Amita's Safety Case Study
Discussion of risks
The main priority in this scenario is Amita’s safety. The main risk is the possibility of her airway becoming compromised due to her low GCS score (Feather & Randall, 2011). There is a risk of further deterioration due to increased cranial pressure (Czosnyka, Pickard, Kirkpatrick & Hutchinson, 2012). If a patient’s GCS is lower than 8/15 they cannot maintain their own airway due to the tongue muscle relaxing and flopping back (Deutschman & Neligan, 2016). A GCS score of eight or below indicates the need for intubation and ventilation (NICE, 2017a). Because of this, NICE (2017b) suggest half-hour GCS monitoring until a GCS of 15 is achieved. An oropharyngeal adjunct should be placed near the bedside as a precaution. This …show more content…
The chest raised equally with no signs of accessory muscle usage and Amita’s breath was felt against the back of the nurses’ hand. However, when listening to Amita, gurgling sounds were heard. Gurgling sounds indicate that there is a presence of liquid in the upper airway (Malamed, 2017). Throat muscles can become weak after a stroke, which makes it difficult for the patient to initiate the swallowing reflex (Udesky, 2018). The gurgling sounds heard by the nurse could be sputum in the airways if Amita has difficulty swallowing. This could be treated by suctioning the sputum by using a yanker (Tollefson, 2012). When a patient has a low GCS score; there is a chance of deteriorating. As mentioned in the risk section; a patient is unable to maintain their airway if their GCS is under 8/15. This means it is crucial for Amita’s airway to be reassessed regularly. If Amita’s airway does become compromised, then a technique to open the airway should be used. The technique widely used is the head tilt-chin lift or a jaw thrust if a cervical spinal injury is suspected (Willis & Dalrymple, 2015). Additionally, an artificial airway such as an OP airway should be used to maintain the airway patency (Markovchick, Pons & Buchanan, 2016). If this technique does not work and the nurse cannot feel air on the back of the hand then Cardiopulmonary Resuscitation (CPR) must be performed unless there is a ‘DNAR’ in place (Peate & Dutton,
The main priority in this scenario is Amita’s safety. The main risk is the possibility of her airway becoming compromised due to her low GCS score (Feather & Randall, 2011). There is a risk of further deterioration due to increased cranial pressure (Czosnyka, Pickard, Kirkpatrick & Hutchinson, 2012). If a patient’s GCS is lower than 8/15 they cannot maintain their own airway due to the tongue muscle relaxing and flopping back (Deutschman & Neligan, 2016). A GCS score of eight or below indicates the need for intubation and ventilation (NICE, 2017a). Because of this, NICE (2017b) suggest half-hour GCS monitoring until a GCS of 15 is achieved. An oropharyngeal adjunct should be placed near the bedside as a precaution. This …show more content…
The chest raised equally with no signs of accessory muscle usage and Amita’s breath was felt against the back of the nurses’ hand. However, when listening to Amita, gurgling sounds were heard. Gurgling sounds indicate that there is a presence of liquid in the upper airway (Malamed, 2017). Throat muscles can become weak after a stroke, which makes it difficult for the patient to initiate the swallowing reflex (Udesky, 2018). The gurgling sounds heard by the nurse could be sputum in the airways if Amita has difficulty swallowing. This could be treated by suctioning the sputum by using a yanker (Tollefson, 2012). When a patient has a low GCS score; there is a chance of deteriorating. As mentioned in the risk section; a patient is unable to maintain their airway if their GCS is under 8/15. This means it is crucial for Amita’s airway to be reassessed regularly. If Amita’s airway does become compromised, then a technique to open the airway should be used. The technique widely used is the head tilt-chin lift or a jaw thrust if a cervical spinal injury is suspected (Willis & Dalrymple, 2015). Additionally, an artificial airway such as an OP airway should be used to maintain the airway patency (Markovchick, Pons & Buchanan, 2016). If this technique does not work and the nurse cannot feel air on the back of the hand then Cardiopulmonary Resuscitation (CPR) must be performed unless there is a ‘DNAR’ in place (Peate & Dutton,