# data[].attributes.headline
Professional Introduction & My SMART Goal - 

# data[].attributes.subject
Professional Introduction & My SMART Goal - 

# data[].attributes.attachment_link.title
Profession Introduction and SMART Goal PART A 

# data[].attributes.body
I was going into week 1 feeling nervous about what the upcoming semester will be like. I was also excited because the thought of this being my last semester is crazy! I heard great things about this INC from other students and unit convenors so it made me feel more prepared going into my first workshop/seminar than my past INCs. It was nice having an orientation on how the semester will work on what order we'd be working in throughout the morning. I haven't had the best of runs through my years at UC due to unfortunate circumstances however I'm feeling more confident with my knowledge and clinical skills than I have before.

I have recognised areas where I need working on and I have recognised areas where I am good at. The struggles that I face are mainly my knowledge of medications, calculations and lots of health conditions. When I was doing up the antibiotic it took me a bit longer than others to work out what rate the pump should be running at. This simulation particularly made me think about what ways can help me remember and calculate. I am currently in the process of making a medication table that is more specifically laid out the way I can understand and memorise the information - I will upload my progress on my medication table.

# data[].attributes.body
Today we learnt about diabetic ketoacidosis, I had heard about it before during my placements and workshops but never dove too much into finding out how it can have a severe effect on someone with diabetes, more specifically type 1.

This is what I've discovered about diabetic ketoacidosis. It's when the body doesn't have enough insulin and can't receive the sugar it needs for energy. When the body can't use sugar for energy, it turns to fat, which turns into fatty acids called ketones. The ketones are built up within the blood and change the chemical balance in your body. The blood becomes acidic when a high amount of ketones is in the bloodstream and causes the pH levels to decrease (the normal range is 7.35 and 7.45).

Normal Blood Glucose Range: Type 1 Before meals - 4.0 to 6.0mmol/L

2 hours after meals - 4.0 to 8.0 mmol/L

Normal Blood Glucose Range: Type 2

Before meals - 4.0 to 8.0mmol/L

2 hours after meals - 5.0 to 10mmol/L

Normal Ketone Range:

Less than 0.6mmol/L - normal

0.6 to 1.5mmol/L - trace or small

1.5 to 3.0mmol/L - moderate/large

Over 3.5mmol/L - large

Note for nurses: if a patient's glucose levels are extremely high, this is why it is important to check ketone levels

The symptoms that can indicate potential DKA are;

Symptoms of DKA:

Fruity-smelling breath

High blood sugar

Low blood pressure

Increased respiratory rate

Rapid breathing

Frequent urination

Nausea/Vomiting

What to do if your patient is in DKA?

Take a set of blood

Do a urine analysis

Conduct an ECG

Once DKA is confirmed, perform biochemical monitoring - Hourly BGL and Ketone testing, at 2 hours and 2-4 hours after that - VBG, UEC, Ca, Mg, PO4

Maintain hydration

Reverse ketosis, correct acidosis and glucose

Monitor complications of DKA and treatments: Cerebral oedema, hypo/hyperglycaemia

Identify and treat any precipitating cause

DKA can be life-threatening and requires urgent medical attention.

# data[].attributes.body
Presenting to the Emergency Department:

Voluntary admission is when someone admits themselves to a public mental health facility in circumstances where they can give consent to receive mental health care and treatment.

Involuntary admission is when someone receives compulsory assessment/treatment from mental health services without the person's consent.

# data[].attributes.headline
Diabetic Ketoacidosis and Fasting Procedures for Infants, Children and Adolescents with Diabetes  

# data[].attributes.subject
Diabetic Ketoacidosis and Fasting Procedures for Infants, Children and Adolescents with Diabetes  

# data[].attributes.body
Standard 1.1 - Accesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice

Standard 1.4 - Complies with legislation, regulations, policies, guidelines and other standards or requirements relevant to the context of practice when making decisions

# data[].attributes.body
Week 2 was an interesting topic and I found it so intriguing to me how DKA works and how life-threatening it can be if left untreated. Diabetes is a very complex condition that I have struggled to understand since I started studying, however, each time I come across Diabetes I'm always learning something new.

I found it helpful when we split the different electrolytes into sections on the whiteboard and wrote out the relevance of each. As a visual learner, this supported my learnings on a deeper pathological level.

# data[].attributes.body
Here's what I learnt during my NICU placement:

A heart rate between 120-160 is normal

How to calculate TPN and Lipids (shown below)

I learnt about what an isolette does - it's a clear crib that maintains a warm environment for a newborn and protects them from germs

Swaddling a premature baby replicates the mother's womb and provides them comfort

I learnt about Jaundice - a yellow discolouration of the body tissue resulting from the accumulation of excess bilirubin

Phototherapy - used to treat newborn jaundice by making it easier for the baby's liver to break down and remove the bilirubin from the baby's blood.

They keep fabric-shaped love hearts that are scented with their mother's breast milk around the babies to provide comfort when unsettled

CPAP is used for neonatal to maintain or increase the functional residual capacity of the lungs, help prevent the alveolar to collapse, reduce the work of breathing and improve gas exchange in infants

I helped provide cares that included - nappy changing, applying cream around the bottom, CPAP cares (if required), swaddled them and changed the sats probe to the opposite foot

I learnt how to read a histogram -

# data[].attributes.attachment_link.title
Bubble CPAP for Increased Lung Function in Premature Babies

# data[].attributes.body
What I learnt in Special Care:

Observing and understanding the importance of individualized care for each baby, recognising their unique needs and family dynamics.

Witnessing the collaboration between various healthcare professionals, including nurses, doctors, and therapists, to create comprehensive care plans.

Learning to navigate the emotional challenges of working with critically ill infants and their families, developing empathy and support strategies.

Recognising the crucial role of family presence and participation in the care process, and how it contributes to the baby's well-being and development.

Understanding the application of current research and best practices in neonatal care, emphasising the importance of staying informed in a rapidly evolving field.

Reflecting on personal growth in confidence, critical thinking, and decision-making skills, preparing me for future challenges in nursing.

# data[].attributes.body
This is a short, brief video that I found helpful while preparing for this week's preparation. I find things that are visually easy to watch beneficial for my learning.

Here's what I learnt about the Integumentary System.

What is the Integumentary System?

The integumentary system is the body’s largest organ, acting as a physical barrier between the external environment and the internal systems it protects and sustains. This system comprises the epidermis, dermis, and hypodermis, along with associated glands, hair, and nails.

Skin is the largest and heaviest organ in your body. Your skin is made up of three layers.

Epidermis: The outermost layer of your skin, visible and tactile. It consists of three types of cells: melanocytes, keratinocytes, and Langerhans cells. This layer provides skin colour and forms a waterproof barrier.

Dermis: The middle and thickest layer of your skin, containing sweat and oil glands as well as hair follicles.

