CRT04102 Patient Management

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Communication Concepts in Radiology Services CRT04102 · Patient Management START READING NOTES Study Communication Concepts in Radiology Services using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic At the end of this session students should be able to; Hospital , It is operated by professionals called radiographer Communication Communication skills Verbal communication Communication must consist of five elements; Medium/channel is a means used to exchange / transmit the message. SENDER Outline 6 communication skills that can be used by a radiographer to a patient. Establishing rapport Andrea G,.Patient communication in radiology: Moving up the agenda.Rockall www.elsevier.com/locate/ejrad SESSION 1: COMMUNICATION CONCEPTS IN PROVIDING RADIOLOGY SERVICES At the end of this session students should be able to; Describe hospital, its existence, organization chart and relationship with radiology department Describe radiology department and its channel of communications Describe communication skills and radiographer patient first contact Leaning objectives Hospital An institution built, staffed and equipped for the diagnosis of disease, treatment of both medical and surgical of the sick and injured people Department A specialized unit within a healthcare facility dedicated to providing focused medical care and service Organization chart A graphical presentation of an organization's structure Organization structure How activities such as task allocation and supervision are directed towards achievement of an organization Definition of terms , Hospital organization chart Hospital Advisory Board Medical officer I/C Nurse officer I/C Health secretary Med. dept Surg. dept Radiology dept Paed. dept Obs & gyn dept Nursing services Lab dept It is operated by professionals called radiographer Under the head of department who reports to the medical officer in charge of the health care facility Communication Is the act of transmitting and receiving information, OR Refers to a two-way process in which information, knowledge and ideas are transmitted by any means from one individual or group to another individual or Group Communication skills and radiographer patient first contact Communication skills Ability of an individual to convey a message to another person or group of people Facilitates people to communicate effectively Verbal communication Non-verbal communication Types of communication Communication must consist of five elements; Sender (encoder, source or communicator) This is a person who sends the message or initiator of communication Message Information facts that needs to be communicated Components of Communication Process Medium/channel is a means used to exchange / transmit the message. Receiver /Decoder is a person for whom the message is intended / aimed Feedback is the main component of communication process as it permits the sender to analyse the efficacy of the message SENDER MESSAGE MEDIUM RECEIVER FEEDBACK Outline 6 communication skills that can be used by a radiographer to a patient. ( In a group of 3 students) Task Establishing rapport Greetings Introduction Get to know the patient concerns, condition and pay attention Provide reassurance Maintain eye contact Ensure privacy Avoid jargon words Be empathetic Radiographer -patient first contact Hospital An institution built, staffed and equipped for the diagnosis of disease, treatment of both medical and surgical of the sick and injured people Department A specialized unit within a healthcare facility dedicated to providing focused medical care and service Organization chart A graphical presentation of an organization's structure Organization structure How activities such as task allocation and supervision are directed towards achievement of an organization Summary Communication Is the act of transmitting and receiving information, OR Refers to a two-way process in which information, knowledge and ideas are transmitted by any means from one individual or group to another individual or Group Communication skills Ability of an individual to convey a message to another person or group of people Andrea G,.Patient communication in radiology: Moving up the agenda.Rockall www.elsevier.com/locate/ejrad Fujishim, R. (2008). Creating Communication Exploring & Expanding Your Fundamental Communication Skills. 2nd Edition. Rowman & Littlefield Publishers Medical practice management body of knowledge review medical group REFERENCE NEXT TOPIC →VIEW ALL MODULE NOTESVIEW SEMESTER NOTESVIEW ALL LEVEL NOTESALL DIAGNOSTIC RADIOLOGY NOTES Need These Notes as PDF? Need a clean, well-formatted PDF copy for offline study, revision or printing? Request the complete notes directly through WhatsApp. GET WELL-FORMATTED PDF NOTES

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Checking PATIENT VITAL SIGNS CRT04102 · Patient Management START READING NOTES Study Checking PATIENT VITAL SIGNS using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic At the end of this session learner is expected to be able to: Vital signs are cardinal signs or physiological parameters that reflect key body processes Thermometer Checking PATIENT VITAL SIGNS Pulse Respiration Blood pressure To identify any abnormalities /changes in body functions Factor affecting body temperature (causes of variation in normal body temperature) Factors contributing to variation in normal pulse rate Average normal range of pulse rate Characteristics of pulse Factors contributing to variation in normal respiration Factors influencing blood pressure in a healthy person Factors responsible for maintaining blood pressure Temperature Checking body temperature by Axilla or Groin Steps for checking body temperature by Axilla or Groin Checking Pulse Steps for checking Pulse rate Checking Respiration Rate Steps for checking respiration Checking blood pressure Steps for checking blood presure Vital signs are cardinal signs which indicate how the body is carrying out the important processes What are the four vital signs? Bunker Rosdahl, C. (1999). Basic nursing (7th ed.). New York: Lippincott Williams &Wilkins. SESSION 2A: CHECKING PATIENT’S VITAL SIGNS. At the end of this session learner is expected to be able to: Define common terms used in checking patients vital signs Identify reasons for checking patients vital signs Outline factors influencing vital signs Identify common anatomical site for checking vital signs Demonstrate the procedure of checking patients vital signs Learning Tasks Vital signs are cardinal signs or physiological parameters that reflect key body processes The vital signs include temperature, pulse, respiration and blood pressure Temperature Temperature: Is the state of hotness or coldness of a substance as measured by a themometer Body temperature: Is the measure of warmth or coldness of the body resulting from body metabolism. It is the balance between heat production and heat lost. Normal body temperature range from 36.5OC- 37.5OC depend on the site taken Common Terms Used in Checking Vital Signs Thermometer Thermometer: Is an instrument used to measure the degree of heat or cold Clinical Thermometer: Is a thermometer used to measure body temperature (Example of thermometers used in clinical settings are mercury and digital thermometers) Fever: Is abnormal elevation of body temperature. Pyrexia: Is elevated body temperature ranging from 38 0C Hyperpyrexia: Is an extremely elevated body temperature ranging from 41oC and above Hypothermia: Is abnormal body temperature below 36 OC Constant Fever: The patient’s body temperature is constantly high throughout a period of some days. The fluctuation