Question

Mr. Aguillard, a 62-year-old man, is severely burned over 90% of his body during an accident on the job. He presents to the ED. The rescue personnel (first responders) were unable to start an IV during transport to the hospital.

6. 
   Which type of IV device is most appropriate for this patient at this time?

6. For which complications, associated with the selected IV device, should the nurse monitor in Mr. Aguillard?

6. List the various considerations for older adults, such as Mr. Aguillard, as related to infusion therapy.

6. In providing best practice in managing Mr. Aguillard’s infusions, the “burn” nurse consults/collaborates with another member of the interprofessional health care team.

Which other type of nurse or nursing role would this be?

Answer 1

Most appropriate IV device

USG guided Central line catheter or peripherally inserted central line catheter can be appropriate for this patient. Because there is need of large volume to be resuscitated.

Complications related to IV device

The complications expected related to central line is CLABSI (central line associated blood stream infection). The nurses should monitor signs of infection such as fever, chills, shivering, increased WBC count. If symptoms appears, blood culture to be sent immediately before starts any antibiotics.

IV consideration for elders

The older persons may have weaker immune system. There is chance of infection.

There may chance of volume overload.

Chance of breathing difficulty due to volume overload.

More chance of phlebitis- There is chance of extravesation of fluids.

Collaborate with other nurse

Another type of nurse needed to provide best care to the patient with burns is Intravenous therapy nurse / Infusion nurse

Role of Infusion nurse

Initiate IV access.

Calculate IV fluids needed to administer for 24 hours

Maintainence of IV therapy

Calculate the nutrition requirement of patients

Administer IV nutrition therapy

Provision of care related to avoidance of complications of Intravenous therapy