Hypodermis: The innermost layer of your skin, composed of fatty tissue that aids in insulating your body.

Nails provide protection to the ends of your fingers and toes. The nail anatomy consists of:

Nail plate: The visible, hard surface of your nail.

Nail bed: The skin beneath the nail plate.

Cuticle: The delicate skin at the base of the nail plate.

Matrix: The “root” of the nail that is responsible for its growth.

Lunula: The white, crescent-shaped area at the base of the nail plate.

Hair on your head provides heat to your body and your eyelashes and eyebrows help protect your eyes from dirt and water. The three parts of your hair consist of:

Hair shaft: The visible portion of your hair that you can see, touch, and style.

Hair follicle: The tubular structure that anchors your hair within the skin.

Hair bulb: Situated beneath the skin, this is the part responsible for hair growth.

Glands are distributed throughout your skin, releasing substances such as water, salt, and oil from beneath the skin to its surface. Your integumentary system includes the following types of glands:

Sudoriferous glands: These glands secrete sweat through your skin

Sebaceous glands: produce sebum, also known as oi and give your face its oil

Ceruminous glands: These glands are in your ear that secrete ear wax

Mammary glands: These glands are on a person's chest. When females give birth, that's when these glands produce milk

What is the purpose of the Integumentary System?

Your integumentary system safeguards your body from infections and injuries that may arise from the external environment. It acts as a protective barrier, serving as the first line of defence against viruses, bacteria, and other microbes. Additionally, it protects against harmful light and aids in regulating body temperature. This system also stores fat, water, glucose, and vitamin D, while supporting your immune system to help guard against diseases.

# data[].attributes.attachment_link.title
Introduction to the Integumentary System -- Animated Tutorial | Complete Anatomy

# data[].attributes.body
Primary Survey is a systematic approach used in nursing and emergency care to quickly assess and stabilise a patient in a critical situation. The goal is to identify and manage life-threatening conditions promptly. The primary survey typically follows the A-G method: Airway, Breathing, Circulation, Disability, Exposure and Glucose

How to Conduct a Primary Survey:

Airway:

- Check if the airway is clear. Look for any obstructions, such as foreign bodies, vomit, or swelling. If the patient is unconscious or unable to maintain their airway, consider interventions like positioning or suctioning.

Breathing:

- Assess the patient's breathing by observing the rise and fall of the chest and listening for breath sounds. Check for adequate ventilation and oxygenation. If the patient is not breathing or has inadequate breathing, provide supplemental oxygen or assist ventilation as necessary.

Circulation:

- Evaluate the patient's circulation by checking their pulse, skin colour, and temperature. Look for signs of shock, such as low blood pressure or altered mental status. Control any visible bleeding and initiate intravenous access if required for fluid resuscitation.

Disability:

- Perform a quick neurological assessment using the AVPU scale (Alert, Voice, Pain, Unresponsive) to determine the patient's level of consciousness. Check pupil response and limb movement to assess neurological function.

Exposure:

- Expose the patient to identify any hidden injuries while maintaining their dignity and warmth. This may involve removing clothing carefully and assessing the entire body for burns, fractures, or other injuries.

Glucose:

- Check BGL and Ketones if relevant to patient symptoms or finding any major concerns.

After completing the primary survey, reassess the patient's condition and provide necessary interventions based on your findings. Continuous monitoring and documentation are vital, as the situation may change rapidly. Conducting a primary survey efficiently ensures that critical issues are addressed promptly, laying the foundation for further assessment and management.

Secondary Survey is a thorough and systematic assessment performed after the primary survey in nursing and emergency care. It aims to identify any additional injuries or medical conditions that were not immediately life-threatening but still require attention. This detailed evaluation is crucial for comprehensive patient care.

Performing an Assessment:

Head and Face

Examine the face and scalp for:

- Signs of injury: Look for bleeding, lacerations, bruising, depressions, or irregularities in the skull. Check for behind the ear, which may indicate a skull base fracture.

Assess on areas such as;

- Eyes: Inspect for foreign bodies, subconjunctival hemorrhage, hyphema, irregularities in the iris, penetrating injuries, and the presence of contact lenses.

- Ears: Check for bleeding and blood behind the tympanic membrane, which can suggest a skull base fracture.

- Nose: Look for deformities, bleeding, nasal septal hematoma, or cerebrospinal fluid (CSF) leaks.

- Mouth: Assess for lacerations on the lips, gums, tongue, or palate.

- Teeth: Examine for subluxation, looseness, missing teeth, or fractures.

- Jaw: Check for pain, trismus, or malocclusion, which may indicate a fracture.

Palpate the:

Bony edges of the orbit, maxilla, nose, and jaw.

Scalp and skull to identify any fractures.

Test eye movements, pupillary responses, vision, and hearing.

Neck

Examine the neck, ensuring to open the collar while maintaining manual in-line stabilisation. Assess the anterior neck for:

Tracheal deviation

Wounds or bruising

Subcutaneous emphysema

Tenderness over the larynx

Distension of neck veins

Carotid pulsations and any hematoma; listen for a bruit.

Assess the cervical spine by palpating the cervical vertebrae

Chest

Inspect the chest and observe its movements, looking for:

Bruising (especially from seatbelts)

Asymmetric or paradoxical chest wall movement

Potential penetrating wounds, which are rare in children; check for "hidden" wounds in areas like the axilla and back.

Palpate for tenderness in the clavicles and ribs, and auscultate the lung fields and heart sounds.

Abdomen

Examine the abdomen, perineum, and external genitalia, specifically looking for:

Seatbelt bruising or handlebar injuries

Distension

Blood at the urinary meatus or introitus

Palpate for tenderness, especially over the liver, spleen, kidneys, and bladder, and auscultate bowel sounds.

Pelvis

Inspect the pelvis for any abrasions over the iliac crest. Check for bruising, deformities, pain, or crepitus during movement.

Limbs

Inspect all limbs and joints, palpating for tenderness in bony and soft tissue. Check joint movements, stability, and muscular strength. Assess sensory and motor functions of any potentially injured nerve roots or peripheral nerves.

Back

A log roll should be conducted during either the primary or secondary survey.

Inspect the entire length of the back and buttocks.

Palpate and then percuss the spine for tenderness.

Palpate the scapulae and sacroiliac joints for any tenderness.

Inspect the anus; a digital examination is rarely necessary and, if indicated, should be performed only once.

# data[].attributes.attachment_link.readable_text
Table of contents will be automatically generated here...

The primary survey
The purpose of the primary survey is to rapidly identify and manage impending or actual life threats to the patient.
Introduction

Always assume all major trauma patients have an injured spine and maintain spinal immobilisation until spine is cleared.

Priorities are the assessment and management of:
Prior to arrival:

Activate Trauma Team (as per Trauma Team Activation criteria).

