SAFETY

1. SAFETY Pgs. 364-372 -old book 415-433 -new book NURSING FUNDAMENTALS

2. Safety • Measures that prevent accidents or unintentional injuries

3. Who is risk for injury? • Everyone is, there is no age limit • Anyone at any time can become injured

4. Infants & Toddlers • These kiddies rely on their caretakers to protect them • Infants and toddlers become injured in the following ways: • can fall of changing tables • not be restrained in automobiles • Have accidental poisonings • Fall from high places if not watched • Get burned, electrocuted, if not watched • drown

5. School-Age Children • Very active little people • Get hurt from play related injuries • Are also at risk for poisonings if products are not labeled or if labels are changed

6. Adolescents • Are cool and never get hurt…yeah right! • This age group suffers from sports-related injuries • This age group wants independence and is influenced by peers • This age group starts driving cars...scary • This age group is impulsive and spontaneous and takes risks because it’s cool

7. Adults • We ignore safety rules, we feel that it won’t happen to me because I am an adult and that’s just for little kids

8. Environmental Hazards • These are potentially dangerous conditions in one’s physical surroundings • These include: • Sensitization/allergies to latex or bee stings • Thermal burns from equip. • Asphyxiation such as choking, exhaust gas • Electrical shock • Poisonings • Falls • overdoses

9. Latex Sensitization • These are people who have an allergic response to the proteins in latex • Long time latex users have a high chance of becoming allergic over time, the body builds up enough antigens and all it takes is another time of using a latex product and one could react

10. Allergies • A response occurs in the body when a person is allergic: Histamine reaction • Histamine causes the release of large amounts a mucus, dilation of the smallest blood vessels called capillaries, then gases cannot be exchanged and the person cannot breathe, contraction of smooth muscle causes breathing problems in the lungs

11. Treatment of a histamine release • Benadryl – usually first med given to stop the histamine response • It blocks the release of histamine stopping all of the bad things • Steroids take away swelling and calm the body down • Epinephrine (Epi-pen) – usually given in an emergency allergic reaction, helps constricts blood vessels and opens the lungs

12. Types of Latex Reactions • Contact dermatitis • Immediate hypersensitivity

13. Contact Dermatitis • This is a delayed localized skin reaction that occurs within 6-48 hrs and can last several days

14. Immediate hypersensitivity • An instant or prompt systemic reaction manifested by: • Swelling (edema) • Itching (pruritis) • Hives (urticaria) • Respiratory distress or S.O.B. (dyspnea) • Low blood pressure (hypotension) • Possible death

15. Watch items that contain latex • As a nurse, you must be fully aware of the pt’s needs. Nurses are always asking if a pt is allergic to latex…very common allergy today • Some pts cannot even have latex balloons in a room, they will break out • Watch your equipment such as tubing and gloves • Watch some foods such as avacados, bananas, almonds, peaches, peanuts…it has been proven that the molecular structure in latex is similar to plant substances

16. Always read the labels(tell story of latex catheter that was placed in my urology pt during surgery, edematous labia d/t allergy)

17. Minimize the exposure • You must ask the pt about allergies • You must check to see if pts are catheterizing themselves or if they are being cath’s frequently • Flag the pt’s chart so others will see the allergy • Make the environment “Latex Free”, use latex cart • Communicate with other staff that your pt is on latex precautions

18. Pt teaching • Encourage your pt to wear a “Med-Alert” bracelet at all times • Encourage pt to tell his employer about this allergy, it can lead to death • Teach parents to notify school of allergy

19. Burns • Thermal burn – is a skin injury caused by flames, hot liquids, steam or some caustic chemical such as lye, acid, electric wires, or lightening • Thermal burns are the MOST COMMON forms of burns

20. Burn Prevention • You must start with YOU • Know what your facility’s policies are • Know where the exit door are and stairwells • Know where the fire extinguisher is • Know that exits must be properly lighted, unlocked and easily identified

21. Fire Plans • Know your facility’s fire escape routes, you will practice them from time to time on your unit • JCAHO The Joint Commission On Accreditation of Health Care Organizations is always watching you on the job

22. Fire Management • Use the acronym to remember what to do: • R – rescue • A – alarm • C – confine the fire • E – extinguish the fire

23. Fire Management cont’d… • Always remove the pt from the direct fire • Close all doors • Place towels under the door to prevent smoke from coming out into the halls • Always pull the fire alarm • Clear the halls of equipment or people • Find the fire extinguisher

24. Fire Extinguishers • 4 types are available: • Class A – is water under pressure, use this type for burning paper, wood or cloth • Class B – contains CO2, used on fires caused by gasoline, oil, paint, grease or other flammable liquids • Class C – contains dry chemicals and is used on electrical fires • Class ABC – contains graphite and is used on fires of any kind

25. Several types of fire extinguishers are available

26. Use the acronym: P – pull the pin A – aim at the BASE of the fire S – squeeze the trigger S – spray How to use a fire extinguisher

