#WeCYPNs - Wednesday 28th November 2018 8pm (GMT Standard Time)
Case Study ‘Not all that wheezes is bronchiolitis’
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#WeCYPNs transcript
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@hepworth_becky
28 November 2018 20:04
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Hey! Becky CCN from the Isle of Wight. Looking forward the @Webb20Richard first chat! #Wecypns |
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@robbradley01
28 November 2018 20:06
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@WeCYPnurses #Wecypns take observations including sats, look at his breathing any recession? Or other signs like t… https://twitter.com/i/web/status/1067872259971432448 |
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@cdodd09
28 November 2018 20:07
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@WeCYPnurses baseline obs - sats, RR, HR, temp, signs of dehydration, ?wheeze, recession, ? bronchiolitis #wecypns |
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@mazp74
28 November 2018 20:07
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@WeCYPnurses Yes, definitely sats and resps. #Wecypns |
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@hepworth_becky
28 November 2018 20:08
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@WeCYPnurses Set of obs, listen to his chest, assess the history of illness? Feeding pattern? #Wecypns |
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@WeCYPnurses
28 November 2018 20:08
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RT @hepworth_becky: @WeCYPnurses Set of obs, listen to his chest, assess the history of illness? Feeding pattern? #Wecypns |
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@WeCYPnurses
28 November 2018 20:08
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RT @cdodd09: @WeCYPnurses baseline obs - sats, RR, HR, temp, signs of dehydration, ?wheeze, recession, ? bronchiolitis #wecypns |
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@WeCYPnurses
28 November 2018 20:08
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RT @mazp74: @WeCYPnurses Yes, definitely sats and resps. #Wecypns |
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@WeCYPnurses
28 November 2018 20:09
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RT @robbradley01: @WeCYPnurses #Wecypns take observations including sats, look at his breathing any recession? Or other signs like trachea… |
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@cdodd09
28 November 2018 20:09
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@WeCYPnurses A-E assessment #wecypns |
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@WeCYPnurses
28 November 2018 20:10
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and if you're keen to learn, there are loads of FREE resources online... start with YouTube! #Wecypns |
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@robbradley01
28 November 2018 20:11
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@WeCYPnurses I would use ABCDE approach #Wecypns |
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@paedsnursebeth
28 November 2018 20:13
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@WeCYPnurses A to E! Covers all of those plus extra bits like looking for rashes, recession/increased WOB etc. #WeCYPNs |
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@WeCYPnurses
28 November 2018 20:13
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RT @paedsnursebeth: @WeCYPnurses A to E! Covers all of those plus extra bits like looking for rashes, recession/increased WOB etc. #WeCYPNs |
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@pea88
28 November 2018 20:13
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@WeCYPnurses #wecypns |
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@mazp74
28 November 2018 20:13
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RT @paedsnursebeth: @WeCYPnurses A to E! Covers all of those plus extra bits like looking for rashes, recession/increased WOB etc. #WeCYPNs |
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@WeCYPnurses
28 November 2018 20:14
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Cardiac causes is interesting thought... why do they present like bronchiolitis?? #Wecypns |
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@hepworth_becky
28 November 2018 20:17
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@WeCYPnurses Sorry @Webb20Richard SVIA..? I’m being dim...! #Wecypns |
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@robbradley01
28 November 2018 20:18
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@WeCYPnurses My priority would be to apply oxygen and saturation monitoring. #Wecypns |
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@WeCYPnurses
28 November 2018 20:18
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#Wecypns sepsis... good thought. Always to be considered, BUT be careful not to attribute everything to sepsis as i… https://twitter.com/i/web/status/1067875348170358784 |
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@cdodd09
28 November 2018 20:18
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@hepworth_becky @WeCYPnurses @Webb20Richard glad you asked that Becky I was too scared to! #wecypns?? |
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@sn_barnes
28 November 2018 20:18
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@cdodd09 @WeCYPnurses All of the above and if coryzal, npa sample? #WeCYPNs |
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@robbradley01
28 November 2018 20:18
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@hepworth_becky @WeCYPnurses @Webb20Richard Self ventilating in Air I think #Wecypns |
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@WeCYPnurses
28 November 2018 20:19
