Critical Care Trans Emergency Nursing NCM118 PDF

MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC vomiting or symptoms); “Nagsuka NEUROLOGIC DISORDER po ba kayo” (if not present...

MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC vomiting or symptoms); “Nagsuka NEUROLOGIC DISORDER po ba kayo” (if not present) 6. Start cardiac monitoring TOPIC OVERVIEW 7. Protect and clean wounds A. Neurologic Disorder 8. Identify significant medical a. TBI and Craniotomy history and allergies b. SCI 10. Document the findings in medical c. Spinal Shock Syndrome records. d. Neurologic Shock e. Autonomic Dysreflexia SCOPE OF EMERGENCY NURSING: ★ to provide immediate action to treat the patient A1 EMERGENCY NURSING ★ for crisis intervention ★ to treat emergency condition ★ Emergency means "urgent" or irrespective of age group "immediate" ★ to treat a wide variety of illness or ★ Concept of emergency nursing: injury situations, ranging from sore The term emergency is used for throat to a heart attack. those patients who require ★ immediate action to prevent further deteriorations or stabilizing SCOPE AND PRACTICE OF the condition toll the availability of EMERGENCY NURSING: the services close to the patients. ★ specialized education ★ expertise in assessing and PRINCIPLES OF EMERGENCY identifying patients health care NURSING: problems ★ establish priorities, monitor acutely 1. Establish a patent airway and pro ill and injured patients. ide adequate ventilation ★ Nursing interventions are 2. Control hemorrhage prevent and accomplished independently. manage shock 3. Maintain and restore effective PRINCIPLES OF EMERGENCY circulation MANAGEMENT AND EMERGENCY 4. Evaluate the neurological MEDICAL SERVICES: status.of the client. ★ Early detection 5. Carry out a rapid initial and ★ early reporting ongoing physical assessment: ★ early response “Nahihilo po ba kayo?” (If you were ★ good on scene care present when she experienced ★ care during transportation ★ transport to definitive care NCM 118 CHOCO-NOG 1  MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC patients are designed to be of GENERAL PRINCIPLES OF EMERGENCY benefit to the patient not merely to MEDICAL CARE: avoid harm. ★ Triage ★ Honesty: individual patients and ★ Primary survey using ABCD family are given honest information approach regarding progress and prognosis. ★ Airway, Breathing, Circulation and ★ Justice: equity of access rather than Disability post code services ★ Secondary survey using EFGHI approach ROLE IF EMERGENCY NURSE: 1. Exposure to environment ★ Accept without prior warning any 2. Full set of vital signs person requiring health care with undifferentiated and undiagnosed 3. Give comfort measures problem originated from social 4. History collection psychological, spiritual or cultural 5. Inspect the posterior surface factors ★ Secondary survey using AMPLE ★ Leads , initiates and coordinates approach patient care 1. Allergies ★ Rapid patient assessment and 2. Medication assimilation of information often 3. Past medical History beyond the presenting problem. ★ Allocation of priority for care. 4. Last meal ★ Intervention based on the 5. Event leading up to the incident assessment ★ Ongoing evaluation ETHICAL ASPECTS OF EMERGENCY ★ Discharge or referral to other NURSING: sources of care undertaken independently by the nurse within Ethics are involved as the boundary of what guideline. is acceptable and what is not yet EMERGENCY TROLLEY: acceptable five key of ethical principle are: ★ An emergency department e-cart, also known as a crash cart, is a ★ Respect for individual: the need to mobile medical cabinet that ensure confidentiality and privacy contains equipment and ★ Respect for the autonomy of the medications used to treat individual: the need to ensure emergencies. appropriate consent is given by the ★ Crash carts are used in a variety of patient or relatives. situations, including cardiac arrest, ★ Beneficence / nonmaleficence: the respiratory distress, and severe need to ensure that divisions allergic reactions regarding treatment for individual NCM 118 CHOCO-NOG 2  MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC CRASH CART ★ A crash cart typically contains a defibrillator and intravenous medications (such as epinephrine and atropine), plus a variety of medical supplies such as latex gloves, endotracheal tubes, Ambu bags, cannula. NCM 118 CHOCO-NOG 3  MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC Cut down tray (dehydrated patients) Cut in the branchial arch, break the vein and the vein will be seen it can also through subclavian vein. procedure is down on the bedside TRIAGE ★ It is the process by which a patient is classified according to the type and urgency of their condition to get the right patient to the right place at the right time with the right case provider. ★ Triage in an emergency department (ED) is the process of prioritizing patients based on the severity of their injuries or illnesses so that they can receive