AAHI_S1_2021_Card set 2 (Escalation criteria)

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Assessment and care planning Flashcards on AAHI_S1_2021_Card set 2 (Escalation criteria), created by Tafe Teachers SB on 10/07/2019.
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Flashcards by Tafe Teachers SB, updated more than 1 year ago More Less
Tafe Teachers SB
Created by Tafe Teachers SB over 5 years ago
Tafe Teachers SB
Copied by Tafe Teachers SB over 5 years ago
Tafe Teachers SB
Copied by Tafe Teachers SB over 5 years ago
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Resource summary

Question Answer
Escalation criteria (MET): Respiratory Rate 1. Equal to, or below 8 2. Equal to, or above 35 (varies with facility) 3. Also: RR is ineffective (shallow, irregular, periods of apnoea)
Escalation criteria (MET): Oxygen saturation 1. When a NRBM is in use 1. SpO2 to < 90% without response to oxygen
Escalation criteria (MET): Heart rate 1. HR 39 or below 2. HR = or >140 or above
Escalation criteria (MET): Neurological status 1. Patient is having a seizure 2. Any acute, rapid change in GCS or 3. Decrease in GCS by 2 points or more
Escalation criteria(MET): Blood pressure 1. Systolic BP 89 mmHg or below 2. A drop in normal BP trend, associated with symptoms (dizziness, light-headedness, nausea, chest pain, dyspnoea, tachycardia)
Escalation criteria (MET): Airway 1. Any threat to airway a. Vomitus b. Respiratory secretions c. Food or fluid d. Acute bronchoconstriction e. Acute allergy (associated with respiratory distress) f. Sedated or obtunded patient who can no longer protect their own airway (occluding tongue)
Escalation criteria: Code Blue 1. Unconscious with ineffective breathing 2. Unconscious with absent breathing
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