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MS LEC MONTHLYS > Emergency Care > Flashcards

Emergency Care Flashcards

1
Q

What is emergency management?

A

Care given to patients with URGENT and CRITICAL needs
- severe conditions affecting their ABCs
- concept has evolved from mgmt of life-threatening conditions to managing emergencies as whatever the patient or family considers it to be

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2
Q

What is emergency nursing?

A

Field of nursing that requires specialized education, training, and expertise in assessing and identifying pt’s healthcare problems in crisis situations

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3
Q

What are the functions of an ER nurse?

A

[EMC-2S-EWPAN]

  • Establishes priorities
  • Monitors
  • Continuously assesses pts who are acutely ill and injured
  • Supports and attends to families
  • Supervises allied health personnel
  • Educates patients and families within a time-limited, high-pressured environment
  • Works with a team
  • Performs highly technical, hands-on skills (for ER pts
  • Accomplishes interventions independently or in consultation w/ MD or NP
  • Nursing area specialty
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4
Q

RE: Functions of ER Nurse

In terms of supervising allied health personnel, the nurse acts as a team leader in:

A
  • Code Management
  • Staff Supervision
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5
Q

RE: Functions of an ER Nurse

What are the different certifications for ER Nursing?

A
  • BCLS/BLS : Basic Cardiac Life Support; noninvasive assessment and mgmt for ABCs; no pharma
  • ACLS : Advanced Cardiac Life Support; Invasive airway mgmt skills; involves pharma (e.g. if epi is given at a certain point); with AED
  • PALS : Neonatal and pedia resuscitation
  • CERN : Certified Emergency Registered Nurse
  • CCRN : Certified Critical Care Registered Nurse
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6
Q

Challenges in emergency care include? (Subtopics only)

A
  1. Diversity of Conditions and Situation
  2. Ethical and Legal Issues
  3. Occupational Health and Safety Risks
  4. Holistic Care in the Context of Fast-Paced Technology-Driven Environment
  5. Disaster Nursing
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7
Q

Under Ethical and Legal Issues:

What is Negligence?

A

Not performing necessary actions = damage or death to pt

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8
Q

Under Ethical and Legal Issues:

What is Malpractice?

A

Gives substandard practice with ill intention to harm

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9
Q

Under Ethical and Legal Issues:

What is the “Good Samaritan Law”?

A
  • Gives legal protection to those who help accident victims via emergency medical care within the golden hour
  • Usually do not apply to emergency personnel on duty; medicolegal cases are handled by that dept
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10
Q

Under Ethical and Legal Issues:

What is informed VS. implied consent?

A

Informed : Before receiving the pt, inform them about procedures to be done to get their agreement (e.g. inform na ure going to auscultate)

Implied : No verbal consent, but no signs of disagreeing; other party didn’t impose

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11
Q

Under Ethical and Legal Issues:

What are the 2 duties nurses have?

A
  1. Duty to report suspected crimes to the police
    - Will be handled by medicolegal team
  2. Duty to gather evidence in criminal investigations
    - Be aware of hospi policy + state laws; whatever u do / remove = evidence, must be documented
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12
Q

Under Ethical and Legal Issues:

What are the 2 kinds of advance directives?

A
  • Durable power of attorney: designates a person to make decisions on your behalf
  • Living will regarding health matter AKA advance healthcare directive: specified medical treatments you do or do not wish to receive
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13
Q

Under Ethical and Legal Issues:

What is the order of proxies to provide consent for the pt?

A

Spouse → Children → Parent/s → Sibling/s

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14
Q

Under Ethical and Legal Issues:

What is loco parentis?

A

Doctor takes control of the situation and makes decision on behalf of pt to perform life saving procedures

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15
Q

Under Ethical and Legal Issues:

What are the exemptions in obtaining consent to examine and to treat?

NOTE: ALL 3 MUST BE PRESEN

A
  • Unconscious / in critical conditions
  • Unable to make decisions
  • Without family and friends (of legal age)

IF ALL 3 PRESENT: we get to make the decision

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16
Q

Under Ethical and Legal Issues:

Data Privacy Act of 2012 is RA __________?

A

10173

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17
Q

Under Ethical and Legal Issues:

Before gathering evidence, it is imperative to:

A

Ask pt first if they will file for medico-legal. All pieces of evidence should be taken into consideration and properly documented

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18
Q

Under Occupation Health and Safety Risks:

What are the reasons HCW have this risk?

