use of sedation; Q shift SWAP and dose reduction unless contraindicated Daily SBT screen for readiness; daily SBT if screen passed Subglottic Secretion Drainage Initiated safe enteral...

ANSWER TO QUIZ: VAP is diagnosied in CCTC using this Critical Care Services Ontario VAP criteria . Brenda Morgan Clinical Nurse Specialist, CCTC Last Update: November 12, 2018

ANSWER TO QUIZ OF THE WEEK: CAP, HAP AND VAP CAP is the abbreviation for C ommunity A cquired P neumonia and is used to define pneumonia that develops within 48 hours of admission to hospital. HAP is the abbreviation for H ospital A cquired P neumonia and defines pneumonia that develops > 48 hours...

ABOUT DELIRIUM LEARNING MODULES DELIRIUM PREVENTION Diagnosis: DSM-IV definition ELearning Modules: Prevention (Appendix C) Hallmarks of Delirium Significance and Diagnosis of Delirium Prevention Signage ASSESSMENT TOOLS Module 1 Part A: Significance FAMILY EDUCATION Delirium Screening Steps: Pain...

SCREENING QUESTIONS SEDATION ADMINISTRATION QUESTIONS My patient has a MASS score of 2. Can I screen for Delrium? How can I achieve a VAMASS goal of 3A with propofol? My patient has a MASS score of 1. Can I screen for Delirium? When is it acceptable to give a bolus of propofol? Why do we screen in...

Case A: 38 year old female post traumatic brain injury and multiple trauma The patient is ventilated and receiving fentanyl infusion for pain without any sedation. She is unable to self-report pain and has a CPOT of 1/8. Here VAMASS is 2A based on her ability to open eyes to voice. Her only other...

Delirium is a syndrome (not a disease) that causes acute cerebral dysfunction. Cognitive or perceptual distrubances develop acutely over a short period of time in conjunction with a general medical condition, substance use or abuse or drug withdrawal (including prescription or illegal drug use or...

What is the first treatment for delirium? The first step in treatment is to determine the possible cause(s) and treat as required. Medications may be used after considering the cause(s) and clinical presentation. Are patient outcomes better if we treat their delirium with antipsychotic medications...