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Sorry, Self Ventilating In Air #Wecypns (don't be scared to ask, there will be lots of abbreviations to cut down on… https://twitter.com/i/web/status/1067875531994144773 |
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@cdodd09
28 November 2018 20:19
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@robbradley01 @hepworth_becky @WeCYPnurses @Webb20Richard ah yes, well done Rob! '#wecypns |
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@hepworth_becky
28 November 2018 20:19
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@robbradley01 @WeCYPnurses @Webb20Richard Top marks Rob!! #Wecypns |
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@WeCYPnurses
28 November 2018 20:20
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#Wecypns definitely NOT making dogs dinner of everything... as a student you will be involved in the patients! This… https://twitter.com/i/web/status/1067875946060021760 |
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@mazp74
28 November 2018 20:20
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RT @WeCYPnurses: Sorry, Self Ventilating In Air #Wecypns (don't be scared to ask, there will be lots of abbreviations to cut down on space)… |
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@WeCYPnurses
28 November 2018 20:21
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Gold star... Hold that thought ;) #Wecypns |
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@hepworth_becky
28 November 2018 20:23
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@pea88 @WeCYPnurses Ohhh! Good thought! #Wecypns |
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@WeCYPnurses
28 November 2018 20:23
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Anyone else got thoughts on NPA? What does NICE say? #Wecypns |
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@hepworth_becky
28 November 2018 20:24
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@MrsRBurnell @WeCYPnurses Don’t forget your #WeCYPNs hashtag so we can all see your tweets Rachel |
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@cdodd09
28 November 2018 20:25
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@WeCYPnurses we haven't routinely performed NPAs for years on our ward only if unsure of diagnosis #wecypns |
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@hepworth_becky
28 November 2018 20:25
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#WeCYPNs |
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@hepworth_becky
28 November 2018 20:26
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@paedsnursebeth @WeCYPnurses You are good!!! #WeCYPNs |
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@robbradley01
28 November 2018 20:26
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@WeCYPnurses #Wecypns to be fair it's a test that doesn't actually change any treatment. |
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@mazp74
28 November 2018 20:26
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RT @cdodd09: @WeCYPnurses I'm Caroline one of the @wecypnurses volunteers and work on a general paediatric ward #wecypns |
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@mazp74
28 November 2018 20:27
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RT @WeCYPnurses: and if you're keen to learn, there are loads of FREE resources online... start with YouTube! #Wecypns |
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@hepworth_becky
28 November 2018 20:28
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Forgot the #WeCYPNs myself!! #naughtystep |
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@mazp74
28 November 2018 20:28
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RT @robbradley01: @WeCYPnurses #Wecypns to be fair it's a test that doesn't actually change any treatment. |
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@cdodd09
28 November 2018 20:29
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@pea88 @robbradley01 @WeCYPnurses we don't isolate or co-hort either just reverse isolate the more vulnerable #wecypns |
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@WeCYPnurses
28 November 2018 20:29
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#wecypns would anyone get help?? |
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@cdodd09
28 November 2018 20:30
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@paedsnursebeth @robbradley01 @WeCYPnurses and saves money not doing NPAs #wecypns |
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@hepworth_becky
28 November 2018 20:31
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@WeCYPnurses Yes - To see how much he’s compensating #WeCYPNs |
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@mazp74
28 November 2018 20:32
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@WeCYPnurses I’d be asking for a medical review. #WeCYPNs |
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@sn_barnes
28 November 2018 20:32
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@WeCYPnurses Blood gas to see if he’s compensating. #wecypns |
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@WeCYPnurses
28 November 2018 20:33
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Good. DGH though, one SHO, one reg, both at emergency C-section. You're on your own for a while... #Wecypns |
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@mazp74
28 November 2018 20:34
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@WeCYPnurses ANP? #WeCYPNs |
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@hepworth_becky
28 November 2018 20:34
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@WeCYPnurses I think I would be getting this baby into hospital if I was seeing this at home. Sooner rather than later. #weccns #weCYPNs |
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@WeCYPnurses
28 November 2018 20:34