between morning and evening temperature doesn’t exceed1OC. Intermittent Fever: The patient’s body temperature swings from normal or subnormal to high fever regularly. Common Terms Used in Checking Vital Signs cont… Checking PATIENT VITAL SIGNS Remittent Fever: The patient’s body temperature may fall by more than 1OC in the morning and rise again later in the day. The characteristics fact is that the temperature does not reach the normal within twenty four hours. Inverse Fever: The patient’s body temperature is high in the morning and low in the evening. Irregular Fever: The patient’s body temperature rises and falls without definite pattern. Relapsing Fever: The patient’s high body temperature falls to normal and remains normal for a day or two and then it rises again Common Terms Used in Checking Vital Signs cont… Pulse Pulse: Pulse is a wave of contraction felt in the arterial walls when the left ventricle contract or is the vibration produced by heart beat waves of blood through the arteries Pulse Rate: (heart rate) Tells how often a person’s heart beats or Is the frequency of heart beats per minute, normal adult pulse rate ranges from 60-80 beats/minute (average beats per minute is 72), Newborn 120 beats/minutes, 4-8 years child ranges from 90-100beats/minutes Bradycardia: Is the term describing adult pulse rate below 60 beats/minutes Tachycardia: Is the term describing adult pulse rate above 100 beats/minutes The Rate: This is the speed at which the heart is beating. The Rhythm: Is the regularity of the heart; a normal pulse has beats of uniform force and separated by equal intervals. The Volume: Is the strength of the beats, it indicates the power of the heart and the amount of the Common Terms Used in Checking Vital Signs cont… Respiration Respiration: Is the process of breathing in oxygen and exhaling out carbon dioxide External respiration is the exchange of gases between lungs and atmosphere Internal respiration is the exchange of gases between blood and cells Dyspnea: Is a condition where the person experience difficult in breathing Wheezing: Is production of whistling sound during difficult breathing as occurs in asthmatic patients Apnoea: Is term describing a temporary cessation in breathing Orthopnoea: This is inability to breath easily and freely unless patient is in a sitting – up position Croup: Is noisy or harsh- sounding sort of breathing due to laryngeal obstruction (common causes of the obstruction are oedema or spasm or could both) Common Terms Used in Checking Vital Signs cont… Blood pressure Blood pressure: Is the force exerted by the blood against the arterial walls. Normally is recorded as systolic/diastolic in millimeters of mercury (mmHg) Systolic pressure: Is force exerted when the left ventricle contracts and pushes blood out of the heart through the Aorta. It ranges from 110 -140 mmHg for adult. Diastolic pressure: Is the force of the blood against the arterial walls when the heart is at rest between beats. It ranges from 60-90mmHg for adult Pulse pressure: Is the difference between systolic pressure and diastolic pressure Hypertension: Is when the systolic blood pressure is over 160mmHg or/and diastolic pressure is over 100mmHg Hypotension: Is when the systolic blood pressure is bellow 100mmHg or/and diastolic blood pressure is bellow 60mmHg. Common Terms Used in Checking Vital Signs cont… To identify any abnormalities /changes in body functions To evaluate patient condition during admission, before discharging, before and

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Admission CRT04102 · Patient Management START READING NOTES Study Admission using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic Learning Tasks ADMISSION OF A PATIENT IN A HEALTH FACILITY TYPES OF ADMISSION PURPOSE OF ADMITTING PATIENT TO HEALTH FACILITY Common Patients Worries Admit Patient to Health Facility Admit Patient to Health Facility cont… SUMMARY EVALUATION References: SESSION 2B: ADMISSION OF A PATIENT IN A HEALTH FACILITY Learning Tasks At the end of this session each learner is expected to be able to: Define the term admission Identify types of admission outline the purpose of admitting patient to health facility Identify common worries of patient during admission Admit patient in a health facility ADMISSION OF A PATIENT IN A HEALTH FACILITY Definition Admission: Is a process of receiving patents with serious health problems to a health facility for diagnosis/investigations, care and treatment. TYPES OF ADMISSION There two types of admission these are:- Planned admission: The patient is admitted from a waiting list or as a booked case Emergency admission: The patient is admitted following an accident or acute illness PURPOSE OF ADMITTING PATIENT TO HEALTH FACILITY To provide treatment and care to the patient To obtain baseline data on the patient’s condition which involves observation Reduce patient anxiety related to his/her illness Draw initial patient’s need and problems that need immediate medical and nursing intervention For investigation and diagnostic procedures For advanced management e.g. surgery Common Patients Worries During admission the patient may have some worries which may predispose him to respond in a negative way. As a nurse you must be aware with the following worries and assist the patient accordingly About his/her family at home About his job or business or missing lessons at school About lack of privacy if she /he has to share room with many patients About unexpected diagnosis such as cancer or HIV infection About diagnostic or therapeutic procedures About unknown reason Admit Patient to Health Facility Assessment: Patient’s ability to adopt to the environment How much the patient understands about his illness and the imposed effects If patient is allergic to any drug Whether the patient is taking any medication The patient’s ability to perform self-care Assess activity level of the patient if has any difficulties in walking or moving, has deformity Observe general condition of the patient if critically or moderately ill Assess his level of consciousness if alert, drowsy, semi conscious or unconscious Admit Patient to Health Facility cont… Assess his emotional state if depressed, irritable or anxious Observe his skin for any rashes, scars or birth mark, if soft, dry, smooth, clean or dirty Observe if has prosthesis or dentures Assess his ability to see, hear and speak Collect past and present medical history if condition allows Verify availability of equipment and supplies for admission Determine availability of suitable bed for the patient Admit Patient to Health Facility cont… Preparation of the environment Identify suitable place for the patient Ensure safe and conducive room Preparation of the patient Discuss information regarding admission to the patient and relatives Preparation of the care giver Revisit the policy guideline for admission as per institution Check own competency on the procedure Review literature on admission procedure, review the policy Admit Patient to Health Facility cont… Preparation of the necessary requirement: Vital sign tray (with thermometer, sphygmomanometer, stethoscope, observation chart, cotton wool swabs, receiver for used swabs) Patient case note for reference and documentation Admission book for record keeping Intake and output chart for recording patients intake and output History taking forms for taking patients history Physical examination guide/checklist Admit Patient to Health Facility cont… Kitting book for recording patients property Weighing scale for determining patients weight Treatment chart for recording patient’s treatment Tray for specimen if any for obtaining patient’s specimen