Pre-arrival briefing for team with synthesis

Use of Pre-arrival checklist to help with role and task allocation

Estimate the child's weight using the formula:

Prepare age / weight appropriate doses of medication (use the Monash Drug book or other similar resource)

Prepare age appropriate equipment

Ensure personal protective equipment and lead aprons are worn by the trauma team

On arrival:
Airway and the cervical spine

The life threat to identify and manage when assessing the Airway is airway obstruction

This is typically the responsibility of the "Airway Doctor" although it is a role which may be shared with the "Assessment Doctor". The Airway Doctor is typically responsible for assessing the airway, the anterior neck and the GCS. Their goal is to ensure and maintain a patent airway, through which the patient can be successfully oxygenated.

When assessing the airway. The airway doctor should start with assessing for:

Evidence of facial fractures

Contaminants such as blood, vomit or teeth in the mouth / airway

Epistaxis

Where the patient has suffered a burn, the airway doctor should look in particular for:

A complete airway assessment also requires an assessment of the anterior neck - looking in particular for signs of blunt or penetrating trauma, or an impending airway life threat. This requires the airway doctor to open the C-spine collar whilst an assistant maintains manual in-line stabilization of the cervical spine. The Airway doctor should then examine the anterior neck to look / feel for the following (TWELVE-C):

Tracheal deviation

Wounds

Emphysema (subcutaneous)

Laryngeal tenderness / crepitus

Venous distension

oEsophageal injury (injury unlikely if able to swallow easily)

Carotid haematoma / bruits / swelling

The airway doctor also needs to assess the GCS

The life threat to identify when assessing the Airway is airway obstruction. Causes of airway obstruction may be due to:

The management of airway obstruction is to ensure a patent airway through which the patient can effectively be oxygenated. This may require some or all of the following techniques:

The cervical spine should be protected by manual in-line stabilisation, followed by the rapid (gentle) application of a properly fitted hard collar. ( see cervical spine assessment clinical practice guideline)

Breathing
The life threats to identify and manage with regards to breathing include:
The assessment of breathing, in the spontaneously ventilating child, is the responsibility of the assessment doctor. Where a child requires positive pressure ventilation (either bag-valve-mask ventilation, or intubated) there will be a shared responsibility for the assessment of breathing by the airway and the assessment doctors. At the start of the assessment, ensure all patients who are spontaneously breathing have high flow oxygen applied - typically 10-15L O 2 via a non-rebreather mask. The child's breathing is then assessed by looking at:

Assessment of the thoracic cage requires feeling for:

Emphysema / crepitus

Clavicle / chest wall tenderness

Request a chest X-ray - this is an important addition to the primary survey

Assessment also requires listening for:

Breath sounds or added sounds
The life threats to identify with regards to breathing include:
The management of these life threats is typically carried out by theprocedure doctor under direction from the Team Leader. Once a life threat has been identified, the assessment doctor should communicate this to the Team Leader, and then continue on with the primary survey allowing the procedure doctor to carry out any interventions. Typical interventions include:

Intubated children may also benefit from the early insertion of a large oro-gastric tube to treat and prevent gastric dilatation which in infants and young children especially, can impair effective ventilation.

Circulation

The major life threat to identify and manage with regards to circulation is haemorrhagic shock. However, obstructive shock does also occur, and causes for this should also be actively sought and managed.

The assessment of the circulation is the responsibility of the "Assessment" Doctor. They should assess the child's circulatory state by:

checking the pulse rate, skin colour, capillary refill time, blood pressure

looking for other effects of an inadequate circulation (increased respiratory rate, decreased mental state).

It is useful for the assessment doctor to calling out the patients vital signs at this stage of the assessment - so the team is aware of them. The assessment doctor should continue with a focused assessment that involves looking for sites of potential bleeding. These include the following sites:

The assessment doctor should, in consultation with the Trauma Team Leader, consider the need for a pelvic x-ray (see also Pelvic Injury CPG).
The major life threat to identify with regards to circulation is haemorrhagic shock
However, care should be taken to actively look and exclude:

obstructive cause for shock - for example tension pneumothorax or cardiac tamponade)

neurogenic shock - associated with spinal injury above the level of T6

The management of haemorrhagic shock is to identify and stop the source(s) of bleeding whilst concurrently resuscitating the patient. The management of these life threats may need multiple team members and is co-ordinated by the Trauma Team Leader. Once the assessment doctor has identified these life threats, they must communicate their findings to the Trauma Team Leader, then continue with the primary survey. The management of haemorrhagic shock may include:

In external haemorrhage bleeding may be stopped through the use of direct pressure, or in some cases the judicious use of a tourniquet.

Inserting a chest drain into a patient with a massive haemothorax may improve ventilation, but stopping ongoing bleeding can only be done in theatre.

Similarly life threatening bleeding into the abdomen / pelvis or retroperitoneum that is not otherwise controlled will require surgery or interventional radiology to stop the bleeding. Early consultation with a senior paediatric surgeon +/- an interventional radiologist is required. Rapid transit to theatre, prior to completion of the secondary survey, may be required to manage patients with ongoing bleeding that cannot be controlled in the emergency department.

Application of the pelvic binder is a haemostatic adjunct

Bleeding from bone fractures may be reduced through traction

Resuscitation of shock requires intravenous access with two cannulae that are as large as practicable - ideally one situated in each cubital fossa.

If an IV cannula cannot be sited rapidly (within 90 seconds), consider the use of an intra-osseous needle inserted into a non-traumatised leg or humerus in the older child.

As the IV is inserted, take blood for a VBG, FBE, cross-match, UEC, LFTs, lipase and coagulation screen

If circulation is inadequate, give an initial fluid bolus. If there is ongoing bleeding this may be packed red blood cells (10ml/kg), if bleeding is controlled and blood loss is not thought to be major, you may opt to give of 10-20 ml/kg of crystalloid however care needs to be given to avoid contributing to coagulopathy, acidosis and hypothermia that can occur with excessive crystalloid administration

Assess the child's circulatory state by observing:

1. pulse rate, skin colour, capillary refill time, blood pressure;

2. the effects of an inadequate circulation (respiratory rate, mental state).

Disability (mental state)
The life threat to identify is traumatic brain injury
The assessment of 'Disability' is typically the responsibility of the airway doctor - although the assessment doctor may add and complement to this by assessing peripheral function. Initial assessment of the level of consciousness may be done using the AVPU assessment:

Any impairment on detected on the AVPU scale should prompt a formal assessment of the patient's GCS (link to GCS-level of consciousness in Head Injury CPG). Pupil response to light should be noted, as should movement in all four limbs. The assessment doctor should check for this as well as reflexes if the prior to intubation where possible. The blood glucose level should be measured on arrival and periodically during the management of the trauma patient.

