Istan Reflective Journal

#1: 1:Completed blood draw  2:partial assessment, got him hooked up to all of the leads and BP cuff    3: recognized he was having decreased oxygen saturation and tried to correct it with help of O2 and a nasal cannula  4: then switched him to a non-rebreather mask for better O2 administration, though it was the wrong size.

#2: the mask that we used was a pediatric mask and that there is a correct adult size one that fits Stan. His sats never came back up out of the 80's because it was an incorrect size and we did not have the O2 set high enough for the non-rebreather. The bag attached to the mask will in fact inflate in simulation if the O2 is high enough (all the way up).

#3: Ensure his O2 mask is the correct size and fit for his face since all people are different. Recognize that his pedal pulse and tibial pulses were not palpable due to his disease process and not a malfunction in Stan's system. The cyanosis of the hands and feet is why his nails would not blanch and that he was just showing toxcicity, need to call the Dr. about this next time. Write the time on the label so that the labs do not have to be redone, correct the first time is the best way to go and the pt will be happier with not having to be re-stuck.

#4: 1:Not everyone reacts the same way to the same situation and to not get frustrated with people on the phone and to delegate to your team when needed, or at least ask them to help you with what you need. 
2: Some people have a better way of talking to and with the pts and sometimes it just takes sitting down and talking to them and not being so "by the book". 
3: Not everything goes how you planned, take a second look at what you are doing or have done so that you will not have to redo it just because of a missed time on a label or location of a culture missing from a label.

#5: 1: The need to humidify O2 for higher quantity of O2, however i forgot you do not humidify a non-rebreather. 
2: Check everything on the pt during assessment, including wrapped wounds. Cleansing isn't necessary right then, but knowing what is there when you first assess is key to helping the pt heal. 
3: Sit the pt up to help them breathe and allow opening of the airway. Orthopneic would have been best but Istan doenst really sit that high up it seems.