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nursing in emergency ppt for nursing students
- 1. NURSING IN EMERGENC Y Ms. Shivanidhasmana Assistant professor DIMS
- 2. INTRODUCTIO N The term ‘Emergency’is used for those patients who require immediate action to prevent further deterioration or stabilizing the condition.
- 3. •The emergency management traditionally refersto care given to patients with urgent and critical needs.
- 4. •The emergency nursehas had specialized education, training, experience and expertise in assessing and identifying patient health care problems in crises situation.
- 5. The emergency nurseestablishes priorities, monitors and continuously assess patient who are acutely I’ll and injured. Emergency nurses also deals with non emergency populations that present with non-life threatening issues as well pt that present to the emergency department may range from birth to geriatric.
- 6. •Large number ofpeople seek emergency care for seriouslife threatening conditions such as: • Cardiac Dysrhythmia. • Acute heart failure. • Acute coronary syndrome.
- 7. • Pulmonary edema •Stroke
- 8. PRINCIPLES OF EMERGENCY NURSING CARE: TRIAGE •Triageis the first principle of emergency care . •The word “Triage” come from the French word Trier, meaning “to sort”.
- 9. •Triage system has3 categories: 1. Emergent : had the highest priority. 2. Urgent : had serious health problem but not immediate, life-threatening one. 3. Non urgent: had episodic illness.
- 11. CATEGORY-1 / EMERGENT– (life- threatening illness). Pt needs medical care with zero delay. Conditions such as:- • Severe acute chest pain. •Major trauma. •Continuous seizures.
- 12. • Massive bleeding. •Hypotension. •Head injury with unconsciousness. Category- 2/ Urgent category:- (Potential for life threatening illness). Require careful medical evaluation and treatment
- 13. Initiated with in10 minutes. • Dyspnea • High grade fever • acute confusion Category-3: Non life threatening conditions such as-
- 14. • Chronic pain •Fever •Simplefracture to limbs •Dislocation of joints •Minor injuries.
- 17. ASSESS AND INTERVENE •Patient assignedto an urgent or higher triage category stabilization, provision of critical treatment and prompt transfer to appropriate settings ( Intensive Care Unit, Operating room, General care unit) are the priorities of emergency care.
- 18. A systematic approachto effectively establishing and treating health priorities is the :- 1. Primary Survey Approach 2. Secondary Survey Approach
- 19. PRIMARY The primary surveyfocus on stabilizing life threatening conditions. The ED staff work collaboratively and Follow ABCDE (airway,breathing,circulation,disability,exp osure) method.
- 20.
- 21. CONT... • Establish apatent airway. • Provide adequate ventilation. • Control haemorrhage,prevent and manage shock. • Maintain and restore effective circulation.
- 22. •Evaluate the neurologicalstatus of the client. Determine neurologic disability by using the Glasgow Coma Scale. • A quick neurologic assessment may be performed using the AVPU mnemonic. • A- alert. Is the pt alert and responsive?
- 23. CONT..... • V- verbal.Does the pt respond to verbal stimuli. • P- Pain. Does the pt respond only to painful stimuli? • U- unresponsive. Is the pt unresponsive to all stimuli,including pain????
- 24.
- 25. CONT.. . • Carry outrapid initial and ongoing physical assessment. • Start cardiac monitoring. • Protects and clean wounds. • Identify significant medical history and allergies. •Document the findings in medical records.
- 26. SECONDARY SURVEY APPROACH •Thisincludes the following- • Complete health history,including history of the current event. • Head to toe assessment. • Diagnostic and laboratory testing. •Insertion or application of devices. •Splitting of suspected fracture.
- 27. CONT.. . •Performance of othernecessary interventions based on the pt condition.
- 28. ISSUES IN EMERGENCYNURSING CARE •Emergency nursing is demanding because of the diversity of conditions and situations that present unique challenges. •These challenges include legal issues, occupational health and safety risk for ED staff.
- 29. DOCUMENTATION OF CONSENT AND PRIVACY •Consentto examine and treat the pt is part of the ED record to give consent for invasive procedures (eg angiography,lumbar puncture) unless he or she is unconscious or in a critical condition and unable to make decisions. If the pt is unconscious and brought to the
- 30. CONT... . to the EDwithout family or friends, this fact must be documented. Monitoring of the pt‘s condition as well as treatments and the time at which they were performed must documented.After treatment,a notation is made on the record about pt’s condition.
- 31. LIMITING EXPOSURE TO HEALTH RISKS... Becauseof increasing no. Of people infected with hepatitis, HIV ,TB, and other infectious diseases, Health care providers are at an increased risk for exposure to communicable diseases through blood, respiratory droplets or other body fluids . All emergency health care providers must
- 32. CONT.... . Strictly to standardprecautions for minimizing exposure. The re-emergent Of TB as major health problem is complicated by multidrug – resistent TB and by TB concomitant with HIV infection. Nurses in the ED are usually fitted
- 33. CONT... . With personal efficiencyparticulate air (HEPA) filter masks to use when treating pts with airborne diseases.
- 34. VIOLENCE IN THE EMERGENCY DEPARTMENT Notonly do ED staff members encounter pts who may be violent because of the effects of substance abuse, injury, or other emergencies. Pts and family waiting for assistance may emotionally volatile. Often waiting rooms are the sites where feelings of dissatisfaction fear, anger , violent.
- 35. PROVIDING HOLISTIC CARE... Patients andfamilies experiencing sudden injury or illness are often overwhelmed by anxiety because they have not had time to adapt to the crises. They experience real and terrifying fear of death,mutilation,immobilization and other assault on their personal identity and body integrity.
- 36. CONT... . Assessment of thept and family’s psychological function includes evaluating emotional expression, degree of anxiety and cognitive functioning. 1. Pt –focused Interventions 2. Family – focused Interventions.
- 37. EMERGENCY NURSING AND THECONTINUUM OF CARE... Emergency care is that the pt rapidly assessed ,treated and referred to the appropriate settings for ongoing care.ED is the temporary point on the continuum of care. Most pts who receive emergency care are discharged directly from ED to their home.
- 38. CONT... . Emergency nurses mustplan and facilitate the pt’s safe discharge and follow up care in the home and community. 1. Discharge planning. 2. Community services. 3. Gerontologic consideration. 4. Obesity considerations.