The life threat to identify is traumatic brain injury - whilst the primary brain injury cannot be reversed, secondary brain injury can be minimised by the prevention of hypoxia/hypotension and instigation of neuroprotective strategies to minimise intracranial pressure, along with the expedited progress of the patient to CT imaging of the brain, and then to a site capable of any necessary neurosurgical intervention.

Exposure and environmental control

Remove clothing initially and look for any other obvious life threatening injury. Avoid hypothermia by limiting exposure of the body, and by warming all ongoing fluids.

Radiology

Arrange for chest to be done in the resuscitation room as part of the primary survey.

Pelvic injury is rare in children, the pelvic x-ray does not always need to be requested in paediatric trauma. However, it is done where there are risk factors for pelvic injury and the patient is unlikely to need CT imaging of the abdomen and pelvis. The risk factors for pelvic injury include:

high risk mechanisms - these include:

high speed / rollover or lateral impact motor vehicle accidents

Pedestrian vs car

Cyclist vs car

MVA where another person has died

Abnormal pelvis examination

Significant lower limb injury (eg femur fracture)

Intubated or unable to assess pelvis

If there is no high risk mechanism, no clinical suspicion of a pelvic injury AND the child is haemodynamically stable withhas a normal conscious state, the pelvic X-ray may be omitted.

Arrange additional radiology as indicated

References

1. Browne GJ, Cocks AJ, McCaskill ME. Current trends in the management of major paediatric trauma. Emergency Medicine (Fremantle, W.A.). 2001;13(4):418-25.

2. Cantor RM, Leaming JM. Evaluation and management of pediatric major trauma. Emergency Medicine Clinics of North America. 1998;16(1):229-56.

3. Mackway-Jones K, Molyneux E, Phillips B, Wieteska S, eds. Advanced Paediatric life Support - the Practical Approach. Third ed. London: BMJ Books, 2001.

4. Rothrock SG, Green SM, Morgan R. Abdominal trauma in infants and children: Prompt identification and early management of serious life-threatening injuries. Part 1: injury patterns and initial assessment. Paediatric Emergency Care 2000;16:106-115.

5. Royal Children's Hospital Melbourne. Clinical Practice Guidelines

- Trauma (Major)

Secondary survey

Introduction

The secondary survey is commenced after the primary survey has been completed, immediate life threats identified and managed, and the child is stable. Continue to monitor the child's:

Mental state

Airway, respiratory rate, oxygen saturation

Heart rate, blood pressure, capillary refill time.

Any unexpected deterioration in these parameters require reassessment and management of evolving life threats.

Preparation:

Before commencing the examination:

Performing the examination:

Head and face

Inspect the face and scalp. Look for:

Bleeding, lacerations, bruising, depressions or irregularities in the skull, Battles sign (bruising behind the ear indicative of a base of skull fracture).

Look specifically at the:

Palpate the:

bony margins of the orbit, the maxilla, the nose and jaw.

the scalp / skull looking for evidence of fracture

Test eye movements, pupillary reflexes, vision and hearing

Neck

Inspect the neck - it is necessary to open the collar to do this - whilst maintaining manual in-line stabilisation of the neck. Examine the anterior neck (as per the primary survey) checking for:

Asses the c-spine by palpation of the cervical vertebrae ( see Cervical spine assessment CPG)

Chest

Inspect the chest, observe the chest movements. Look in particular for:

bruising (from seat-belts)

asymmetric or paradoxical chest wall movement

penetrating wounds are rare in children, but in cases where there is a stabbing or other assault look for "hidden" wounds - checking areas such as the axilla and back

Palpate for clavicular and rib tenderness and auscultate the lung fields and heart sounds.

Abdomen

Inspect the abdomen, the perineum and external genitalia. Look for in particular for:

seat-belt bruising / handle-bar injuries

distension

blood at the urinary meatus / introitus

Palpate for areas of tenderness especially over the liver, spleen, kidneys and bladder, and auscultate bowel sounds.
Pelvis
Inspect the pelvis for grazes over the iliac crest. Examine for bruising, deformity, pain or crepitus on movement.
Limbs
Inspect all the limbs and joints, palpate for bony and soft tissue tenderness and check joint movements, stability and muscular power. Examine sensory and motor function of any nerve roots or peripheral nerves that may have been injured.

Back

A log roll should be performed either in the primary survey or in the secondary survey.
Urinalysis
Interpretation of the urine dipstick in blunt paediatric trauma suffers from high rates of false positive and false negative results - formal microscopy is the better test where renal injury is suspected.
Disposition planning
During the examination, any injuries detected should be accurately documented, and any urgent treatment required should occur, such as covering wounds and splinting fractures. Appropriate analgesia, antibiotics or tetanus immunisation should be ordered. Following the secondary survey, the priorities for further investigation and treatment may now be considered and a plan for definitive care established. At this stage the patient may require advanced imaging in CT, or transfer to the ward, intensive care or theatre.

Typically the trauma team leader will remain responsible for the patient until they have completed their imaging and arrived at their inpatient destination. Handover of care may occur sooner than this - for example if the anaesthetist is present in the ED and will accompany the patient to theatre or intensive care. On these occasions formal handover where the new team leader and team acknowledge that responsibility for the patient has been transferred. A departure checklist made aid in this process.

References

1. Browne GJ, Cocks AJ, McCaskill ME. Current trends in the management of major paediatric trauma. Emergency Medicine (Fremantle, W.A.). 2001;13(4):418-25.

2. Cantor RM, Leaming JM. Evaluation and management of pediatric major trauma. Emergency Medicine Clinics of North America. 1998;16(1):229-56.

3. Mackway-Jones K, Molyneux E, Phillips B, Wieteska S, eds. Advanced Paediatric life Support - the Practical Approach. Third ed. London: BMJ Books, 2001.

4. Royal Children's Hospital Melbourne. Clinical Practice Guidelines

- Trauma (Major)

# data[].attributes.attachment_link.description
Table of contents will be automatically generated here... The purpose of the primary survey is to rapidly identify and manage impending or actual life threats to the patient. Always assume all major trauma patients have an injured spine and maintain spinal immobilisation until spine is cleared.

# data[].attributes.body
Reviewing this allows to me to follow the escalation protocol correctly.

# data[].attributes.body
A useful resource explaining the risk assessments that could be used for adolescents.

# data[].attributes.body
Recognising and responding to acute deterioration is an important clinical skill to have. Knowing how to conduct an A-G assessment correctly will enable you to escalate appropriately. This is something I would like to practice during my upcoming 4 week placement.

NSQHS Standards:

The Recognising and Responding to Acute Deterioration Standard is a standard that is set out for healthcare workers to follow to ensure a adequate and appropriate treatment to deteriorating patients is escalated correctly. These guidelines include information on how to assess patients, recommended actions such as an A-G assessment, guidelines on how to communicate and coordinate with the multidisciplinary team. Following these standards enables healthcare workers to provide quality care to their patients.

