Wednesday, August 8, 2012

Emergency Nursing - Overview

Emergency Nursing
  • Assessment, diagnosis and treatment of perceived actual or potential, sudden or urgent, physical or psychological problem that is primarily acute or episodic
  • Requires minimal care or life-support measures, education of patient and significant other, appropriate referrals and knowledge of legal implications
The principles of emergency care of any patient are based on the following objectives:
  • Establish a patent airway and provide adequate ventilation – employ resuscitation measures when necessary – protect the cervical spine first and assess for chest injuries with subsequent airway obstruction and ventilator impairment
  • Evaluate, maintain and restore circulatory function
  • Determine patient’s ability to follow commands
  • Carry out rapid initial and on-going physical examination
  • Start cardiac monitoring
  • Splint any suspected fractures
  • Protect and clean wounds, apply sterile dressing
  • Identify allergies and significant medical history
  • Document and record patient’s condition to guide in decision making
Special Considerations for Emergency Nursing
  • Data collection
    • Time of incident
    • Place of incident
    • Nature of incident
  • Infection control – adhere to standard precaution
  • Individualized discharge planning
  • Psychological support – act confidently/competently
  • Documentation – careful monitoring and treatment should be well documented
Priority Emergency Measures
  • Establishing Airway
    • Hypoxia produce permanent brain damage / cell death within 5 minutes
  • Control hemorrhage
    • Direct pressure, check pressure points
    • Elevate/immobilize injured extremity
  • Control Shock
    • Restore circulating volume
    • Start peripheral line
    • Monitor arterial blood gas
    • Monitor central venous pressure
    • Insert catheter
    • Pharmacologic therapy
Goals of Emergency Nursing
  1. Provide emergency care to patients as quickly as possible
  2. Assure that the right client arrives at the right hospital in the soonest possible time
Focus of Emergency Nursing
  • To preserve life
  • Prevent deterioration before definitive treatment can be given
  • Restore the patient to useful living
  • The nurse must be prepared to provide care to clients of all age groups who may have any possible illness or injury
  • Must have understanding of almost all diseases/ illnesses specific to any age group

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