Foundations of ED Nursing

OverviewEMS

Culture

What it takes

• Multi-tasking• Stress handling• Competent• Quick thinking• Team Player• Confident decision maker• Strong advocate for your patient

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

ED Nursing Positions

• Staff Nurse• Charge Nurse• Case Manager• Researcher• Flight Nurse• Pre-Hospital• Nurse Practitioner

ED Flow

ESI Triage Score Sheet

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

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”

EMS System (Brief Overview)

ED care initiated

EMS Types

• Ground Transport– Ambulance

• Air Transport– Air Evac,

• Transfers– Ground or Air

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.

ED patient Assessment

• Focused– But complete

• History means everything• Get the story– It tells you a lot

ABCDEFGHI

• An easy way to prioritize assessment in the ED– We will go more in depth in TRAUMA

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

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

Course organization

• Top complaints in each system• Top interventions for each complaint• Nursing considerations• Quiz