About Physician-Assisted Death and The Responsibility of Nurses


The Supreme Court of Canada says a law that makes it illegal for anyone to help people end their own lives should be amended to allow doctors to help in specific situations.

The ruling only applies to competent adults with enduring, intolerable suffering who clearly consent to ending their lives.

The court has given federal and provincial governments 12 months to craft legislation to respond to the ruling; the ban on doctor-assisted suicide stands until then. If the government doesn’t write a new law, the court’s exemption for physicians will stand.

These Guidelines are applicable to Nurses working in Ontario.  Check your provincial or state licensing board for guidelines applicable to you.

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What are your opinions on doctor-assisted death? Do you think it’s sanctioned murder/suicide?  Or do you believe it should be allowed in terminal cases.  What about the role of the nurse?  How comfortable are you with this new legislation in your daily practice?

 

 

 

 

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What Are the Procedures for a Blood Transfusion?


Patients who have suffered large blood loss from trauma or surgery–or who have a low hemoglobin level because of a disease process–may receive a blood transfusion. When to transfuse blood depends on several factors such as the person’s vital signs, hemoglobin level, current injury or disease process and the presence of underlying health problems. Hospitals across the country follow standardized procedures for a blood transfusion to promote patient safety.

Preparation

A staff member ensures a blood transfusion patient has at least an 18 gauge IV catheter in place, according to Kathleen Ouimet Perrin, Ph.D, author of “Understanding the Essentials of Critical Care Nursing.” The nurse uses a 500 milliliter bag of sterile normal saline to flush IV blood tubing and the patient’s IV site before connecting the blood tubing.

Obtain Patient Consent

The nurse obtains informed consent before initiating the blood transfusion. The nurse explains the procedure, all possible risks, and the signs and symptoms of a transfusion reaction to the patient.

Type and Cross Match

The Canadian Blood Services recommends that red blood cell compatibility testing be done when possible to give the patient blood that matches his type. In life-threatening situations, Type O negative blood is given because it is the universal donor.

The hospital blood bank creates special labels with a unique patient identification number and applies one to the transfusion record, a red patient identification bracelet and all allocated matching blood units. Lab personnel draw blood from the patient to type and cross match the patient’s blood and label all blood tubes with the corresponding blood bank identification number. Once the type and cross match results confirm the patient’s blood type, lab personnel label matching blood units with the assigned blood bank identification number and notify the nurse that the blood is ready.

Verify Blood Bank Number

Two nurses verify that the blood bank ID number on the unit of blood matches the ID number on the patient’s wrist band. Both nurses sign on the transfusion record that this has been done.

Vital Signs

The nurse measures the patient’s temperature, heart rate, respiratory rate and blood pressure before initiating the blood transfusion and then every 5 minutes for the first 15 minutes. Vital sign changes during the transfusion, especially an increase in temperature, indicate a possible blood transfusion reaction.

Begin Transfusion

The nurse starts the blood transfusion within 30 minutes of checking the unit of blood out of the lab because blood needs to be refrigerated. The nurse will return the blood to the lab if circumstances call for delaying the transfusion. The blood bank discards the unit of blood if it has been out of the fridge for more than 30 minutes.

The nurse transfuses the blood at a rate of 1 to 2 milliliters per minute for the first 15 to 30 minutes and remains with the patient during this time because transfusion reactions often occur in the first 30 minutes. The nurse has 4 hours to transfuse the blood. After 4 hours, the nurse discards any remaining blood.

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Quick 12 Lead Interpretation


Learn how to identify Anterior, Inferior, and Lateral MI’s on a 12 lead ECG quickly!

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Main symptoms of swine flu. (See Wikipedia:Swi...
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Swine Flu Quick Facts:

What is Swine Influenza?

Swine Influenza, swine flu, is a respiratory disease of pigs caused by type A influenza virus (H1N1) that regularly causes outbreaks of influenza in pigs. H1N1 viruses cause high levels of illness and low death rates in pigs.

Humans and Swine Flu?

Swine flu viruses do not normally infect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others.

What are the symptoms of swine flu in humans?

The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

Can people catch swine flu from eating pork?

No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses. How can human infections with swine influenza be diagnosed? To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Identification as a swine flu influenza A virus requires sending the specimen to CDC for laboratory testing.

What medications are available to treat swine flu infections in humans?

This swine influenza A (H1N1) virus is sensitive (susceptible) to the neuraminidase inhibitor antiviral medications zanamivir and oseltamivir.  It is resistant to the adamantane antiviral medications, amantadine and rimantadine.

The Canadian Public Health Agency precautionary measures include:

If you are experiencing severe flu-like symptoms, please call Telehealth Ontario at 1-866-797-0000.


Get informed on your rights as a patient, or family member! Do you know the 10 questions you as a patient, or family member should absolutely ask your Nurse when you are first admitted to hospital? Improve your outcome when you are in need of care in a hospital.

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