A
  1. Non-comprehensive medical history
  2. Infections, hazards
  3. Physical Threats (also verbal abuse)
19
Q

Under Occupation Health and Safety Risks:

What are non-restraint techniques?

A

Talking, decreasing stimuli, distancing yourself

20
Q

Under Holistic Care:

What are the 2 kinds of interventions?

A
  1. Patient-focused
    - human contact, reassuring words; individualized care
  2. Family-focused
    - family kept informed + with patients as much as possible; verbalization encouraged
21
Q

What is compassion fatigue?

A

Combi of physical, emotional, and spiritual depletion assoc with caring for pts in significant emotional pain and physical distress

TLDR: too much care affects u

22
Q

What is the function of the Critical Incident Stress Management team?

A

They allow ppl the chance to cope with the stressful event they experienced via 3 steps

23
Q

What are the 3 steps to cope in CISM?

A
  1. Defusing: rendered immediately after
  2. Debriefing: after 1-10 days
  3. Follow-up: after 10 days; could also be after months

During these sessions, HCW expresses their feelings about the incident they experienced

24
Q

In discharge planning, METHODS stands for?

A
  • Medications
  • Exercise
  • Treatment
  • Hygiene
  • Out-patient
  • Diet
  • Sleep, Sexuality, Spirituality
25
Q

What’s the difference between EMTs and Paramedics?

A

EMT: Emergency Medical Technicians; BLS certified, 200h training, prereq to paramed
PARAMEDICS: ACLS certified; >1k hrs training, includes ET insertion

26
Q

Assessment + Intervention should be done rapidly in less than ?

A

5 minutes

27
Q

Primary Survey involves?

A
  • Airway / Cervical Spine
  • Breathing
  • Circulation
  • Disability
  • Exposure
28
Q

If GCS < 8, what does it mean and what should we do?

A
  • Severe condition
  • ET intubation, mech vent

Note: GCS 3 = coma

29
Q

What size of catheters are used to facilitate fluid resuscitation or blood transfusion?

A

g20 or g18

For bolus of fluids or blood transfusion

30
Q

AVPU is?

A
  • Alert
  • Verbal
  • Pain (does pt respond to painful stimuli ONLY?)
  • Unresponsive (to all stimuli? Incl. pain?
31
Q

How do you prevent hypothermia?

A
  • Blankets
  • Heat lamps
  • Infusion warm IVF
32
Q

Meaning of “SAMPLE” history mnemonic?

A
  • S/sx
  • Allergies
  • Medications
  • Past med history
  • Last food/liquid
  • Events
33
Q

Triage Acuity System includes:

A
  1. Emergent - continuous assessment
  2. Urgent - q30m
  3. Non urgent - q1-2h
34
Q

What are the ESI levels:

A

1: x immediate life saving intervention
2: high risk, disoriented, severe pain, vitals in danger zone
3: requires multiple resources to stabilize pt, but vitals are not in danger zone
4: one resource needed to stabilize pt
5: doesn’t require any resources to be stabilized

35
Q

Canadian Triage and Acuity Scale levels:

A
  1. Resuscitation: immediate, continuous nursing surveillance
  2. Emergent: q<15mins
  3. Urgent: q<30mins
  4. Less urgent: q<60 mins
  5. Nonurgent: q<120 mins
36
Q

4-tiered hospital model triage (Berber, 2005) includes:

A
  1. Emergent: seen + treated agad; threat to life/limb
  2. Urgent: threat doesn’t exist atm; treated w/i 30 mins to 1 hour
  3. Nonurgent: no threat; doesnt req immediate treatment; treated w/i 2-24 hrs
  4. Fast track: simple first aid; can be referred to clinic
37
Q

Disaster Triage

A

Emergent (Class I / Red Tag): Airway compromised
Urgent (Class II / Yellow Tag): Needs tx w/i 30 mins. to 2 hrs.
Non-urgent (Class III / Green Tag): tx delayed > 2 hours
Expectant (Class IV / Black Tag): Expected and allowed to die; dead

38
Q

Mass Evacuation order?

A

Ambulatory > Wheelchair > bed bound > unit manager

39
Q

Code blue?

A

Reqs RRT

40
Q

Code Gray?

A

Dangerous person present, missing person, criminal activity

41
Q

Code red?

A

Fire, deactivated by head of security ONLY

42
Q

Code black?

A

Bioterrorism, bomb threat

43
Q

Code pink?

A

Missing child, deactivated only by head of security and dept unit manager

MS LEC MONTHLYS (7 decks)

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