ED Care Flashcards
Most common reasons for ED
Abdominal pain Chest pain Breathing difficulty Injuries (esp falls) Headache Fever *pain
Describe what the forensic nurse examiner does
Specialty team member Obtain pt hx Collect forensic evidence Offer counseling/follow up for victims of rape, child abuse, domestic violence *there are also sexual assault examiners
Psychiatric crisis nurse team
- pt with chronic mental health disorders
- evaluate pt with emotional behaviors or mental health illness
- facilitate treatment plan like admission to psych unit
Older adults who are on beds or stretchers should always…
Have side rails up
Have access to call light
Reorient and reassess older pt mental status
Who are the vulnerable pop that are in the ED
Uninsured or underinsured
Poor
Homeless
Older adults
What are the care competencies of nursing in ED
Pt assessment (noticing) Priority setting/clinical decision making (crucial in triage) Multitasking Documental Communication
What is the team approach in ED
Teamwork and inter professional collaboration
- communication
- standard of practice
Who are the health care workers in ED
Prehospital care providers Emergency medical team (EMT) Paramedics who are ALS providers Emergency medicine physician Emergency nurses
What is the hand off communication
Standardization approach prevents errors caused by poor communication
Ie/SBAR
What is the patient safety and quality care (QSEN)
1) pt identification
2) injury prevention for patients
3) risk for errors and adverse events
4) injury prevention for staff (standard precautions)
In the ED what are the major concerns
Staff and patient SAFETY
What are the common pt safety issues
- pt identification
- fall risk
- skin breakdown invulnerable pop
- high risk for medical errors or adverse events
What are the certifications for ED nursing
Basic life support
Advanced cardiac life support
Pediatric advanced life support
Non invasive assessment and management skills for airway maintenance and CPR
Basic life support
Invasive airway management pharm and electrical therapies
Advanced cardiac life support
Neonatal and pediatric resuscitation
Pediatric advanced life support
System for sorting and classifying pt into priority levels depending on illness and injury severity
Triage ED
Who gets served first in the ED
Pt who presents with highest acuity needs to receive the quickest eval
Pt with lower acuity may wait longer
RN, physician or PA triage the pts
Is there a universally accepted triage system in the US
No
What is the tier level triage system
1) emergent
2) urgent
3) nonurgent
What is the emergent level
- life threatening
- resp distress
- stroke
- active hemorrhage
- unstable VS
- chest pain
What is the urgent level
- quick not life threatening
- severe abdominal pain
- renal colic
- fractures (displaced or multiple)
- soft tissue injury (complex and multiple)
- new onset resp infection (esp pneumonia)
Describe nonurgent level
- skin rash
- strains and sprains
- colds
- simple fracture
Describe the 5 tier system
Acuity and predictions of resources to categories
- emergency severity index
- Canadian triage
- acuity scale
What can be a pt safely risk
Mistriage
What is mandated federal law concerning ED
To perform ER screening exam on all pt despite inability to pay
How to act around vulnerable pop
-demonstrates behaviors that promote trust
What does trauma in HC mean
Bodily injury (unintentional or intentional) *trauma centers have roots in military medicine
Trauma center is only as good as what
The overall trauma system that supports it
What are the critical elements of trauma system:
- access to communication technology
- timely availability to EM
- rapid transport to trauma center
- early provision of services
- system wide prevetion and research
What is a trauma system
Organized and integral approach to trauma care
What is the key role of emergency nurse
Health teaching
- discharge instructions
- health education
- home safety issues
- consider reading level and language
Family presence during resuscitation…
Is gaining more acceptance
How to act with death in the ED
concrete communication (death/died)