27. Smoke Inhalation • Asphyxiation – inability to breathe, this can result from an airway obstruction, drowning or inhalation of noxious gases such as smoke or CO • If a pt suffers from this, remove the pt 1st, administer O2 • Smoke can be more deadly than fire

28. NO SMOKING • As nurses, we are to encourage that pts STOP smoking • Smoking is unhealthy to begin with • Many smokers fall asleep at home with a lit cigarette that causes a fire • Encourage the use of smoke detectors • Discourage smoking when O2 is being used, O2 is flammable/explosive

29. Carbon Monoxide (CO) • This is an odorless gas that is released during the incomplete combustion of carbon fuels such as: • Kerosene, natural gas, wood and coal…all that heats homes • When CO is inhaled, it binds with hemoglobin and doesn’t allow O2 to bind and now the person has no O2…can be lethal

30. Prevention of CO poisoning • The use of CO detectors saves lives, nurses promote this in teaching • Symptoms of CO poisoning: (NCLEX) • Flu-like symptoms such as N/V, headache, dizziness, muscle weakness, S.O.B., cherry red skin color • people overlook it, as the condition worsens, person becomes confused, can become comatose and can die

31. What to do if there is CO poisoning • Open doors and windows immediately • Call 911 • Pt may need to be placed in a hyperbaric chamber that delivers ridiculous amounts of high pressured O2 as in the coal miner stuck underground

32. Encourage the use of a CO detector

33. Drowning • A condition in which fluid occupies the airway and interferes with ventilation and therefore interferes with the exchanging of gases • Swimming pools and lake drownings occur all too often • Victims of cold water drownings are more likely to be resuscitated because the cold water lowers their metabolism, conserving oxygen

34. Resuscitation • CPR – cardio pulmonary resuscitation • If done correctly, saves lives • If done incorrectly, can save a life but can cause complications also • You will learn CPR in 2nd semester • It takes 2 minutes to get brain damage

35. Electric Shock • Is a discharge of electricity through the body • Our body is susceptible to electric shock because it is made up of water and electrolytes…both of these are excellent conductors of electricity

36. Person electrocuted

37. Macroshock vs. Microshock • MACROSHOCK - Is a low voltage, low amp electricity over a large area of the body, it feels like a tingling or when you touch another person • MICROSHOCK – is a low voltage but high amp electricity. • NOT ON TEST, DON’T PANIC

38. How to avoid shock • Use equipment that has been grounded only • Never use an adaptor that bypasses a grounded outlet • Make sure all switches have cover plates • Unplug equipment that is not in use • No electrical devices near water • Do not use equip. with frays in the plugs • Grasp the plug, not the cord to remove it • Do not use extension cords • Clean liquid spills ASAP • Stand clear of the bed and pt during cardiac defibrillation

39. Poisonings • Are more common in homes • Are more common in younger children and elderly • Many kids treated for accidental poisonings have a repeat episode • The wrong meds given to a pt by you could be considered a form of poisoning

40. Prevention of Poisonings • Nurses can educate people about the do’s and don’ts • Teach people never to remove a liquid and replace it with a chemical such as bleach d/t error in use • Tell story of boy in O.R. NS bottle contained cleaning solution and boy who drank DRANO

41. Treatment of poisonings • Maintain ABC’s 1st, always, always, always • Call 911 • Call Poison Control • DO NOT RECOMMEND syrup of Ipecac, is being used incorrectly and by bulimics and anorexics

42. Falls • Falls more than any other injury are the most common accident experienced by older adults and have more serious consequences for this age group • Many who survive a fall suffer years of disability, impaired mobility, and pain….these lead to further probs. for the pt

44. Why do people fall? • Visual impairment • Diseases that affect gait, balance or coordination • Meds cause dizziness and low BP esp. upon rising • Urinary urgency causes people to rush • Use of throw rugs • Use of slippers vs. better tractioned shoes

45. Assessment • The nurse determines who is at risk for falls using a falls risk assessment tool. • It asks several questions based on one’s ability to fall or if the pt has already fallen, it rates them at a high number and others will know this pt is at risk for more falls

47. Prevention of Falls • Keep areas clean and free of clutter • Discourage the use of: throw rugs, slippers with no traction • Care for your pt properly, check in on your pt frequently • Order a sitter or bedside companion or family member to avoid falls • Check with facility policy, can you leave one side rail down so pt will not climb over the rail, rather he will get OOB with ease

48. Incident Report • Once a pt falls or even receives the wrong medication or wrong dose of medication, you must bring the pt to safety 1st, 1st, 1st • This means you check the condition of the pt • (tell the story of the pt who was double dosed on insulin and the next shift nurse found the error) • Then you can tell you head nurse and the Dr. • The last thing you must do is write an incident report, must, must, must you need to report what happened even if it was or was not your fault. CYA, CYA, CYA

49. You are in charge • It’s your pt • Handle them well • Keep them safe • Always stay on top of the game • The moment you let your guard down, things happen

50. Look at the Picture….. • Found in back of power point…. • Circle all that’s wrong