Medical Assessment Units: The Initial Management of Acute Medical Patients

338 Pages·2002·2.13 MB·English

by  Ian Wood

Medical
Assessment
Units
The Initial Management of
Acute Medical Patients
Edited by
IANWOOD MA, RN, DipN (Lond)
Lecturer, Department of Nursing & Midwifery
Keele University, Keele
MICHELLE RHODES BSc(Hons), RN, DipN (Lond)
Senior Lecturer, Department of Nursing Studies
St Martin’s College, Carlisle
W
WHURR PUBLISHERS
LONDON AND PHILADELPHIA

Medical Assessment Units
The Initial Management of
Acute Medical Patients

Medical
Assessment
Units
The Initial Management of
Acute Medical Patients
Edited by
IANWOOD MA, RN, DipN (Lond)
Lecturer, Department of Nursing & Midwifery
Keele University, Keele
MICHELLE RHODES BSc(Hons), RN, DipN (Lond)
Senior Lecturer, Department of Nursing Studies
St Martin’s College, Carlisle
W
WHURR PUBLISHERS
LONDON AND PHILADELPHIA
© 2003 Whurr Publishers
First published 2003 by
Whurr Publishers Ltd
19b Compton Terrace, London N1 2UN, England and
325 Chestnut Street, Philadelphia PA 19106, USA
Reprinted 2003
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying or otherwise,
without the prior permission of Whurr Publishers Limited.
This publication is sold subject to the conditions that it shall not,
by way of trade or otherwise, be lent, resold, hired out, or
otherwise circulated without the publisher’s prior consent in any
form of binding or cover other than that in which it is published
and without a similiar condition including this condition being
imposed upon any subsequent purchaser.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British
Library.
ISBN: 1 86156 325 6
Typeset by HWA Text and Data Management, Tunbridge Wells
Printed and bound in the UK by Athenaeum Press Limited
Gateshead, Tyne & Wear
Contents
List of contributors vii
Acknowledgements ix
List of normal clinical values ix
Preface xi
Introduction xiii
Chapter 1 1
Service organisation in Medical Assessment Units
Ian Wood
Chapter 2 14
Initial assessment of the acute medical patient
Michelle Davies, Judith Morgan and Ian Wood
Chapter 3 35
Vulnerable groups
Linda Miller, Michael Gibbs, Judi Thorley and
Elizabeth Whelan
Chapter 4 72
Sudden death
Sue Read and Jane Jervis
Chapter 5 94
Cardiac arrest
Carole Donaldson, Ian Wood and Michelle Rhodes
v
vi Medical Assessment Units
Chapter 6 125
Shock
Judith Morgan
Chapter 7 150
Altered consciousness
Brendan Davies, Michelle Davies, Lorraine Taylor and Ian Wood
Chapter 8 188
Shortness of breath
Susan Hope, Jacqueline Mitchell, Michelle Rhodes,
Helen Whitehouse and Ian Wood
Chapter 9 232
Chest pain
Michelle Rhodes
Chapter 10 271
Abdominal pain and upper gastrointestinal bleeding
Ruth Harris and Terry Wardle
Chapter 11 299
Extremity pain and swelling
Ian Wood
Index 311
Contributors
Brendan Davies Consultant Neurologist, Department of Neurology, North
Staffordshire Hospital NHS Trust
Michelle Davies Senior Staff Nurse, MAU, North Staffordshire Hospital NHS
Trust
CaroleDonaldson NightNursePractitioner,MedicalDivision,NorthStaffordshire
Hospital NHS Trust
Michael Gibbs Lecturer in Nursing, Department of Nursing & Midwifery, Keele
University
Ruth Harris Consultant Physician & Gastroenterologist, Countess of Chester NHS
Trust
SusanHopeRespiratoryNurseSpecialist,DepartmentofRespiratoryMedicine,North
Staffordshire Hospital NHS Trust
Jane JervisStaff Nurse, MAU, North Staffordshire Hospital NHS Trust
Linda Miller Lecturer in Nursing, Department of Nursing & Midwifery, Keele
University
JacquelineMitchellAssociateLecturer,DepartmentofNursing&Midwifery,Keele
University and Sister, Intensive Care Unit, Mid Cheshire NHS Trust
Judith MorganConsultant Nurse, A&E Department, Oldchurch Hospital
Sue ReadLecturer, Department of Nursing & Midwifery, Keele University
Michelle Rhodes Senior Lecturer, Department of Nursing Studies, St Martin’s
College
Lorraine TaylorStaff Nurse, MAU, North Staffordshire Hospital NHS Trust
Judi ThorleyTeam Manager, Combined Healthcare NHS Trust, Stoke on Trent
Terry WardleConsultant Physician, Countess of Chester NHS Trust
Elizabeth Whelan Assistant Director of Nursing, Emergency Department, Mater
Misercordiae Hospital, Dublin
Helen Whitehouse Respiratory Research Nurse, Department of Respiratory
Medicine, University Hospital Birmingham
Ian Wood Lecturer, Department of Nursing & Midwifery, Keele University
vii
Acknowledgements
The editors would like to thank the following people for their valuable
contributions to the writing of this book.
• The contributors for their hard work in writing and revising their
respective chapters
• Stephen Boyce, ICU, Mid Cheshire NHS Trust, for his work on acute
respiratory failure
• JaniceBailey,KathleenBentley,SuePassandBarbaraRickardfromthe
MAU, North Staffordshire Hospital NHS Trust for their contributions
tothechapteroninitialassessmentofacutemedicalpatients(Chapter2)
• Alison Clarke, Jane Jervis, Michelle Davies, Marsha Holding and Sue
Lapper for their ideas and comments when the book was originally
conceived
• Debbie Danitsch and Sara Morris for their constructive comments
• Helena Priest and Bernard Beech for their review of the mental health
section in Chapter 3
• Sam,Stephanie&Alexander(IW)andAndy(MR)fortheirsupportand
patience
viii