Laboratory forms Admit Patient to Health Facility cont… Interventions Therapeutic aspect Warmly welcome and greet patient and relatives in a friendly way and offer chairs, make them feel at easy. Introduce yourself and state your role Wash hands and bring equipment nearby patient Admit Patient to Health Facility cont… Fill the following information in admission book: Full name Age and date of birth Sex Marital status Address Religion Nationality Occupation Name and address of next of kin Name of the doctor Provisional diagnosis Date and time of admission Hospital registration No. Admit Patient to Health Facility cont… Check and record vital signs as required Assist the patient to change into hospital garments Orient patient to health facility policy and regulations depending on his/her condition (visiting hours, doctors round, billing system any limit to number of visitors, , toilets and how to use them, meal time, where to get help in case of problem) Take the patient and show his/her bed and introduce his/her room or cubicle mates Maintain privacy and comfort when assisting patient Take care of his/her belongings or handle them to the relatives Perform general physical assessment as per guideline Remove decontaminates and cleans the used equipment Admit Patient to Health Facility cont… Communicative aspect Observe verbal and non verbal expression indicting pain, fear, and anxiety Record findings i.e. vital signs, weight, height, physical examination, interpret and communicate findings to the patient and other health profession Communicate rights of the patient, institution rules and regulations during admission Orient patient to the environment and show him his/her bed Initiate and implement nursing care plan Call relatives to see their patient when the patient is settled and tell them visiting hours and other relevant information regarding the patient. Allow the to say goodbye to the patient and escort them to the door Admit Patient to Health Facility cont… Teaching aspect Discuss with relative information regarding admission of the patient Educate patient about his illness Evaluation Answer the following questions and document Was significant information about the patient obtained? Were patient concerned addressed? Was the patient comfortable and safe while in hospital? Did the doctor see the

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Discharge Of Patient CRT04102 · Patient Management START READING NOTES Study Discharge Of Patient using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic Learning Tasks DISCHARGE OF PATIENT IN HEALTH FACILITY TYPES OF DISCHARGE PURPOSE OF DISCHARGE PROCEDURE FOR DISCHARGE PROCEDURE FOR DISCHARGE cont… DISCHARGE A PATIENT STEPS FOR DISCHARGING A PATIENT FROM THE HOSPITAL cont… SUMMARY EVALUATION REFERENCES: SESSION 2C: DISCHARGE OF PATIENT IN HEALTH FACILITY Learning Tasks At the end of this session each learner is expected to be able to: Define discharge Identify types of discharge Outline the purposes of discharge Explain procedure for discharge of a patient Discharge a patient DISCHARGE OF PATIENT IN HEALTH FACILITY Definition of term Discharge Discharge: Is an official permission granted to a patient to leave the health facility Is the point at which the patient leaves the hospital and either returns home or is transferred to another facility such as one for rehabilitation or to a nursing home TYPES OF DISCHARGE There are two types of discharge 1.Official discharge: Patient is evaluated by a physician and is discharged if he/she is medically ready to leave, the hospital 2.Discharged against medical advice (DAMA): Patient decide to leave hospital without physician's approval PURPOSE OF DISCHARGE Fulfil patients’ and relative’s request Facilitate a return of the patient to his family after recovery or for home based care Assist a patient to transfer positively from a dependent to a more independent role Help relatives to provide an environment that best meet the needs of the patient Obtain relative and community support of the client during convalescence at home PROCEDURE FOR DISCHARGE Assessment: Needed information about the physical, emotional and psychological needs of a client Disabilities and limitations that will extend after discharge Home plans if well understood Areas to be involved in teaching the client Family involvement in continuing support to the patient at home PROCEDURE FOR DISCHARGE cont… Preparation of the patient: Patient’s chart and discharge summary note Admission and discharge register Daily returns form (census sheet) Medication for home use Educational pamphlets as required Specific equipment needed upon discharge DISCHARGE A PATIENT Steps for discharging a patient from the hospital Start planning for discharge early while the patient is still in hospital Verify discharge orders from patient’s doctor Collaborate with appropriate heath team members Order any equipment or supplies patient will need to take home Coordinate with patient and family regarding time and day of discharge and mode of transportation Talk with patient about his future expectation regarding his health Encourage patient to verbalize his concern and be alert of nonverbal clues Discuss with family or significant others on how they can help the patient to maximize potential Teach on self-care at home where possible and supply written instructions Evaluate patient’s understanding of teaching STEPS FOR DISCHARGING A PATIENT FROM THE HOSPITAL cont… Assist patient to put together all his belongs and assist him in packing Collect required medication for home use from pharmacy. Repeat instructions for use to patient and relatives Give the discharge form (discharge summary) to patient and make sure the instructions regarding medication, diet, exercise and date for follow up appointment are clear Collect patient’s valuables and countercheck with him to make sure that everything is in order Assist client to dress his home clothes Instruct patient or relatives to settle the hospital bills Escort client to his transport and say ‘bye’ Strip the bed and put linen into the laundry bag Clean the bed thoroughly using disinfectant and re make it Empty the locker or bed side table and clean for the next client Wash hands and clear up equipments SUMMARY Discharge is an official permission granted to a patient to leave the health facility Plan for patient’s discharge should start early, and be incorporated in patient’s total care. It should not be left until the day of discharge EVALUATION What assessments will you make before discharging a patient? What are the preparations of a patient for discharge? REFERENCES: Bunker Rosdahl, C. (1999). Basic nursing (7th ed.). New York: Lippincott Williams & Wilkins. Kozier, B., Erb, G., Blais, K., & Wilkinson, J. M. (1995). Fundamental of nursing: Concepts, process and practice (5th ed.). Oakland, CA: Wesley.KMTC-VVOB. (2009). Skills lab project: Nursing procedure manual. Kenya.Lynn, P. (2011). Taylor’s clinical nursing skills: A nursing process approach (3rd ed.). New York: Lippincott Williams & Wilkins. MOHSW. (2008). Basic nursing procedures: A manual for nursing practice in Tanzania (3rd ed.). NCP: KIUTA. Moshi, N., & Karungura, J. (2005). Basic nursing procedures. KCMC Nursing Profession Paulinus, S. (2004). Basic nursing care (2nd ed.). Tanzania: Ndanda-Peramiho: Benedictine Potter, P., & Perry, A. (2005). Fundamentals of nursing (6th ed.). USA: Mosby Rider Ellis, J. (1992). Basic nursing skills (5th ed.). New York: Lippincott Williams & Wilkins Thomas, C. (1993). Taber’s cyclopedic medical dictionary. Philadelphia: F. A. Davis. Barbara K. Timby, Nancy E. Smith-Introductory Medical-Surgical Nursing, 10th Edition (Lippincott's Practical Nursing) – Lippincott Williams & Wilkins (2009).pdf. ← PREVIOUS TOPICNEXT TOPIC →VIEW ALL MODULE NOTESVIEW SEMESTER NOTESVIEW ALL LEVEL NOTESALL DIAGNOSTIC RADIOLOGY NOTES Need These Notes as PDF? Need a clean, well-formatted PDF copy for offline study, revision or printing? Request the complete notes directly through WhatsApp. GET WELL-FORMATTED PDF NOTES

