13.1 Essentials of Emergency and Trauma Nursing

Question 1

Emergency Nursing

Answer 1

• An emergency is whatever the patient and family considers to be an emergency.

Question 2

Sentinel Events

Answer 2

• Medical Errors

Interventions in case of these events
- Patient/Family Focused
- Relieve anxiety and provide security
- Allow family to stay with patient
- Provide explanations and information

Question 3

Triage

Answer 3

• Sorts patients by hierarchy of severity of health problems

ED Triage
- Those are most critically ill receive the most resources regardless of outcome

Disaster Triage
- Allocation of treatment priorities are designed to maximize the number of survivors.

Question 4

Basic System Categories

Answer 4

Emergent
- Highest priority

Urgent
- Serious health problem but not life threatening

Nonurgent
- Episodic Illness

Question 5

Emergency Severity Index (ESI)

Answer 5

• Level 1 - MOST URGENT
• Level 5 - Least Urgent
• Although this is a reliable system, triage bypass, or moving an incoming patient directly to an open bed when available helps to eliminate patient waiting and allow nurses to preform initial assessment and vital signs.

Question 6

Triage Team

Answer 6

• Has the power to move patients to diagnostics or discharge patient without full admission to ED.
• This decreases wait time in the ED
• Patient flow issues are due to availability of in-house beds.
• ED must be efficient to decrease wait time and maintain flow.

Question 7

Primary Survey

Answer 7

• Focuses on stabilizing life threatening conditions

A - Airway
B - Breathing (ventilation)
C - Circulation (cardiac output, hemorrhage, shock)
D - Disability (neurological status, AVPU (alert, verbal, pain, unresponsive))
E - Exposure (Undress to assess wounds or area of injury)

Question 8

Secondary Survey

Answer 8

• Health History
• Head to Toe (reassess vs, airway, breathing)
• Diagnostic’s and labs
• Monitoring devices (ECG, arterial lines, urinary catheters)
• Splinting of fractures
• Wound care
• Other interventions based on condition

Question 9

Priority Emergency Measures

Answer 9

1. Airway obstruction
2. Hemorrhage
3. Hypovolemic shock
4. Wounds
5. Trauma/Multiple Trauma

Question 10

PPE

Answer 10

Level A
- Self-contained breathing apparatus (SCBA) and vapor-tight chemical-resistant suit, gloves and boots

Level B
- High level respiratory protection (SCBA) but lesser skin and eye protection; chemical resistant suit

Level C
- Air-purified respiratory, coverall with splash hood, chemical resistant gloves and boots

Level D
- Typical work uniform