Week 4 #1 (6/11)

Was given a great learning experience yesterday. Got to do a full assessment and treatment on one of the ventilated patients at the Quad Centre. Assessment consisted of a subjective component (asking about SOB, cough, secretions etc), then auscultation and palpation of chest wall. Treatment consisted of hooking up the cough assist machine and connecting that too his trache. All was going well but then it was time to suction, this is where you put a catheter down the trache and suction up the secretions. Has to be done quickly and smoothly because patient cant breathe will this is happeneing. Anyway wasnt my best performance, first catheter had to be thrown out because as soon as i took it out of the package i let hit hit against the bed rail=infection risk. Then did two more which weren't that successful because i didnt do it quick enough or deep enough (much to the amusement of my supervisor).
Felt my communication, subjective assessment and auscultation were all pretty good however my suctioning skills need a lot of improvement. Sure that would come with practice though. Had to write up the session in his patient files-didnt do a great job. Learnt how important it was to be specific when writing in patient notes i.e. which lobe you felt the secretions in and how many rounds of cough assist you did and what were the settings on the machine.
Probably the most interesting thing i took from the session was how prominent secretions can be in the lungs. Because with palpation of the chest wall you could feel the rough areas that had secretions in them. Never realised how obvious they could be.