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Providing First Aid To Patients CRT04102 · Patient Management START READING NOTES Study Providing First Aid To Patients using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic At the end of this session students should be able to: First aid procedure follow an abbreviation of DRABC R Response – is the casualty conscious? A Airway – clear the airway B Breathing – is the casualty breathing normally? C Circulation-check for any pulse Performing procedures in managing radiology emergencies a)Define Hemorrhagic shock. Shock Many organs can be damaged as a result of shock. 1.Hypovolemic shock Hypovolemic shock 2. Septic shock 3. Anaphylactic shock 4.Cardiogenic shock 5.Neurogenic shock. Hemorrhagic shock Severe burns Blue lips and fingernails Abdominal pain Do not remove embedded glass, knife, stick and arrow or any other object that stuck in the wound. Providing First Aid To Patients OSMOSIS HYPERTONIC IV FLUIDS Fluids to administer are: A burn is a tissue injury resulting from excessive exposure to thermal, chemical, electrical or radioactive agents. Dry burn Chemical burn Burns are usually classified as: Third degree Stop the burning process Cooling Covering/dressing Assessment of ABC Assessment of burns severity Analgesics Read on Management of patient with poisoning, musculoskeletal injuries, Fainting and collapse. Immobilization –stopping of something to move Alexander, M. F., Fawcett, J. N. & Runciman, P. J. (2002). Nursing Practice: (2nded). London, Churchill Livingstone. SESSION 4:APPLYING NURSING CARE CONCEPTS IN PROVIDING FIRST AID TO PATIENTS DURING RADIOLOGICAL PROCEDURES At the end of this session students should be able to: Describe first aid techniques and procedures Perform basic first aid procedures Performing procedures in managing radiology emergencies Perform immobilization and procedures in fractured and patients with possible spinal injuries Learning objectives First aid procedure follow an abbreviation of DRABC D Danger – ensure the area is safe and find out what has happened Make sure that it is safe for you to approach the casualty. Do not put yourself in any danger, because if you get injured you won’t be able to help the casualty. Remove any danger from the casualty, or if that is not possible, and it is safe to do so, try to move the casualty away from the danger area. Try to find out what happened, making sure that you are safe doing so. DO NOT PUT YOURSELF IN ANY DANGER. Basic first aid procedures R Response – is the casualty conscious? Try to get a response from the casualty. Gently shake their shoulders, shout and clap your hands in front of them, pinch their underarm or fingernail to get a pain response. If they do not respond, immediately shout for help A Airway – clear the airway Clear the airway by placing your fingertips under the casualty’s chin and lifting, so the front of the neck is extended. Simultaneously placing your other hand on their forehead to gently tilt the head back. B Breathing – is the casualty breathing normally? When their airway is cleared, check if they are breathing normally. You are looking for two breaths in ten seconds. Take no longer than this to assess their breathing, as every second counts. Check whether their chest and abdomen are rising and falling. Listen for breath (more than a sporadic gasp). Use the back of your hand (lick the back of your hand if that will help) or your cheek to feel for any breath from the casualty C Circulation-check for any pulse Also assess any bleeding to the patient. If any bleeding compress the site with pressure to stop bleeding. Performing procedures in managing radiology emergencies CARE OF PATIENT WITH SHOCK a)Define Hemorrhagic shock. Outline causes of bleeding. Identify signs of shock in a bleeding patient Provide measures to control bleeding. Administer Intravenous fluid to a patient in shock due to bleeding. Link a bleeding patient for further management. Learning Tasks Shock Is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do not get enough oxygen and nutrients to function properly. Introduction Many organs can be damaged as a result of shock. Shock requires immediate treatment and can get worse very rapidly. 1.Hypovolemic shock Neurogenic shock Anaphylactic shock 4.Septic shock Carcinogenic shock Types of shock Hypovolemic shock Is the type of shock which occurs if there is significant loss of body fluids like water, blood and electrolytes. Or Hypovolemic shock is caused by severe blood and fluid loss, such as a blood and fluid loss from traumatic bodily injury, which makes the heart unable to pump enough blood to the body, or severe anemia where there is not enough blood to carry oxygen through the body. Causes Severe bleeding Severe persistence diarrhea Persistence vomiting 2. Septic shock Is the type of shock which results from bacteria multiplying in the blood and releasing toxins. Common causes are Pneumonia Urinary tract infections Skin infections (cellulitis) intra-abdominal infections (such as a ruptured appendix). Meningitis. 3. Anaphylactic shock Is a type of shock caused by severe hypersensitivity or allergic reaction of the body. Causes include allergy to insect stings medicines, or foods (nuts, berries, seafood) 4.Cardiogenic shock Happens when the heart is damaged and unable to supply sufficient blood to the body. This can be the end result of a heart attack or congestive heart failure. 5.Neurogenic shock. Occurs when blood vessels stop working properly and don’t push enough blood through the body. You don’t experience blood loss, but the blood does not circulate correctly. This shock is caused by spinal cord injury usually as a result of a traumatic accident or injury. Hemorrhagic shock Is a type of hypovolemic shock that’s caused by heavy blood loss, which can be caused by internal or external bleeding. Hemorrhagic shock is life threatening condition which needs to be treated as a medical emergency. Severe burns Deep cuts Gunshot wounds Trauma Amputations Surgical procedure Ante partum hemorrhage Post-partum hemorrhage

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Care of Patients with Choking CRT04102 · Patient Management START READING NOTES Study Care of Patients with Choking using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic At the end of this presentation student should be able to Choking refers to impaired or Impeded breathing caused by an obstruction within the air-passages. OR Care of Patients with Choking Partial Obstruction: This is where the airway is not completely blocked. If severe enough, airway obstruction leads to oxygen deprivation and death if not rapidly and effectively addressed. If an adult is choking, you may observe the following behaviors:- Turning blue (Cyanosis), a blue coloring to the skin, can be seen earliest around the face, lips, and fingernail beds. Advanced age. Presence of tracheotomy and artificial airway (endotracheal tube). Choking is caused when a piece of food or other object gets stuck in the upper airway. When swallowing occurs, the trachea is covered by a flap called the epiglottis, which prevents food from entering the lungs. In adults, choking most often occurs when food is not chewed properly. CHOKING (INFANT 1 year) CHOKING CHILD CHOKING ADULT If still not breathing. Not