# data[].attributes.headline
Main things I need to know about Naloxone:

# data[].attributes.subject
Main things I need to know about Naloxone:

# data[].attributes.body
Naloxone is a medication that instantly reverses an opioid overdose, it is an opioid antagonist. It attaches to opioid receptors and reverses and blocks the effects of other opioids

It quickly restores normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose

It only reverses overdoses in people with opioids in their systems

Routes can either be injectable or prepackaged nasal spray

Opioids include heroin, fentanyl, oxycodone, hydrocodone, codeine and morphine

People who have an addiction to opioids may experience withdrawal symptoms within minutes after they are given naloxone.

Withdrawal symptoms: headaches, changes in blood pressure, rapid heart rate, sweating, nausea, vomiting, and tremors

Police officers and first responders are trained on how to give naloxone

Naloxone can be taken home for people who are at risk of an opioid overdose or adverse reaction, carers, friends and family members can be educated on how to administer the medication

Here is information on the 'Take home naloxone' package. https://www.act.gov.au/health/topics/drugs-alcohol-smoking-and-vaping/take-home-naloxone#:~:text=Anyone%20who%20is%20at%20risk,for%20free%20without%20a%20prescription

# data[].attributes.attachment_link.description
Take home naloxone is available for free to people who may experience or witness an opioid overdose or adverse reaction.

# data[].attributes.body
This week we focused on our A-G assessments, we learnt about how to recognise and respond appropriately to a deteriorating patient and being able to look for links between the cues of the A-G assessment to holistically evaluate the patient and provide adequate care.

Simulation:

This case we got involved with a young patient named Avery, who overdosed on opioids. The simulation was to encourage the students to perform an appropriate A-G assessment and outline areas of deterioration. During this simulation it made me recognise that when a patient isn't responding and is rapidly deteriorating always escalate to the doctors and if you're feeling like it needs to be addressed urgently always call a MET.

In reflection of the NMBA Standards, more specifically Standard 6.1 provides comprehensive safe, quality practice to achieve agreed goals and outcomes that are responsive to the nursing needs of people. Providing comprehensive, safe, and quality nursing practice for an adolescent who has overdosed on opioids requires a holistic and individualised approach. Initial assessments must consider the adolescent’s medical history and psychosocial background to tailor interventions effectively. To include this in my future nursing practice I will always communicate with the appropriate healthcare workers my concerns or patient concerns to ensure good patient care is provided.

Here is my overview of an A-G assessment I thought about after practising it during my workshop.

Performing an A-G - Opioid Addition

Airway - Assessing the patient's breathing and if they're able to maintain their airway.

Keywords that can be used when documenting: patent/obstructed, clear, speaking appropriate/inappropriate sentences.

What to look for with an opioid overdose: increased respiratory can be a side effect of an opioid overdose so ensuring the airway is clear and the patient is breathing adequately is crucial.

Breathing - Assessing the patient's breathing pattern, lung sounds and oxygenation.

Keywords that can be used when documenting:

Sufficient/Insufficient work of breathing, equal rise and fall, bradypnoea, tachypnoea, asymmetrical/symmetrical, wheeze.

What to look for with an opioid overdose:

Opioids can suppress the respiratory function, leading to shallow or slow breathing. Ensuring that monitoring their saturation levels and providing adequate oxygen if needed.

Circulation - Assessing the patient's heart rate, blood pressure, and peripheral perfusion.

Keywords that can be used when documenting:

Tachycardia/bradycardia, high/low blood pressure, pallor, oedema, warm to touch, cool/sweaty/clammy, <3 cap refill, regular/irregular heart rate.

What to look for with an opioid overdose:

An overdose of opioids can decrease blood pressure and affect circulation. Monitoring these vital signs and administering relevant interventions such as fluids or medications to maintain symptoms.

Disability - Assessing the patient's level of consciousness, neurological status, and mental function and neurovascular observations.

Keywords that can be used when documenting:

Pupils are equal/unequal, non reactive/reactive, Glascow Coma Scale (GCS)

What to look for with an opioid overdose:

Assessing the patient's response and neurological function is important in determining the severity of the overdose and what interventions are needed to be considered to ensure appropriate treatment is achieved.

Exposure - Assessing the patient's skin from head to toe to find any signs of trauma or injury, and expose areas for further examination.

Keywords that can be used when documenting:

Rashes, swelling, signs of infection, bruising, catheter, surgical drains, lacerations, temperature,

What to look for with an opioid overdose:

Any injection sites on the skin, signs of scratches, bleeding, rashes and wounds.

Glucose - Assessing the patient's blood sugar levels, in cases where deteriorated mental health is present.

Keywords that be used when documenting:

BGL, Ketones

What to for with an opioid overdose:

Monitoring blood glucose levels is vital as opioids can cause hypoglycemia or hyperglycemia, which can severe concerns.

Holistic:

Have they mobilised? How do they mobilise?

Any complaints?

What's the plan?

Further information from family/friends?

# data[].attributes.body
I've added this to ensure I familiarise myself with the procedure when caring for a patient who is experiencing MH concerns at present.

# data[].attributes.body
Show genuine interest in the patient's concerns

Use verbal and non-verbal cues to demonstrate understanding

Validate the patient's feelings and experiences

Use phrases like "I understand this is difficult for you"

Maintain a calm voice and body language

Avoid confrontational or aggressive postures

Use simple, clear instructions

Avoid using medical terms that the patient doesn't understand

Set clear expectations for behaviour

Politely but firmly address unacceptable behaviour

Empower patients by providing options

Redirect the patient's focus on neutral topics

Maintain a safe distance between you and the patient

Escalate to other staff members if needed

# data[].attributes.body
The LOWLINE strategy for de-escalation emphasizes a holistic approach to managing conflict in nursing settings. It stands for Listen, Observe, Wait, Link, Inform, Negotiate, and Engage. Reflecting on this strategy, I appreciate how it encourages a thoughtful and patient-centred approach to de-escalation. By actively listening and observing, I can better understand the patient's emotions and triggers, allowing for a more tailored response. Waiting gives both the nurse and the patient a moment to process while linking their concerns to potential solutions fosters a sense of collaboration. Informing the patient about the next steps and negotiating outcomes empowers them, ultimately building trust. Engaging in this manner not only de-escalates tense situations but also promotes a supportive therapeutic environment, aligning with best practices in nursing care. This reflective process highlights the importance of empathy and communication in maintaining a safe and respectful healthcare setting.

# data[].attributes.attachment_link.title
How can I de-escalate a situation when someone is angry or agitated?

# data[].attributes.attachment_link.description
It is not your job to stop the person being angry, but these steps may help to make the person feel calmer. It is only then that you can look at how to deal with the situation and their concerns.

