INITIAL MANAGEMENT OF ACUTE MEDICAL PATIENTS
A GUIDE FOR NURSES AND HEALTHCARE PRACTITIONERS
Second Edition

Initial Management of Acute Medical Patientsis a clinically focused, practical and contemporary guide for assessing and managing patients with acute medical conditions. Suitable for all nurses and healthcare practitioners working in medical assessment units, medical wards and emergency departments, it presents a structured approach based on common presenting features and focuses on the first 24 hours of the patients hospital stay. The book draws on a wide range of supporting evidence and also provides the reader with sources for further reading.

KEY FEATURESWritten predominantlyby nursesfor nurses, this text is also suitable for a range of healthcare professionals, including paramedics and nurse practitioners, and anybody working in an acute care environment including primary care assessment units, clinical decision units and intermediate care.Designed as a quick reference text for use in clinical practice.Extensively referenced throughout, thus increasing its appeal to practitioners at all stages of their careers and to those who are undertaking further study.Devotes two entire chapters to assessing and meeting the acute care needs of vulnerable adults (i.e. older adults, those with mental health needs and those with learning disabilities), and discussing best practice in dealing with sudden death.Each chapter offers clear, concise and down-to-earth information based on a common presenting symptom and provides practical advice, supported by best evidence and the most up-to-date clinical guidelines.Fully updated and extensively expanded to include recent guidelines and procedures.

ABOUT THE EDITORS

Ian Woodis a Lecturer in the School of Nursing& Midwifery, Keele University. His clinical background is in emergency nursing and, in this context, he has worked in emergency departments in Manchester, Leicester and Stoke on Trent.

Michelle Garneris a Senior Lecturer and pathway lead for acute and critical care within the Faculty of Health& Wellbeing, University of Cumbria. Her clinical background is in cardiology and she has worked in cardiac units in Stoke on Trent, Macclesfield and London.

List of Contributors iv

Preface vi

Acknowledgements vii

Introduction viii

Normal Clinical Values ix

1 Initial Assessment of the Acute Medical Patient 1

Judith Morgan and Ian Wood

2 Vulnerable Adults 23

Louise Nelson, Scott Inglis, Fiona Howell, Michael Gibbs and Judi Thorley

3 Sudden Death 56

Sue Read and Jane Jervis

4 Cardiac Arrest 80

Carole Donaldson

5 Shock 108

Judith Morgan and Ian Wood

6 Altered Consciousness 133

Ian Wood and Carole Donaldson

7 Shortness of Breath 170

Michelle Garner, Susan Hope and Ian Wood

8 Chest Pain 221

Michelle Garner Copyrighted Material

9 Abdominal Pain and Upper Gastrointestinal Bleeding 262

Toni Jordan, Ruth Harris and Terry Wardle

10 Extremity Pain and Swelling 288

Ian Wood

Index 300