eating whilst exercising. We can also increase public awareness of choking and confidence at initiating first aid. Suzzanne, C. Smeltzer, B. and Suddharth (1990).Medical Surgical Nursing, 8th edition. Lappincott. EMERGENCY CARE FOR PARTIENT WITH CHOKING At the end of this presentation student should be able to Define choking. Explain Types of choking. Describe the causes of choking. Explain the clinical manifestation of choking. Outline the risk factors of choking. Explain the emergency management of choking. Explain the Complications of choking. Describe the Prevention of choking. OBJECTIVES Choking refers to impaired or Impeded breathing caused by an obstruction within the air-passages. OR Choking is a life-threatening medicine emergency characterized by the blockage of air passage into the lungs secondary to the inhalation/ingestion of food or another object. Food or small objects can cause choking if they get caught in your throat and block the airway. This keeps oxygen from getting to the lungs and brain. INTRODUCTION Care of Patients with Choking Complete Obstruction: This is where there is no air going in and out and as a result the casualty is unable to breath and unable to cough. There may be very high pitched wheezing sounds. Because the casualty can not cough they will most likely not be able to expel the object without assistance. Categories of Choking Partial Obstruction: This is where the airway is not completely blocked. The casualty is able to cough strongly enough to expel the object on their own. Because they can get the object out on their own, first aiders should not do abdominal thrusts. Instead, just stay with the casualty and encourage them to keep coughing. Categories of Choking. If severe enough, airway obstruction leads to oxygen deprivation and death if not rapidly and effectively addressed. If there is partial obstruction of the airway, a sub-acute process may result in infection, inflammation, and lung injury distal to the lodged object Another mechanism of choking involves the impaction of foreign material in the esophagus, with resultant airway compression. Choking results from a complex interaction among the individual, the environment, and the object at hand Care of Patients with Choking Young children are at highest risk for choking owing to their incompletely developed dentition and oral skills, smaller airways, immature swallowing mechanisms, and lack of experience and cognition. Also, they tend to explore the world by bringing objects to their mouths. Children with developmental delay, hypertonia, dysphagia, or anatomic abnormalities retain this increased risk into their later years. If an adult is choking, you may observe the following behaviors:- Coughing or gagging Hand signals and panic (sometimes pointing to the throat) Sudden inability to talk. Clutching the throat: The natural response to choking is to grab the throat with one or both hands Inability or difficulty breathing. Labored breathing; including gasping or wheezing may be present. CLINICAL MANIFESTATION Turning blue (Cyanosis), a blue coloring to the skin, can be seen earliest around the face, lips, and fingernail beds. The person may become unconscious, if breathing is not restored. If an infant is choking, more attention must be paid to an infant's behavior.(Difficulty breathing, Weak cry, weak cough, or both) Clinical manifestation cont.. Advanced age. Anesthesia or medication administration. Delayed gastric emptying. Depressed cough or gag reflex. Drug or alcohol intoxication. Facial, oral, or neck surgery or trauma. Impaired (difficulty) swallowing. Unsafe eating behavior like eating and drinking very quickly. Presence of gastrointestinal tubes. RISK FACTORS Presence of tracheotomy and artificial airway (endotracheal tube). Reduced level of consciousness. Seizure activity. Situations hindering elevation of upper body. Tube feedings. And Wired jaws. Choking is caused when a piece of food or other object gets stuck in the upper airway. In the back of the mouth are two openings. One is the esophagus, which leads to the stomach; food goes down this pathway. The other is the trachea, which is the opening air must pass through to get to the lungs. CAUSES CHOKING When swallowing occurs, the trachea is covered by a flap called the epiglottis, which prevents food from entering the lungs. The trachea splits into the left and right main stem bronchae. These lead to the left and right lungs. They branch into increasingly smaller tubes as they spread throughout the lungs. In adults, choking most often occurs when food is not chewed properly. Talking or laughing while eating may cause a piece of food to "go down the wrong pipe.“ Normal swallowing mechanisms may be slowed if a person has been drinking alcohol or taking drugs, and if the person has certain illnesses such as Parkinson's disease. In older adults, risk factors for choking include advancing age, poor fitting dental work, and alcohol consumption. Care of Patients with Choking In children, choking is often caused by chewing food incompletely,

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE First Aid CRT04102 · Patient Management START READING NOTES Study First Aid using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic Learning Tasks Activity: Brainstorming Definition of terms Definition of terms Cont…. PURPOSE OF FIRST AID First aid Priorities First aid Priorities Cont… Components First Aid Kit Basic Materials for First Aid Kit Disposable gloves (non-latex) Sterile adhesive compresses (1 inch x 3 inches), individually packaged Two crepe rollers Adhesive tape Principles of First Aid Principles of First Aid Cont… Key points Session Evaluation References References Cont… SESSION 6.Appling nursing concepts in determining first aid tools for radiological procedure Learning Tasks By the end of this session, students are expected to be able to: Define the terms commonly used in first aid Outline the purpose of first aid Explain the first aid priorities Identify the components first aid kit Explain the principles of first aid READ or ASK participants to read the learning tasks Activity: Brainstorming What do you understanding by the term First aid? Definition of terms First aid Is the initial assistance or treatment given to someone who is injured or suddenly become ill Casualty: Is a person who is injured or killed in an accident Definition of terms Cont…. Mass casualty: Is any incident in which emergency medical services resources, such as personnel and equipment, are overwhelmed by the number and severity of casualties Definition of terms Cont… Emergency An urgent condition perceived by patient requiring immediate Medical or Surgical evaluation or surgical treatment First aider A person who is trained to give first aid to a sick or injured person Definition of terms Cont… First aid kit A small box containing a first aid equipment PURPOSE OF FIRST AID The purposes of first aid are to: Save life Prevent further injury Alleviate suffering and Promote recovery until professional medical care becomes available, or the casualty recovers First aid Priorities First aid priorities are: To assess the Situation Observe what has happened quickly and calmly To ensure the appropriate emergence service are alerted To keep the casualty alive (attention to airway, breathing and circulation is paramount) First aid Priorities Cont… To provide reassurance and comfort to the casualty Prevent cross infection between yourself and the casualty To ensure both the rescuer and casualty safety Give early treatment and treat the casualties with the most serious (life threatening) conditions first Components First Aid Kit Activity: Brainstorming What are the