Rates patient injury

Paper based surveys are more useful than web based surveys for hospital staff. Significant local support is required to increase participation in the survey. Safety culture factors explained more variance in safety behaviour measures than they did variance of worker and patient injury rates. 

Medical Practice Studies (MPS) conducted in the United Kingdom, Canada, Australia, New Zealand, France, the Netherlands, and Denmark reported patient injury rates from 7.5% to 15% [2,12,24]. 

EMETICS Because treatment of poison ingestion is an emergency, the nurse immediately obtains equipment for treatment. The nurse obtains the drag, an emesis basin, towels, specimen containers for sending contents of the stomach to the laboratory for analysis, and a suction machine and places them near the patient. The nurse obtains the patient s blood pressure, pulse, and respiratory rate and performs a brief physical examination to determine what other damages or injuries, if any, may have occurred. 

Increased oxygen demand secondary to increased heart rates and blood pressure has been hypothesized to lead to myocardial infarction (especially in patients with fixed coronary disease) and/or ventricular arrhythmias. In patients with no history of cardiac disease, cocaine is thought to induce acute isehemie complications via vasospasm of the coronaries (Ascher et al. 1988). In addition, Virmani et al. (1988) have reported a 20 percent incidence of myocarditis thought to be secondary to accumulated microvascular injuries. 

In patients with life-threatening arrhythmias, weigh the potential risk of hepatic injury against the potential benefit of therapy. Monitor carefully for evidence of progressive hepatic injury. Give consideration to reducing the rate of administration or withdrawing amiodarone IV in such cases. 

In an effort to overcome the lack of solubility, poor penetration across the blood-brain barrier and decreased delivery of conventional systemic agents by a compromised intratumoral blood supply, several studies have evaluated various combinations of BCNU alone or with other agents delivered intraarterally. Unfortunately, response rates and median survival times observed in patients treated with intraarterial chemotherapy have not been significantly different than those seen in patients treated with standard intravenous nitrosurea-containing regimens, while increased rates of toxicity such as leukoen-cephalopathy, retinal injury, edema, myelosuppression, sepsis, and thrombotic complications have been noted (40-46). 

Most of the contraindications specific to pentazocine stem from its excitatory effects. Other contraindications are similar to those for morphine. Pentazocine is contraindicated in patients with myocardial infarction because it increases heart rate and cardiac load. Similarly, it is contraindicated in epileptic patients because it decreases seizure threshold. In addition, in head trauma patients, it can increase intracranial pressure and brain injury. Pentazocine use in patients with psychoses is contraindicated because of its psychotomimetic side effects. 

Inhaled anesthetics decrease the metabolic rate of the brain. Nevertheless, the more soluble volatile agents increase cerebral blood flow because they decrease cerebral vascular resistance. The increase in cerebral blood flow is clinically undesirable in patients who have increased intracranial pressure because of a brain tumor or head injury. Volatile anesthetic-induced increases in cerebral blood flow increase cerebral blood volume and further increase intracranial pressure. 

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