# data[].attributes.body
A "Code Black" in healthcare is an emergency response protocol activated in situations involving a violent or aggressive individual, or a significant threat to safety within a facility. This code alerts staff to prepare for potential violence and ensures that trained personnel, including security, are mobilised to de-escalate the situation and protect patients, staff, and visitors. Effective communication is vital, as it informs relevant personnel of the incident's location and nature. Safety measures are implemented to secure the area, and staff trained in crisis intervention techniques respond to assess and manage the situation. Following an incident, post-incident support and debriefing sessions are often provided to help those affected and to enhance future response strategies. Overall, Code Black is essential for maintaining a safe healthcare environment and ensuring a swift, coordinated response to threats of violence.

# data[].attributes.body
What is Trauma-Informed Care?

Some individuals may show visible signs of being affected, while in others, the indications might not be immediately clear— but they can surface over time. A Trauma-Informed Care approach enhances well-being by ensuring that the policies, procedures, and environments in workplaces, schools, or healthcare settings are sensitive to individuals' trauma histories, prioritising the physical, psychological, and emotional safety of everyone involved. This approach acknowledges the widespread impact of trauma and fosters healing and recovery, avoiding practices and services that could unintentionally cause further trauma.

Key Principles of Trauma-Informed Care:

Trauma Awareness: It's crucial to understand the effects of traumatic experiences on individuals, families, and communities. Establishing a trauma-informed workplace involves incorporating an awareness of trauma and its effects into every aspect of your organisation and team dynamics. It’s especially important to recognize the increased likelihood of certain types of trauma exposure relevant to your organization and the implications for your team or client population.

Promotion of Safety: Within your workplace, it’s vital for both your team and the patients they're working with to experience physical and emotional safety. The aim is to create a sense of security for your team through established policies and practices.

Rebuilding Control: In a trauma-informed organisation, both team members and patients must receive clear and relevant information about their rights and have a voice in shaping trauma-informed policies and practices.

Focusing on Strengths: A strengths-based approach focuses on understanding how a person's behaviour after a traumatic event is shaped by their unique experiences and limited resources. It encourages examining and questioning assumptions about why individuals respond as they do when dealing with trauma. Viewing all behaviours, including challenging ones, through a trauma-informed lens acknowledges that these actions often reflect a trauma-affected individual’s best attempts to cope.

Promoting Connection: Fostering connections with primary support systems, including family, friends, and community resources, aids recovery from trauma by ensuring individuals receive the specific assistance they need throughout their journey.

Belief in Recovery: The focus of trauma-informed care is to instil a sense of hope and support and foster belief in recovery, acknowledging that responses to trauma range in complexity. To support recovery, an organisation must respond appropriately to all different kinds of trauma and the impacts of that trauma, including recent and past traumatic events. Supporting recovery from trauma must also take a preventative approach through managing the risk of future exposure to trauma for team members and patients.

# data[].attributes.body
I found this GIF relevant for this week's class.

During this week we sat in a circle and watched videos of healthcare workers not providing quality and fair care towards mental health patients. I found this topic of discussion eye-opening as I became aware that mental health is a sensitive and confronting topic, especially during our seminar where we had to make assumptions based on professional photos of both men and women. This enabled me to reflect on some of the NMBA Standards, more specifically Standard 6.6.

Standard 6.6 uses the appropriate processes to identify and report potential and actual risk-related system issues and where the practice may be below the expected standards.

Reflecting on the video of Kerry who faced neglect and judgment due to their condition highlights the critical need for adherence to Standard 6.6, which emphasises the identification and reporting of potential and actual risks related to systemic issues in care. Kerry's experience serves as a reminder of the failures that can occur when mental health care is not prioritised or when biases influence treatment. It underscores the importance of recognising when practice falls below expected standards and taking appropriate action to address these deficiencies. By implementing risk identification and reporting, healthcare professionals can advocate for patients who may otherwise be marginalised, ensuring they receive the compassionate, respectful care they deserve. This reflection reinforces the ethical responsibility of mental health practitioners to challenge systemic flaws and work towards a more inclusive and supportive healthcare environment.

# data[].attributes.attachment_caption
The above photo is a MAD, the device used to administrate intranasal fentanyl 

# data[].attributes.body
Intranasal fentanyl is recommended by the Royal Children’s Hospital guidelines as a first-line option for pain management in children with acute burns. It provides rapid analgesia, crucial for this population, especially during initial assessment and treatment. The guidelines emphasize careful dosing based on the child's weight and clinical condition, ensuring safety and efficacy. Intranasal delivery is advantageous in this context, as it minimises the need for intravenous access and allows for quick onset of pain relief, facilitating better overall management of acute burn injuries.

The information I found helpful was retrieved from the Royal Children's Hospital Guideline.

When can you use it:

Fractures and dislocations

Burns

Severe lacerations

Painful procedures under nitrous oxide

Dose:

1. 100mcg/2mL strength fentanyl solution for intravenous use

2. First dose 1 mcg/kg dose

3. A second dose can be administered within 10 minutes after the first dose to ensure adequate pain relief is given - 0.75 - 1.5 mcg/kg

4. If the second dose of the medication doesn't work a review should be escalated for more analgesia

Administration

Draw up the appropriate dose for weight, plus 0.1 mL extra to the first dose (to ensure dead space is filled in the device)

Attach the Mucosal Atomiser Device (MAD) to the end of the syringe

With the child sitting at approximately 45 degrees or with head to one side, insert the device loosely into the nostril and press the plunger quickly

Dose should be divided between nostrils

Do NOT draw up 0.1 mL extra for the second dose when re-using the delivery device (MAD)

Monitoring

Ensure patient monitoring is done which includes heart rate, respiratory rate, oxygen saturation, pain score & sedation score every 5 minutes after administration.

# data[].attributes.body
I've added this in because I found it helpful to visualise the different layers of the skin and positioning of everything.

# data[].attributes.body
Burn injuries can be classified into several types based on their cause:

Heat/Thermal Burns:

Scald Burns - Caused by hot liquids, steam, or vapours. Common in young children and can occur from spilled beverages or cooking liquids.

Flame Burns - Result from direct contact with an open flame, often associated with fires, explosions, or ignited clothing.

Electrical Burns are caused by electrical current passing through the body. These burns can result in internal injuries, muscle damage, and complications such as cardiac arrhythmias. The entry and exit wounds may appear small but can cause significant damage internally.

Friction Burns occurs when skin rubs against a hard surface, leading to abrasion and damage. Common examples include road rash from falls or burns from ropes or belts during sports or accidents.

Chemical Burns result from exposure to corrosive substances, such as acids or alkalis. These burns can cause severe damage to the skin and underlying tissues, depending on the chemical's strength and duration of contact.

Radiation burns are caused by exposure to radiation sources, such as the sun (sunburn) or medical treatments like radiation therapy. These burns can damage skin cells and lead to long-term complications, including an increased risk of skin cancer.