components of first aid kit? Activity: Brainstorming Ask students to brainstorm on the tools/equipment in first aid kit ALLOW few students to respond WRITE their responses on the flip chart/ board Basic Materials for First Aid Kit Bandage tape Hot water bottle Cotton balls Protective gears like Mask, Gloves, etc Disposable facial tissues Disposable gloves (non-latex) Flashlight Gauze bandage (1 inch and 2 inch widths) Ice bags Disposable towels. Pocket mask/face shield for Cardiopulmonary Resuscitation (CPR) Sterile adhesive compresses (1 inch x 3 inches), individually packaged Sterile cotton tipped applicators, individually packaged Sterile gauze squares (2 inches x 2 inches; 3 inches x 3 inches), individually packaged Tongue blades Two crepe rollers Scissors Tweezers Cotton wool Non alcoholic wound cleaning wipes Adhesive tape Notepad, pencil and tags For outdoor activities blanket, survival bag, torch and whistle Thermometer Principles of First Aid First aid Priorities Assess the Situation Observe what has happened quickly and calmly Look for danger to yourself and casualty Never put yourself at risk Principles of First Aid Cont… Make the Area Safe Protect the casualty from danger Be aware of your limitation Triage the patient Asses all casualties and identify the priority of care using TRIAGE system as follows; Principles of First Aid Cont… Red Tag: Patient need Immediate care (Life Threatening injury), treat as you find Yellow Tag: Patient needs medical care or attention within 30 minutes Principles of First Aid Cont… Green Tag: no need of Treatment, Can kept be kept under reassurance of Health Care professional to alleviate anxiety and allow them to relax before discharge Black Tag: Deceased (No sign of Life) Principles of First Aid Cont… Primary Survey Airway: Asses the airway, if obstructed, open using the following techniques Head tilt – chin lift maneuver Jaw thrust maneuver NB: Keep neck in neutral position if cervical spine injury suspected Principles of First Aid Cont… Breathing: Look, listen, and feel for adequacy in breathing If inadequate breathing consider artificial ventilation by using Bag Valve Mask (BVM) Principles of First Aid Cont… Circulation: Check for pulse, capillary refill, signs of active bleeding Stop bleeding by applying pressure at the bleeding site Establish IV access, two large bore cannula is recommended (14G, 16G, or 18G) Administer IV fluid if available Principles of First Aid Cont… Disability: Assess level of consciousness using (AVPU) A – patient is Awake V – patient response to Verbal stimuli P – patient response to Painful stimuli U – Unresponsive Principles of First Aid Cont… Exposure Undress the patient to examine other parts of the body but maintain privacy, body temperature and Immobilization the neck and spine inline to avoid secondary injury Principles of First Aid Cont… Get Help Quickly ensure that any necessary specialist help has been summoned and is on its way NB: Reassessment of ABC's must be undertaken immediately if patient condition deteriorates Key points First aid is the initial assistance or treatment given to someone who is injured or suddenly taken ill Perform Triage to prioritize care by treating those with life threatening conditions first Purposes of first aid includes: Save life, Prevent further injury, Alleviate suffering and Promote recovery Session Evaluation What are the purpose of first aid? What are tools or equipment in the first aid kit? What are the first aid priorities? References Primary Trauma Care Foundation. (2010). Primary care trauma manual: A manual for trauma management in district and remote locations. Retrieved from http://www.primarytraumacare.org Bowden. D.F, Halliwell.D, McMahon.R.M (2007). Emergence care and first aid

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Concepts In Maintaining Aseptic Practice CRT04102 · Patient Management START READING NOTES Study Concepts In Maintaining Aseptic Practice using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic At the end of this session students should be able to; Concepts In Maintaining Aseptic Practice These are evidence based approach preventing patients and health care workers from being harmed by avoidable infections Types of hand hygiene includes; Immediately on arrival at or and before leaving work Whenever there is chance of contamination such as Steps for routine hand washing To make your own, low cost hand rub, combine Kills or inhibits the growth of most transient and resident micro-organisms but does not remove micro-organisms or dirty. Decontamination is a process of making equipment, instruments and linens safer to be handled by a health care provider. Decontamination is done by using Choline 0.5%,soap and water, arranged in steps by buckets Dusting –removing dirt on the surface Sterilization Waste disposal in health facilities follows guidelines and standards, buckets are coded by colors as follows; Red Personal protective equipment are equipment worn by workers to minimize exposure to specific occupational hazards The commonly used PPE includes; Storry, J., et al.(2017).Core components for effective infection prevention and control programmes. SESSION 7. NURSING CARE CONCEPTS IN MAINTAINING ASEPTIC PRACTICE At the end of this session students should be able to; Describe aseptic procedures Perform infection prevention control procedures Perform procedures for simple sterile dressing trolley for radiological procedures Perform sharp and waste disposal procedures in the radiology department. Leaning objectives Concepts In Maintaining Aseptic Practice Aseptic procedures are set of practices aimed to protect patients from health care associated infections during procedures by minimizing contamination and preventing transmission of infection. Aseptic procedures These are evidence based approach preventing patients and health care workers from being harmed by avoidable infections Includes; Hand hygiene Cleaning and Disinfection Sterilization and Decontamination Waste disposal Personal protective equipments(PPE) Infection prevention and control procedures Concepts In Maintaining Aseptic Practice Hand hygiene is an action intended to prevent hand borne infections by removing dirt and debris and inhibiting or killing microorganisms on skin. It include care of hands, nails and skin or Hand washing is the process which mechanically removes dirty and debris from skin and reduces the number of transient micro-organism HAND HYGIENE Types of hand hygiene includes; Routine hand washing Alcohol hand rub Surgical hand scrub Types of hand hygiene Immediately on arrival at or and before leaving work Before and after using the toilet Before and after each patient contact Before and after putting on gloves Before and after any clinical procedure Points to Consider when to Perform Hand Hygiene Whenever there is chance of contamination such as Touching blood bodily fluids, secretions or, excretion and exudates from wound Contacts with items known or considered likely to contaminated with blood, body fluids, secretions, or excretions (e.g. bed bans, urinals, wound dressing) Points to Consider when to Perform Hand Hygiene cont… Steps for routine hand washing Turn on tap. Wet hands thoroughly under running water at least 4 inches above the wrist. Soap hands adequately. Vigorously rub together all surfaces of lathered hands. Rub hands vigorously back and front, in between fingers up to and including the wrist, followed by thorough rinsing under running water. This should be for 10 – 15 seconds Dry hands from tip of fingers to wrist with paper towel. If paper towels are not available, shake off excess water and allow hands to air-dry. Use the same paper