Emergency/ Trauma Flashcards
a sudden illness or injury that is perceived to be a crisis threatening the physical or psychological well being of a person and continues until the condition is stabilized
emergency
a nurse that evaluates the patient, to decide if they are stable enough to go home or if they need to be inpatient in facility
Psychiatric Nurse
system of sorting & classifying patients into priority levels according to illness or injury severity so that highest acuity patients get soonest evaluation, treatment, and prioritized resource utilization
triage
the most important step in the ER
triage
condition that condition must be treated immediately otherwise, life/limb/vision is threatened
emergent
condition that requires treatment quickly but an immediate threat to life dose not exist at the moment
urgent
condition client that requires evaluation and possible treatment but time is not a critical factor
non-urgent
Examples of Emergent Conditions
- Chest pain with diaphoresis
- Respiratory distress
- Active hemorrhage
- Unstable vital signs
- Temperature of 103.5º F or greater
Examples of Urgent Conditions
- Severe abdominal pain
- Renal colic (kidney stones)
- Displaced or multiple fractures
- Complex or multiple soft tissue injuries
- New-onset respiratory infection, especially pneumonia in older adults
- Temperature of 101º to 103.4º F
Examples of Non-urgent Conditions
- Skin rash
- Strains and sprains with good pulses
- “Colds”
- Simple fracture
- Temperature less than 101º F degree
Education materials & instructions must be at a _______ reading level.
6th grade
Medical Examiner is present for:
- Homicide/Suicide
- Suspicious Deaths
- Deaths caused by accidents
- Death during/after surgery
- Death associated with weapons
- Death involving a crime
- Stillbirths
- Death related to drugs
For Medical Examiner Case, leave all _________ in the body.
IV & tubes
For Medical Examiner Case, place clothing in a _________.
paper bag
type of nursing that encompasses the continuum of care from injury prevention and pre-hospital services, to acute care, rehabilitation, and, ultimately, community reintegration
Trauma Nursing
Level of Trauma Center that is usually located in large teaching hospital systems in densely populated areas that provides full continuum of trauma care for all patients in every aspect of injury, from prevention through rehabilitation and offers professional and community education programs, conduct research, and participate in system planning.
Level I
Level of Trauma Center located in community hospitals that provides care to most injured patients & advanced surgical care and plays a significant leadership role in injury management, education, prevention, and emergency preparedness planning and often transports patients to higher trauma center levels if patient needs exceed resource capabilities.
Level II
Level of Trauma Center located in community hospitals that stabilizes patients with major injuries with orthopedic and general surgeons and often transports patients to higher trauma center levels if patient needs exceed resource capabilities.
Level III
Level of Trauma Center located in rural and remote areas that provides advanced life support and transports to higher trauma center levels when able
Level IV
In trauma, assess for DCAP, BLS and TIC =
Deformity
Contusions
Abrasions
Punctures/Paradoxical movement
Burns
Lacerations
Swelling
Tenderness
Instability
Crepitus
Treatment for Crush Injury
- Wrap amputated part in saline gauze
- Do not clean or disinfect
- X=Ray
- Immerse in saline or saline & betadine
- Prepare for surgery
Primary Survey & Order of Approach for Trauma Patients
A-Airway/Cervical Spine
B-Breathing
C-Circulation
D-Disability
E-Exposure
Secondary Survery for Trauma Patients
systemic head to toe assessment
All trauma patients should receive ______.
oxygen!
For trauma patient who is spontaneously breathing, give oxygen via __________.
100% Non Rebreather Mask
For trauma patient who needs ventilation assistance, give oxygen via _______________.
Bag, Valve, Mask Ventilation
To position for an open airway, you should use the __________ method.
jaw thrust
Symptoms of Pneumothorax
- Decreased or absent breath sounds over the affected side
- Respiratory distress
- Hypotension
- Jugular vein distention
- Tracheal deviation (late symptom)
Threats to Circulation (which all lead to shock)
- cardiac arrest
- myocardial dysfunction
- hemorrhage
Radial pulse is palpable at _____ mmHg systolic.
80
Femoral pulse is palpable at _____ mmHg systolic.
70
Carotid pulse is palpable at _____ mmHg systolic.
60
By the time _________ occurs, compensatory mechanisms used by the body in an attempt to maintain vital signs in a shock state have been exhausted.
hypotension
IV Access in a trauma should be at least ____ gauge in the _____.
16; AC
In a trauma, resuscitation fluids are _______.
warmed
During the “Disability” phase of trauma management, evaluate LOC for A.P.V.U.=
- A-Alert
- V- responsive to Voice
- P- responsive to Pain
- U-Unresponsive
Frequent Reassessment of LOC is needed in these situations:
- Metabolic abnormalities
- Hypoxia
- Neurologic injuries
- Drugs/alcohol
Glasgow Coma Scale for Eye Opening:
spontaneously = 4
to speech = 3
to pain = 2
none = 1
Glasgow Coma Scale for Verbal Response:
Orientated = 5
Confused = 4
Inappropriate = 3
Incomprehensible = 2
None = 1
Glasgow Coma Scale for Motor Response
obeys commands = 6
localises to pain = 5
withdraws from pain = 4
flexion to pain = 3
extension to pain = 2
none = 1
General causes of reduced LOC. Remember AEIOU-TIPS.
- A Alcohol
- E Epilepsy
- I Insulin
- O Overdose
- U Uremia
- T Trauma
- I Infection
- P Poisoning, Psychological
- S Sepsis
When cutting clothing, cut in the ______.
center
body temperature < or = to 97º F
hypothermia
Effects of Hypothermia
- Vasoconstriction
- Difficulty with venous & arterial assessment (blood draw)
- Increased bleeding
- Slowed drug metabolism
For secondary assessment, remember A.M.P.L.E.
A – Allergies
M – Meds: Rx, OTC (used and not used)
P – Past medical/ surgical history
L – Last meal, Last menstrual period
E – Events preceding emergency and any care