FUNÇÃO DO TÉCNICO DE ENFERMAGEM NO INFARTO

Summary

This video provides a comprehensive guide for nursing technicians handling patients with chest pain in the emergency room, focusing on the management of suspected myocardial infarction. It covers the critical steps, including performing and documenting an ECG, administering medications following protocols like MONA, patient positioning, and continuous monitoring. The technician’s role in establishing vascular access, collaborating with the medical team, and ensuring patient safety is emphasized. The video stresses the importance of timely action, accuracy, and communication within the healthcare team to enhance patient care during critical moments.

Takeaways

• 😀 The nursing technician should be aware of how to handle a patient arriving at the emergency room with precordial pain, which may suggest heart issues like a heart attack or aortic dissection.
• 😀 The first action is to conduct an electrocardiogram (ECG) to assess the patient's condition. It's important to include the patient's full name, date of birth, and the time the ECG was taken.
• 😀 Never give the ECG to the patient. It should only be given to the attending nurse or placed in the patient's medical records.
• 😀 When a patient is admitted with suspected heart issues, monitor their vital signs, including pulse oximetry, blood pressure, and heart rate. Set the patient at a 45-degree angle for comfort.
• 😀 Blood pressure cuffs should be placed two fingers above the cubital fossa, and ECG electrodes should be applied correctly for accurate readings.
• 😀 Vascular access is essential for administering fluids and medications, such as saline or prescribed drugs, and must be confirmed with the nurse for proper execution.
• 😀 The protocol known as 'MONA-CHB' is followed in cases of suspected heart attack, which includes administering morphine, oxygen, nitrates, and aspirin, along with other necessary medications.
• 😀 Nitroglycerin (sublingual), aspirin, and clopidogrel are common medications used in treating heart attacks. Morphine may also be administered if the patient continues to experience pain.
• 😀 Nurses or doctors must carefully monitor the patient's respiratory drive and saturation after administering morphine to prevent complications such as respiratory depression.
• 😀 Blood sample collection for cardiac enzymes and other tests is the responsibility of laboratory personnel, not the nursing technician.
• 😀 Patients requiring transport for imaging or specialized procedures should always be accompanied by healthcare professionals, such as a nurse or doctor, to ensure their safety.

Q & A

What is the primary role of a nursing technician when a patient arrives with precordial pain?

The nursing technician's primary role is to perform initial assessments, such as conducting an ECG, ensuring proper patient positioning, monitoring vital signs, and preparing the patient for medical intervention according to the established protocols.

What key details must be included on the ECG when performing it on a patient with suspected myocardial infarction?

The ECG must include the patient's full name, mother's name, date of birth or age, and the date and time the ECG was performed, as these details are crucial for proper documentation and avoiding errors.

Why is it important to document the date and time on the ECG, even though it may appear automatically on the machine?

It's important to document the date and time manually because the machine's time could be incorrect due to battery issues or other malfunctions, leading to inaccurate information.

What are the key medications included in the MONA CHIBA protocol, and when are they administered?

The MONA CHIBA protocol includes morphine (for pain relief), oxygen, nitroglycerin (sublingual for chest pain), aspirin, clopidogrel (or ticagrelor), heparin, and beta-blockers or ACE inhibitors. These medications are administered to the patient while awaiting results of cardiac enzymes and other lab tests.

What should the nursing technician do if the patient continues to experience pain after receiving the prescribed medications?

If the patient continues to experience pain after receiving the initial medications, the technician should inform the nurse, who may adjust the treatment or authorize additional interventions, such as administering morphine or other prescribed medications.

What is the correct positioning of a patient with chest pain (suspected infarction) in the emergency department?

The patient should be positioned with the head of the bed elevated to 45 degrees for comfort unless respiratory distress dictates a different angle. This helps in reducing the strain on the heart and aids breathing.

Why is it crucial for the nursing technician to monitor the patient's vital signs continuously?

Continuous monitoring of the patient's vital signs, including heart rate, blood pressure, oxygen saturation, and sometimes temperature, is essential to detect any changes in the patient's condition, such as respiratory distress, shock, or instability.

What are the specific guidelines for applying a blood pressure cuff to a patient?

The blood pressure cuff should be placed two fingers above the antecubital fossa (elbow pit), ensuring it is snug and the correct artery is targeted for an accurate reading.

What role does the nursing technician play in preparing the patient for vascular access, and how does this process work?

The nursing technician assists in preparing the patient for vascular access by ensuring the correct site is chosen and confirming with the nurse or doctor regarding the type of access required. The technician ensures proper placement of the IV and assists with any necessary medications, under the direction of the medical team.

Why is it important for the nursing technician not to transport an unstable patient alone?

It is important not to transport an unstable patient alone because the patient may require immediate medical intervention, and having a medical team member, such as a nurse or doctor, present ensures that any complications can be addressed swiftly during the transfer.