care in the most efficient order. Triage systems are used to help ensure that the most patients receive the best care when resources are limited. GOAL OF TRIAGE ★ Early patient assessment ★ Priority rating 12 PROCEDURAL TRAYS: ★ Assignment of correct area of case 1. Vital signs and infection control ★ Control of patient flow ★ Initiation of diagnostic measure ★ Initiation of emergency care ★ Patient education CATEGORIES OF TRIAGE: 1. Emergent - highest priority, condition is life threatening and 9. Catheterization tray must be attended immediately 10. Tracheostomy tray 2. Urgent - serious health problems but 11. IV Tray not immediately life threatening; 12. Newborn tray must be seen in one hour. NCM 118 CHOCO-NOG 4  MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC negative inotropes ), suppressor 3. Non-Urgent- episodic illness that must be (amlodipine) seen w/n 24 hours without increased ★ oxygen therapy morbidity TRAUMA CARE USE OF COLORS OF SEGREGATION Golden hour: the first hour after trauma is critical for survival LEVEL 1 (Red) : resuscitation - IMMEDIATE Management framework: RESUSCITATION ★ primary survey (ABCDE) LEVEL 2 (ORANGE): EMERGENT ★ Resuscitation ★ Secondary survey (detailed LEVEL 3 (YELLOW) :URGENT evaluation) LEVEL 4 (GREEN : LESS URGENT ★ Definitive care LEVEL 5 (BLUE): NON - URGENT Common injuries: ★ head trauma AIRWAY MANAGEMENT: ★ spinal injuries Techniques: ★ chest and abdominal trauma(hollow ★ head tilt chin lift or jaw thrust organs) maneuver ★ suctioning CARDIAC ARREST AND RESUSCITATION ★ advanced airway devices (e.g. ★ BLS (basic Life support) Focus on endotracheal tube, laryngeal mask CPR (30 compressions: 2 breaths) airway) and use of an automated external defibrillator (AED) Equipment: ★ ALS (Advanced life support) ★ Bag valve mask (BVM), suctioning ★ Administration of emergency drugs device and intubation set. (e.g. epinephrine and amiodarone) ★ defibrillation for shockable rhythms SHOCK MANAGEMENT: (VF, pulseless VT) Types: ★ Hypovolemic (eg. Bleeding) POST CARDIAC ARREST CARE: ★ Cardiogenic (heart failure) ★ Targeted temperature management, ★ Distributive (sepsis, anaphylaxis) oxygenation and blood pressure ★ Obstructive (pulmonary embolism) Key emergency conditions: Interventions: 1. Acute Coronary Syndrome (ACS) ★ IV fluid resuscitation (PNSS) Symptoms: chest pain, shortness of breath, ★ vasopressors(Enhances variant diaphoresis waves) or inotropes (positive & NCM 118 CHOCO-NOG 5  MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC EMERGENCY MEDICATIONS AND Intervention: MONA(morphine, oxygen, EQUIPMENTS: nitroglycerin and aspirin). ECG monitoring, thrombolytics or percutaneous coronary Medications: intervention (PCI) ★ Epinephrine: For cardiac arrest and anaphylaxis 2. Stroke (CVA) ★ Atropine: For bradycardia Types: Ischemic or hemorrhagic ★ Naloxone: For opioid overdose Assessment: FAST(face drooping, arm ★ Nitroglycerin: For chest pain weakness, speech difficulty, time to call 911) ★ Albuterol: For asthma exacerbation Management: Thrombolysis for ishemic stroke (if within 4.5 hours). Equipment: Upportive care for hemorrhagic ★ Defibrillator/AED stroke. ★ Portable oxygen cylinders ★ Trauma kits 3. Sepsis ★ Monitoring devices (ECG, pulse oximeter) Signs: Fever, tachycardia, hypotension, altered mental state Management: Early antibiotics, fluid CASE STUDY 1: Hypovolemic Shock Due resuscitation vasopressors if needed. to Dengue Hemorrhagic Fever Common bacteria : streptoco A 7- year-old boy is brought to the emergency room by his parents. He has had a high fever for four days, abdominal pain, 4. Anaphylaxis and episodes of vomiting. His blood Symptoms: Urticaria, airway obstruction, pressure is 70/50 mmHg, HR is 130 bpm, hypotension and capillary refill time is delayed (>4 Interventions: Epinephrine IM, seconds). His extremities are cold and antihistamines, steroids oxygen, and IV clammy. Laboratory tests reveal fluids thrombocytopenia and elevated hematocrit levels. 5. Burns Assessment: Rule of Nines for estimating CASE STUDY 2: Polytrauma Following a total body surface area (TBSA) Vehicular Accident Management: Stop the burning process, A 45-year-old male arrives at the ER after a fluid jeepney collision. He is semi-conscious, with resuscitation (Parkland formula), wound a large laceration on his forehead, a care. suspected fracture in his left femur, and a bruised chest. His vitals are as follows: BP- 90/60 mmHg, HR- 120 bpm, RR- 28 cpm, SPO2- 88% NCM 118 CHOCO-NOG 6  MEDICAL SURGICAL NURSING SSCTI | BSN 4-A | EMERGENCY NURSING 1ST SEMESTER | LONG QUIZ 2 TOPIC CASE STUDY 3: Mass Casualty Incident (Earthquake Scenario) An earthquake struck a nearby brgy., resulting in multiple casualties. The ER is overwhelmed with patients, including: Patient A: A 30-year-old woman with a fractured arm and stable vital signs Patient B: A 60-year-old man with shallow breathing and weak pulse Patient C: A 5-year-old child who is unresponsive and has no pulse NCM 118 CHOCO-NOG 7