towel to turn off tap if tap not elbow controlled. Routine hand washing with liquid soap and running water To make your own, low cost hand rub, combine 100 mls of 60-90%Ethly or isopropyl alcohol and 2 mls of grecyline Shake and then it is ready for use The technique involves Applying enough alcohol –based hand rub to cover the entire surface of hands and fingers Rubbing the solution vigorously over the hands (covering thumbs, palms and backs of the hands including between fingers, tips of fingers and under nails) until thorough dry Alcohol hand rub Kills or inhibits the growth of most transient and resident micro-organisms but does not remove micro-organisms or dirty. Can be used when hand washing with soap and running water is not possible, as long as hands are not visibly soiled with dirty, blood, or other organic material Alcohol hand rub cont… Concepts In Maintaining Aseptic Practice Surgical hand rub procedure involves hand washing with water and soap, and hand rubbing with alcohol-based hand rub and friction. The process mechanically removes dirty, debris and transient organisms reduces resident flora prior to performing any invasive surgical procedure for the duration of the procedure. The goal of surgical hand rub is to prevent: surgical area contamination by microorganisms from hands and palms of the surgeon and assistant. Surgical hand rub Concepts In Maintaining Aseptic Practice Cleaning is the removal of organic materials and debris (dust, dirty, blood or other bodily fluid) from used items by washing with soap and water and friction. Disinfectants are chemicals that kill or inhibit all microorganisms except bacteria endospores on inanimate objects. Cleaning and disinfection Decontamination is a process of making equipment, instruments and linens safer to be handled by a health care provider. Decontamination According to OSHA, is “the use of physical or chemical means to remove, inactivate, or destroy blood-borne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface of an item is rendered safe for handling, use, or dispose. DECONTAMINATION AND STELIRIZATION Decontamination is done by using Choline 0.5%,soap and water, arranged in steps by buckets SOAP WATER CLEAN WATER CHROLINE WATER SOAP WATER CLEAN WATER Dusting –removing dirt on the surface Principals used in dusting or cleaning are; From clean to dirt. From top to bottom. From far to near. From inside to out. Sterilization Is

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Burn CRT04102 · Patient Management START READING NOTES Study Burn using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic Outlines Introduction EPIDEMIOLOGY CAUSES CAUSES Cont… Pathophysiology of burn Pathophysiology of burn cont… Classification of burns cont… Superficial-thickness burn/1st DEGREE BURN Partial-thickness burn/2nd Degree burn (superficial & deep) Deep partial-thickness burn/ 3rd Degree burn Full-thickness burn/4th Degree burn Calculating % of burn The rule of nines Rule of nines cont… Rule of palm Rule of palm cont… Lund and browder method Severity of burn injuries Severity of burn cont… Body response to burn injuries Local response Systemic responses Systemic responses cont… Phases of management Phase I: Primary survey phase Phase II: Resuscitation phase Fluid replacement + Fluid maintenance Phase III :Secondary survey phase Phase IV: Supportive care phase Phase V: Definitive treatment phase (Wound care) General interventions General interventions cont… Early complications Late complications BURN INJURY Outlines Introduction Epidemiology Causes Classification Management General intervention Introduction Burn injury can be defined as bodily injury resulting from exposure to heat, cold, chemical, electricity or radiation. Human skin can tolerate temperature up to 42-44 centigrade Burn causes coagulation necrosis of the skin and underlying tissues Patients with extensive burns frequently die, and for those with less severe injuries, physical recovery is slow and painful Patients also may suffer emotional and psychological problem EPIDEMIOLOGY Affecting approximately 1% of the world population each year In the United States, approximately 2.4 million burn injuries are reported every year, 700,000 visits per year and 45,000 require hospitalization. In East African countries such as Uganda and Tanzania, studies have found that the age range mostly affected was 1-10 years (53% were female, 47% were male and scalding burns formed 65% of all burn injuries) Risks can be reduced by improving social circumstances, housing and industrial safety. CAUSES Thermal energies Scald – (injury with hot liquids, or steam) Flame Contact -direct contact to extremely hot objects or the contact was abnormally long, commonly seen in people with epilepsy or those who misuse alcohol or drugs CAUSES Cont… Chemical (acids like hydrochloric acid) Electrical energy Radiations Cold injuries Child abuse Adult carelessness, child’s exploring and curious nature, failure to supervise the child adequately all contribute to higher incidence of burn injuries in children Pathophysiology of burn Burns are caused by transfer of energy from the heat source to the body through conduction or radiation Heat energy → tissue destruction due to coagulation, protein denaturation or ionization of cellular contents The skin and the mucosa of the upper airways are the sites of tissue destruction. Pathophysiology of burn cont… The depth of the injury depends on the temperature of the burning agent and duration of contact with agent Disruption of the skin can lead to increased fluid loss infection hypothermia scarring Classification of burns Classification of burns cont… Burns are classified according to the depth of tissue destruction 1st degree burn (superficial-thickness) 2nd degree burn(partial-thickness burn) 3rd degree burns(deep partial-thickness burn) 4th degree burns(Full thickness burn) Superficial-thickness burn/1st DEGREE BURN The epidermis is destroyed or injured, but there is no destruction of tissue or nerve endings. The wound is painful, may appear red and dry, with blister The wound usually takes 3 to 7 days to heal without scarring There is prompt regeneration Superficial burn cont… Partial-thickness burn/2nd Degree burn (superficial & deep) Superficial 2nd degree burn Injury involves destruction of epidermis and upper half of dermis The wound is painful, sensitive to temperature change and air exposure Wound Appearance: Red to pink, Wet and weeping wounds, Thin-walled, fluid-filled blisters, Mild to moderate edema, Extremely painful Wound Healing: In 2 weeks (spontaneous) Minimal scarring; minor pigment discoloration may occur Regeneration of the skin usually occur from the remaining viable epithelial cells in the dermis Partial-thickness burn cont… Deep partial-thickness burn/ 3rd Degree burn Injury involves destruction of entire epidermis and dermis, and in some cases underlying tissue as well The color of the wound varies from white to red, brown or black Pain less severe than in superficial partial thickness burn Full-thickness burn/4th Degree burn Burns which cause the skin to be waxy white to a charred black and tend to be painless. Includes destruction of epidermis and the entire dermis as well as possible damage to the SQ tissues, muscle and bone Healing is very slow if at all, and may require skin grafting. Calculating % of burn injuries The extent of burned body surface area can be estimated or determined by the following ways; Rule of nine Palm method Lund and browder method The rule of nines Rule of nines is a quick way of calculating the extent of burns The system assigns percentages in multiples of nine to the body surfaces 9% for whole head 9% for left arm 9% for right arm Rule of nines cont… 9% for abdomen 9% for anterior thorax (chest) 9% for posterior thorax (upper back) 9% for posterior abdomen (lower back) 9% for anterior right leg 9% for anterior left leg 9% for posterior right leg 9% for posterior left leg 1% for genital area Rule of palm In patients with scattered burns, the useful method to estimate percentage of burn is the palm method This method assumes that the size of the patient’s palm is approximately 1% of the body surface area(BSA) Rule of palm cont… Rule of palm Patient’s palm equals 1% of his body surface area Lund and browder method Is the more precise method of estimating the extent of burn This method recognizes that the percentages of body surface area of various anatomic parts varies with growth The total BSA burned can be estimated by dividing the body into very small areas and assign percentage for each part. Lund and browder: for adults Severity of burn injuries Severity of burn injury based on the following; Depth Extent Location Cause Patient age Severity of burn cont… Burns severity is determined primarily by