First-degree (Superficial) burns affect only the outer layer of skin, known as the epidermis. They are characterized by redness, mild swelling, and pain, but do not involve blisters. Healing typically occurs within a few days without scarring.

Second-degree (Partial Thickness) burns extend beyond the epidermis into the dermis, the lower layer of skin. These burns can cause redness, swelling, and significant pain, along with blisters. Healing may take two to three weeks and can result in some scarring.

Third-degree (Full Thickness) burns penetrate through both the epidermis and dermis, affecting deeper tissues. The skin may appear white, charred, or leathery, and these burns can be painless due to nerve damage. Healing is prolonged and often requires medical intervention, such as skin grafting, and can lead to significant scarring.

Fourth-degree burns extend beyond the skin into underlying tissues, including muscle, tendons, and bone. They are often associated with severe injury, and loss of sensation, and require extensive medical treatment. Healing is complicated and usually necessitates surgical intervention, with a high likelihood of significant scarring and functional impairment. Each type of burn injury requires specific assessment and management approaches to ensure optimal healing and recovery.

# data[].attributes.body
The Parkland formula is a widely used method for calculating the fluid resuscitation required for burn patients in the first 24 hours following a burn injury. The formula is as follows:

Total Fluid Requirement (in mL) = 4 mL × % Total Body Surface Area (TBSA) burned × Body Weight (in kg)

Breakdown:

1. 4 mL: This is the standard factor used in the formula.

2. % TBSA burned: This is the percentage of the patient's total body surface area that has been burned.

3. Body Weight: The weight of the patient in kilograms.

Administration:

- First 24 Hours: The total calculated volume should be administered over the first 24 hours post-injury.

- First 8 Hours: Half of the total volume should be given in the first 8 hours, with the remaining half given over the next 16 hours.

Example Calculation:

For a 70 kg patient with 40% TBSA burned:

- Total Fluid Requirement = 4 mL × 40 × 70 = 11,200 mL

- First 8 hours: 5,600 mL

- Next 16 hours: 5,600 mL

This formula helps ensure that burn patients receive adequate hydration to maintain organ perfusion and support healing. Always monitor the patient closely and adjust fluid rates as necessary based on their clinical status.

# data[].attributes.body
Total Body Surface Area (TBSA) is a crucial measure in burn management, indicating the percentage of the body affected by burns. It plays a key role in assessing burn severity, guiding fluid resuscitation calculations (such as the Parkland formula), and determining treatment protocols, including the need for surgical interventions. TBSA can be estimated using methods like the Lund and Browder chart or the Rule of Nines. Accurate assessment is essential, as misestimating TBSA can lead to inadequate hydration or complications, significantly impacting patient outcomes.

The Rule of Nines is a quick method used to estimate the Total Body Surface Area (TBSA) affected by burns in adults, dividing the body into sections that each represent approximately 9% of the total surface area. Specifically, the head and neck account for 9%, each arm for 9% (18% total for both), each leg for 18% (36% total), the anterior torso for 18%, the posterior torso for 18%, and the perineum for 1%. This method allows healthcare providers to quickly assess burn extent, guiding fluid resuscitation and treatment decisions. While effective for adults, it is less accurate for children due to their different body proportions, making more precise tools like the Lund and Browder chart preferable for pediatric patients. Overall, the Rule of Nines is an essential tool in the initial assessment of burn injuries, facilitating rapid decision-making in emergencies.

# data[].attributes.body
This week's class was interesting for me. I found using the Parkland Formula for Burns easy to work and usually, I find calculations and maths one of my challenges, however, the layout of the table provided in class made it simple and easy to go through each step to ensure the correct TBSA.

Tess and I volunteered to participate in the simulation scenario with Yasmin, who was a pediatric patient who suffered from significant burns. While Tess and I entered the room, Yasmin was extremely unsettled and was clearly in a lot of pain. The mother was rocking her in her lap trying to comfort her, however, nothing seemed to be working. I felt Tess and I communicated, evaluated and assessed the situation well before making any significant decisions about what to do next. We were handed over that Yasmin's wound dressing was changed and all pain relief was given not long before we entered her space. Tess and I communicated as a team that the correct decision would be to escalate to the doctors to get a review on Yasmin and increase her pain relief. As a future nurse, I find it so important to ensure we advocate for our patients and provide quality and effective care.

During our clinical labs, we practised our IV fluid administration and got to use a Mucosal Atomisation Device (MAD). It was so interesting to learn about this device, I was surprised at how much can come out just with one squirt. I was intrigued with how the doses work and how you have to add an extra 0.1ml to ensure you fill in the dead space. I see how valuable these devices can be when a patient is struggling with severe pain and is in need of quick relief.

Standard 6.5, practises in accordance with relevant nursing and health guidelines, standards, regulations and legislation was utilised during our workshop and I ensured I was always reviewing the guidelines throughout my administration of IV fluids and fentanyl. This guided me to provide safe care and reminded me of how important it is to double-check with your buddy or a trusted colleague.

In my nursing practice, Standard 5.2 collaboratively constructs nursing practice plans until contingencies, options priorities, goals, actions, outcomes and timeframes are agreed upon with the relevant person, which will be greatly reflected in my care to my patients to ensure I collaborate my care plans will emphasise the importance of teamwork and communication with patients, families, and other healthcare professionals. Engaging with the multidisciplinary team in the planning process ensures that contingencies, options, priorities, goals, actions, outcomes, and timeframes are clearly defined and agreed upon. This collaborative approach not only foster a sense of shared responsibility but also empowers patients by incorporating their preferences and needs into their care plans. By working together, we can create more personalised and effective nursing strategies, ultimately improving patient outcomes and enhancing the overall quality of care provided. This process reinforces the value of interdisciplinary collaboration in achieving comprehensive and responsive healthcare solutions.

# data[].attributes.body
The Canberra Health Services Procedure on Spinal Injury Management of the Adult Patient outlines a systematic approach for the assessment and management of adults with suspected spinal injuries. The procedure emphasises the importance of early recognition of spinal injuries and the need for immediate stabilization to prevent further damage. Key components include conducting a thorough primary and secondary survey, utilising appropriate imaging for diagnosis, and implementing protocols for immobilisation and transportation. The procedure also highlights the importance of interdisciplinary collaboration, ongoing monitoring, and individualised care plans to address both the immediate and long-term needs of the patient. By following these guidelines, healthcare professionals aim to ensure safe and effective management of spinal injuries while minimizing complications.

Using this procedure guide in my nursing practice will ensure I'm following the policy and ensuring I'm providing safe care to our patient's who could potentially be at a high risk of damage to their spin.

# data[].attributes.body
I decided to do some further research and watch videos on spinal injuries and log roll demonstrations. This helped me gain a visual on how to correctly log roll a spinal patient.

