Download - Foundations of ED Nursing
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Foundations of ED Nursing
OverviewEMS
Culture
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What it takes
• Multi-tasking• Stress handling• Competent• Quick thinking• Team Player• Confident decision maker• Strong advocate for your patient
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What do we do
• Witness and intervene from Birth to Death• Jack of all trades• Treat homeless to heiress• Stabilize and transfer• Broken fingernails to cardiac arrest• Simple fever to MASSIVE trauma
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ED Nursing Positions
• Staff Nurse• Charge Nurse• Case Manager• Researcher• Flight Nurse• Pre-Hospital• Nurse Practitioner
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ED Flow
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ESI Triage Score Sheet
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Case Example (Triage)
• 50 y.o Male with Chest Pain
• 20 y.o Female with chest pain
• 3 week old with fever
• 37 y.o with suicidal ideation
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EMTALA
• Emergency Medical Treatment and Active Labor Act
• All patient must have medical screening exam regardless of ability to pay
• “NO ONE CAN BE TURNED AWAY”
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EMS System (Brief Overview)
ED care initiated
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EMS Types
• Ground Transport– Ambulance
• Air Transport– Air Evac,
• Transfers– Ground or Air
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Things to think about with EMS
• Usually limited information• See it before you believe it• Prepare for the worst• Test ALL THE IV’s• Act quickly, work as a team.
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ED patient Assessment
• Focused– But complete
• History means everything• Get the story– It tells you a lot
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ABCDEFGHI
• An easy way to prioritize assessment in the ED– We will go more in depth in TRAUMA
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Team Work• MD- Nurse working relationship– Trust is key– Know your stuff
• Tech- nurse – Don’t over delegate– Use their expertise– Check their work
• Nurse-Nurse– Trust is Key– Know your teams strengths and weaknesses– Work together
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Patient Cultural Considerations
• Essential to understand culture– Quick emergent interventions depend on this
knowledge
• Talk to the family, but get an interpreter– Hear the story from the patients mouth
• Different treatments at home– Herbs/blessings
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Course organization
• Top complaints in each system• Top interventions for each complaint• Nursing considerations• Quiz