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By Diana Fergusson

Breathing evaluate -- breathing tracking -- Cardiovascular evaluation -- Cardiovascular tracking -- Neurological evaluate -- Acute neurological review and tracking -- Gastro-intestinal method and stomach -- meals -- Fluid and electrolytes -- Head and neck -- Musculoskeletal overview -- Temperature tracking -- convenience and hygiene

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Delays in analysis may also lead to inaccurate results due to the separation of cells and plasma; the sample should therefore be rolled gently to maintain mixing but not shaken as this may cause haemolysis (Woodrow 2004). Blood gas analysis machine There may be a local protocol to input the patient’s temperature to the blood gas analyser to compensate for the effect of temperature on the solubility of gases (Simpson 2004). However, although there are no known reference ranges for parameters when the temperature has been corrected, it is thought that measured parameters (PaO2 and PaCO2) may be lower in the pyrexial patient and higher in the hypothermic patient (Martin 1999).

The catheter is often placed in the femoral artery, particularly in young children, but may also be placed in the radial artery (Weiss et al. 1999). g. lamps for heating) (although the machine may have an alert system for this); • the waveform is adequate and demonstrates no signs of dampening down; • the limb is continually assessed for warmth, pulses and capillary refill. VENOUS BLOOD GAS SAMPLING Blood gas analysis from sampling a vein can be useful in determining the adequacy of ventilatory status (PCO2) and acid–base balance (pH).

Oxygen toxicity is a risk for infants (retinopathy of prematurity in pre-term infants) and children (lung fibrosis). 49 3 3 Clinical Assessment and Monitoring in Children • Lower than normal levels usually indicate hypoxaemia (low levels of oxygen in the blood). PaO2 and SaO2 results must take into account the oxygen therapy at the time. If a child is just maintaining normal PaO2 but is on high levels of oxygen therapy, it indicates an ongoing oxygenation problem. Assessing the acid–base balance pH The hydrogen ion concentration measures the acidity/alkalinity of the blood and a small change in pH can dramatically alter the hydrogen ion concentration (pH expresses the negative logarithm of H+).

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