Wednesday, January 30, 2019
Care of Suicidal Patient in Ed
This article Is ab knocked out(p) caring for pediatric patients who argon unsafe. I believe In coincided with what we digest late been learning about during our clinical experience. I was also Interested in this article beca wasting disease I had worked In pediatrics for six years antecedent to working in a rehab/nursing home setting. aft(prenominal) reading this article, I learned ways to anxietyfully screen the pediatric patient, how to do an judgment and how some families characterization and what measures of support they need during their families time of crisis.This oracle gave a case say of a male child that was brought Into the emergency apartment with his spawn and grandfather. When the hold met him in the reception area he was sitting In a head with his legs pulled up to his chest and his shoe laces were untied. He avoided eye contact during their meeting. The convey in the case study was visibly upset.This boy was brought to the emergency incision because th is young boy was found in the kitchen holding a murder knife to his neck, when his mother walked In and got the young boy to give her the knife, prior to this day in that location were many changes in the young boys life, he recently started a new school and he was diagnosed with Espaliers syndrome. This boy also had unhinge making friends in his school and he was being bullied. Other children at school were threatening this boy. This story made me think of all the children that are In POEMS and how he seemed to have a lot of things In earthy with them. They were all in similar situations.The keep back after obtaining this history from his mother and asking about any medications, vaccinations, allergies, possible exposures to communicable diseases also postulate to obtain his vital signs and head to toe assessment The young boy let the nurse do his height and weight however as soon as the nurse put the stethoscope to he boys chest he felt his heart pounding and he thought It meant he was breathing out to die. The boy had anxiety during the assessment so the nurse stopped the assessment and showed what she needed to do on his mother and after the boy relaxed a little bit, he allowed the nurse to finish the assessment on him.The nurse got a one on one to stay with this patient because he was at risk for doing harm to himself. The nurse also had to obtain an chunk and body of water drug screen. In our clinical setting, I have seen the urine drug screen used on every patient but not the formal. According to this article, It Is Important to obtain a baseline EGG because many psychophysiology agents can affect the conduction system of the heart. After the boy was medically cleared, he was eligible to meet with the psychiatrist and affectionate worker. He had to wait for the psychiatrist and he became agitated and started kicking the wall.Security had to be called Into the manner and the safety door was lowered. The nurse removed their name badge and th eir bandage scissors as they were both safety hazards. The nurse re-entered the room keeping their pathway to the door unobstructed. All riskinessous items were removed from the room. The nurse used many different techniques to deescalate the situation and used the mother to unsex Information of things that have worked In the by. When the boy was ready to discharge, the nurse gave them bringing up on a safety plan the called tort keeping knives out to the boys reach and tallow up tort outpatient compassionate.No medications were given to calm him down. The felo-de-se rate in the entire world has increased over the past few decades with a greater number of boys attempting suicide then girls. In 2010, there was a study hat found 14% of children ages 11-20 reported having suicidal thoughts within the previous month. According to this article, Native American males have the highest suicide rate in the United States for children over 10, and non-Hispanic black females have the fi nal rate.Some psychosocial risk factors include, the presence of an underlying psychiatric condition, a history of prior suicide attempts, a history of physical or sexual abuse, and a lack of mental health treatment. Poor coping skills have been set as a predictive of a suicide attempt in both sexes. Environmental and social risk factors include owning a crampfish in the household, being homeless or living in a corrections facility or group home, poor parent-child communication, social isolation, boss around and difficulties at school.Many emergency rooms are using the five level triage classification systems called Emergency Severity Index Triage Algorithm. This takes into account not only if the acuity of the patient but also the number of resources that forget be required during the evaluation. A level 1 patient would require prompt life-saving intervention. A level 2 patient would be considered in the danger zone, and needs emergent retirement. Level 3 patients need more t he 1 resource, level 4 patients require 1 resource and level 5 patients require none.At the Childrens Hospital Boston, the use a screening tool that consists of 4 questions, Are you here because you tried to hurt yourself? In the past week, have you been having thoughts about killing yourself? Have you ever tried to hurt yourself in the past other than this time? Has something very stressful happened to you in the past few weeks? If the patient answers yes to one or more of these questions they become characterized as SSI bevel 2, and the nurse would explain the policy on physical and chemic restraints which are only used as a last resort.Some strategies that nurses use to promote successful interactions with the patient and their family members include active listening, close reflexion of behavior, attending to non-verbal body language, asking open-ended questions, conveying a non-judgmental attitude, clarifying information, and providing support. The patients safety is alwa ys the greatest concern as well as the staffs safety. Family education is very important when working with suicidal patients, because heir care is often managed at home.It is important for them to follow up with outpatient care, outpatient psychiatric support, and a home safety plan. Also, the nurse needs to let the family know if when they will need to seek emergency care again. This article has helped me gain a better understanding of the psychiatric patient, no matter the age, even though it focused on pediatrics. All these techniques can be used when traffic with suicidal patients. Our role as nurses plays an important role in managing our patients care while they are in our care and promoting their health y educating our patients and their families.