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For help with blood gases - try these links: https://www.nursingtimes.net/clinical-archive/respiratory/four-step-method-of-interpreting-arterial-blood-gas-analysis/204054.article https://geekymedics.com/abg-interpretation/ #Wecypns |
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@WeCYPnurses
28 November 2018 20:35
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How would you be getting this patient to hospital if you're a #CCN?? #Wecypns |
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@mazp74
28 November 2018 20:35
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RT @WeCYPnurses: For help with blood gases - try these links: https://www.nursingtimes.net/clinical-archive/respiratory/four-step-method-of-interpreting-arterial-blood-gas-analysis/204054.article https://geekymedics.com/abg-interpretation/ #Wecypns |
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@WeCYPnurses
28 November 2018 20:35
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@mazp74 no ANP overnight... but nice try ;) #Wecypns |
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@WeCYPnurses
28 November 2018 20:36
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so @sn_barnes are they compensating?? #Wecypns |
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@cdodd09
28 November 2018 20:36
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@WeCYPnurses familiar story! #wecypns |
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@sn_barnes
28 November 2018 20:37
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@paedsnursebeth @robbradley01 @WeCYPnurses I always think the less you unsettle a little one with bronchiolitis, the better! #WeCYPns |
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@hepworth_becky
28 November 2018 20:37
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@WeCYPnurses Think I’d be calling 999. He’s heading into the red catagory on the @Health_2gether charts! #WeCYPNs |
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@cdodd09
28 November 2018 20:38
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@WeCYPnurses thanks spent years trying to master BG always think yes I get this but then always forget bits #wecypns |
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@MrsRBurnell
28 November 2018 20:38
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@WeCYPnurses Metabolic acidosis.... Does a renal cause need ruling out? #wecypns |
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@WeCYPnurses
28 November 2018 20:39
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@MrsRBurnell Is it metabolic? What makes you say that? #Wecypns |
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@hepworth_becky
28 November 2018 20:42
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@WeCYPnurses Respiratory acididotic...? Retaining c02. #weCYPNs |
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@hepworth_becky
28 November 2018 20:42
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#WeCYPNs https://t.co/83I2Z5mkqi |
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@claireL23
28 November 2018 20:44
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@WeCYPnurses when co2 is increased but the bicarb is normal #wecypns |
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@pea88
28 November 2018 20:47
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@WeCYPnurses Sure, and I’ll remember the #wecypns! Hypoxia alone = type1 resp failure. Hypoxia plus High co2 = type… https://twitter.com/i/web/status/1067882694569275392 |
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@hepworth_becky
28 November 2018 20:47
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@WeCYPnurses ...acute? (Rusty CCN!) #WeCYPNs |
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@WeCYPnurses
28 November 2018 20:48
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Lots of discussion on the assessment and the gas, so lets have a quick timeout before we continue. #Wecypns https://t.co/4XvoUpSv1z |
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@hepworth_becky
28 November 2018 20:50
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@WeCYPnurses Yes! Haven’t lost it!! #WeCYPNs |
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@sn_barnes
28 November 2018 20:51
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@WeCYPnurses Ooh retaining c02! I’d start setting up airvo so it’s ready. I would have already moved him to monitoring/ hdu bay. #wecypns |
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@MrsRBurnell
28 November 2018 20:53
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@WeCYPnurses #Wecypns |
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@claireL23
28 November 2018 20:53
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@WeCYPnurses @pea88 by hfnc do you mean optiflow? sorry probably being thick #wecypns |
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@paedsnursebeth
28 November 2018 20:55
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@WeCYPnurses As Airvo is given in oxygen, does that oxygen need to be prescribed before it can be started? #WeCYPNs |
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@MrsRBurnell
28 November 2018 20:57
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@hepworth_becky @WeCYPnurses #Wecypns |
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@hepworth_becky
28 November 2018 20:57
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#WeCYPNs |
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@WeCYPnurses
28 November 2018 20:57
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Not trick question. But important to know physiology of noises heard to consider other diagnoses... #Wecypns |
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@hepworth_becky
28 November 2018 20:59
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@MrsRBurnell @WeCYPnurses You are heading for the naughty step!! #wecypns https://t.co/vJLv5kBJsQ |
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