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER ONE Communication Skills and First Contact with Patients CRT04102 · Patient Management START READING NOTES Study Communication Skills and First Contact with Patients using the sections below. Use the topic navigation to continue through Patient Management. Contents of This Topic Learning Tasks Patient Central position of a patient The First Radiographer Patient Contact The First Radiographer Patient Contact (2) Forms of interactions and communication techniques Forms of Interactions and Communication Techniques (2) Forms of interactions and communication techniques (3) Forms Of Interactions And Communication Techniques (4) Forms of Interactions and Communication Techniques (5) Forms of Interactions and Communication Techniques (6) Forms of interactions and communication techniques (7) Forms of Interactions and Communication Techniques (8) Forms of interactions and communication techniques(9) Methods of Effective Communication Methods of Effective Communication (2) Methods of Effective Communication (3) Methods of Effective Communication (4) THINGS TO CONSIDER DURING FIRST RADIOGRAPHER –PATIENT CONTACT THINGS TO CONSIDER DURING FIRST RADIOGRAPHER –PATIENT CONTACT (2) THINGS TO CONSIDER DURING FIRST RADIOGRAPHER –PATIENT CONTACT (3) After Care of The Patient After Care of The Patient (2) Evaluation: COMMUNICATION SKILLS AND RADIOGRAPHER PATIENT FIRST CONTACT Learning Tasks At the end of this session student should be able to: Define a patient Explain the first radiographer patient contact Outline forms of interactions and communication techniques Outline things to consider during first radiographer –patient contact Describe the after care of the patient Patient Patient is an individual who is searching health care. Health care refers to those services provided to assist the patient in maintaining or restoring optimum health. A comprehensive health care to the patient can not be given by a single person, but requires the effort of a medical team(health professions and workers),so the center of the team is the patient Central position of a patient PATIENT Accountant Nurse physician Radiographer Pharmacist Lab . technician psychiatrist Health attendant Psychotherapist Dentist Social worker Occupational therapist The First Radiographer Patient Contact This is the interaction between the radiographer and the patient and people around them (relative) It is important psychologically to present the patient with an image of an efficient department. This includes clean and tidy rooms and radiographers will look professional The feelings, comfort and kind treatment of the patient may be as significant as radiograph itself. The First Radiographer Patient Contact (2) The body posture and a smiling facial expression is important in giving a patient a feeling a welcome also addresses as; Mr., Mrs., Miss, Hon or Rev etc. and avoiding the temptation of using diminutives as they distract from the patient dignity and individuality. In improving relationships with patients that dramatic results in clinical situations. Forms of interactions and communication techniques The following forms of interactions and communication techniques have proved effectiveness. Verbal skills Is used in establishment an open relationship the health professional and the patient a basic to quality of the interaction, vocabulary, clarity of voice and even the organization of the sentences must be at an appropriate for the patient Forms of Interactions and Communication Techniques (2) Non- verbal communication Although verbal language as our primary means of communication, non verbal behavior reveal a great deal about how we feel. How non verbal communication is interpreted is largely based on cultural background. E.g. Refusal to look someone directly to the face is avoidance, refusal or rejection Forms of interactions and communication techniques (3) Crunched teeth or fits suggest angry under rigid control. Patient in pain may suggest tight or rigid posture Leaning forward while listening to another shows that a person is interested in the subject being discussed. What other non- verbal behavior do you see around? Forms Of Interactions And Communication Techniques (4) Eye contact Is considered as the positive behavior, when make direct eye contact with the person while speaking, it is usually perceived as an expression of interest, concern or honest Touching It is also a means of communication, an abrupt or tentative touching may demonstrate as distaste or reluctance to care for an individual. Forms of Interactions and Communication Techniques (5) A positive touch is firm but gentle reassures the patient that you are both capable and caring. People touch one another for variety of reasons; To provide reassurance, support or encouragement. To imply domination, anger, or frustration To form a positive connection, as in a handshake or shoulder pat To perform professional services, such as those provided by a doctor, hairdresser, or masse use Forms of Interactions and Communication Techniques (6) Appearance Patients tend to place their confidence in health care, workers to the degree that they feel their expectations, of a professional person are being met. Everyone we meet forms an impression of us from our away we communicate how we feel about our work and appearance, and whether we realize it or not, appearance is another, our patients. What does your appearance tell patients? Forms of interactions and communication techniques (7) Listening skills How do you feel when you are interrupted, or when the listener looks out the window while you attempt to make your point? Are you irritated when others, "put words into your mouth" or change the subject without responding to what you have just said? Forms of Interactions and Communication Techniques (8) Good communication is a two-way street, and a good listener does more than await his or her turn to speak. As a skill, listening involves the ability to give full attention to the speaker. When you focus on the speaker, you can respond to what has been said rather than making a quick switch to the next item on your mental list. Forms of interactions and communication techniques(9) In conversation, patients often give us clues about a physical problem that could be easily missed if we rush to get to the next question. This approach may seem impractical in a busy imaging department. but it can become automatic with practice. Methods of Effective Communication For effective care and communication to the patients, the following interactive