# data[].attributes.headline
Class Reflection - Primary and Secondary Survey

# data[].attributes.subject
Class Reflection - Primary and Secondary Survey

# data[].attributes.body
In this week's simulation, we worked on a case scenario involving Sam Green who suffered from fractured ribs and a subdural haematoma caused by a workplace accident. Fortunately, spinal damage was ruled out. During the scenario, a first-year student (Ivy) had been left with Sam to monitor him. Ivy called the staff to assist because she was concerned about Sam deteriorating and wasn't sure what to do. During this simulation, it was clear that providing a thorough primary and secondary survey was the goal for the nurses involved. This showed that Standard 4.2, uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice is an important component when finding a diagnosis for the patient.

This week allowed me to practice my primary and secondary surveys and reminded me how important it is to be thorough in your initial assessment needs to be. I know I have a lot of practising to do and I would like to continue using the correct abbreviations when documenting my findings. I will read examples and seek advice from experienced nurses on what they do when documenting their assessment.

# data[].attributes.body
Multidisciplinary team care involves one patient and several healthcare professionals from various fields. The health professionals in a multidisciplinary team work together, collaborating and communicating to address multiple facets of the patient’s care effectively.

The Multidisciplinary Team includes:

- Nurses deliver patient care, administer medications, and monitor the condition of patients.

- Doctors and physicians offer medical expertise, make diagnoses, and develop treatment plans.

- Pharmacists ensure medications are used safely and effectively, providing management of medication therapy.

- Social workers evaluate and address the social and emotional needs of patients and their families, offering counseling and connecting them with community resources.

- Therapists include physical, occupational, speech, and respiratory therapists who deliver specialized rehabilitation services.

- Dietitians conduct nutritional assessments and provide guidance to enhance patients' overall health and well-being.

- Case managers coordinate communication and continuity of care among team members, assisting patients in navigating the healthcare system.

- Specialists, such as cardiologists, neurologists, psychiatrists, or oncologists, contribute their direct expertise to a multidisciplinary team in specific cases.

# data[].attributes.body
During this week's simulation, we participated in an activity called tabletop, where we got 4 different patients who were experiencing Gastroenteritis symptoms. This activity required us to organise what patient we would prioritise based on their deterioration. My group and I changed it each round as each patient deteriorated in different ways. It was very interesting to see how quickly patients can rapidly deteriorate. I have included a photo of my group's end result to show how each patient changed position throughout the activity.

# data[].attributes.body
A prioritising table I found helpful

# data[].attributes.body
Nasogastric (NG) tubes are flexible tubes inserted through the nose, down the esophagus, and into the stomach, primarily used for patients who cannot safely eat or drink. They serve several purposes, including providing enteral nutrition, decompressing the stomach by draining excess gas or fluid, administering medications, and obtaining gastric contents for diagnostic analysis. The insertion procedure involves measuring the required tube length, lubricating the tip, and gently guiding it into the nostril while ensuring proper placement through aspiration or pH checks. Ongoing care includes monitoring the tube's position, maintaining hygiene, and managing drainage if applicable. While NG tubes are beneficial, they can present complications such as nasal irritation, misplacement into the lungs, or esophageal perforation, making careful management essential for effective use.

Kangaroo Pumps:

Kangaroo pumps are specialised enteral feeding pumps designed to deliver nutrition directly to patients via feeding tubes, commonly used in hospitals and home care settings for those with swallowing difficulties or specific medical needs. These pumps offer precise control over the rate and volume of feed, ensuring patients receive the correct nutritional intake. With user-friendly interfaces and safety features like occlusion detection and alarms for feeding issues, they are easy for healthcare providers and caregivers to operate. Kangaroo pumps accommodate various enteral nutrition formulas and can be portable, allowing for mobility during feeding. Overall, they are essential tools that enhance the convenience and effectiveness of nutritional support, improving patient health and quality of life.

# data[].attributes.attachment_link.title
Nasogastric (NG) Tube Insertion - OSCE Guide

# data[].attributes.headline
Knowledge, Skills and Understanding of Teamwork and Leadership Skills

# data[].attributes.subject
Knowledge, Skills and Understanding of Teamwork and Leadership Skills

# data[].attributes.body
The implementation of knowledge, skills, and understanding of teamwork and leadership in nursing is essential for delivering high-quality patient care. Effective teamwork allows collaboration among healthcare professionals, enabling them to leverage diverse expertise and perspectives to address complex patient needs. By applying leadership skills, nurses can facilitate communication, delegate tasks appropriately, and motivate team members, creating an environment of trust and accountability. Working as a team will be a huge goal of mine when I endure my nursing career. I find that this is such an important quality to have as a nurse. This collaborative approach not only enhances clinical outcomes but also promotes a supportive workplace culture, leading to increased job satisfaction and reduced burnout. Ultimately, integrating teamwork and leadership skills empowers nurses to advocate for patients effectively and contribute to a cohesive healthcare team focused on achieving optimal results.

# data[].attributes.attachment_caption
Keeping a close eye on their hand-washing skills!

# data[].attributes.body
In today's workshop, we did something different. We were split into groups, one side could practice nasogastric tube insertions, and another had an infectious patient. There were two team leaders and two hand hygiene auditors (I was one of the hand hygiene auditors). I couldn't participate much in the activity however from observations the team leaders had to spin the wheel and it would come up with different scenarios. I found this interactive and fun! I liked how informative our teacher was and I found her helpful throughout the class.

Overall my classmates did well with their hand hygiene, I was very proud of them!

During our seminar, we got some insight into what a credit and distinction response looks like in our upcoming VIVA. Hearing these responses made me a little nervous because the responses were quite detailed. It made me feel better knowing that most of my classmates felt the same and we were all reassured that going into the VIVA with a clear mind and reassuring ourselves that we know a lot more than we think and that we just need to form a good, quality response. I found these week's classes helpful and I'm very grateful for how this unit was set out.

Relating to my allocation as the hand hygiene auditor I reflected on Standard 6.4, provides effective timely direction and supervision to ensure that delegated practice is safe and correct. This enabled me to work effectively and ensure I correctly followed the provided form to fill out while assessing my classmates to ensure there was safe and correct practice.

# data[].attributes.body
Thank you to the INC 6 staff who have supported and guided me through my journey. It truly has been a long, personal journey for me. It has been eye-opening and reassuring that my nursing journey really didn't end when I failed my INC 5 OSCE in 2023. Things do happen for a reason and I'm very lucky things worked out the way they did.

Thanks again, team!

# data[].attributes.body
Assessment Tools for Adolescents:

HEEADS provides a systematic approach to developing rapport with young people and performing a holistic, psychological resilience and risk assessment across the areas that involve their home, education, eating (and/or employment), activities, drugs and alcohol, sexuality, suicide, mental health and safety.

CRAAFT is another risk assessment designed to identify substance use, substance-related abuse or use that is between 12-21 years.