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Flashcards in Introduction Deck (29):
1

Approach to the Emergency Patient

Pressures of time and volume
Variety of conditions faced
Paucity of information available
Limitation of therapeutic options
Constraints of disposition

2

Pressures of Time and Volume

Turbulent flow
Treat first, ask questions later
May have 15 minutes total with each patient
Be aware of priorities among patients

3

Variety of Conditions

Be ready to shift domains rapidly

4

Paucity of Information

Old records unavailable
Poor historians or unable to speak and family unavailable
Information gathering limited

5

Limited Therapeutic Options

Provide symptomatic treatment
Tolerance for mistakes is very low
"Treat and street"

6

Constraints of Disposition Components

Sick or not?
Treat or not?
Admit or discharge?

7

Bedside Evaluation

Build working relationship with patient
Get on patient's level
Think aloud
Listen to your patient, don't interrupt
Watch out for the helpful family member

8

3 Options of Patient Disposition

Admit
Discharge
Transfer

9

3 Common Pitfalls to the Approach of the Emergency Patient

Tunnel vision
Inability to see "forest for the individual trees"
Failure to attend to the patient

10

Define Triage

To sort or choose

11

Define Disaster Triage

Where casualties overwhelm the ability to provide care

12

Routine ED Triage

Goal is to sort according to priorities of medical need

13

4 Categories in Disaster Triage

Immediate
Delayed
Minimal
Expectant

14

Describe the Immediate Category in Disaster Triage

Life threat that is easily addressed

15

Describe the Delayed Category in Disaster Triage

Patient can wait without risk

16

Describe the Minimal Category in Disaster Triage

Patient requires little intervention

17

Describe the Expectant Category in Disaster Triage

Patient will likely die with or without any interventions

18

Goals of Routine ED Triage

Define and classify urgency based on complaint and presentation
Ensure patient safety
Facilitate care and flow through ED
Satisfy legal requirements for "screening"

19

5 Levels of Routine ED Triage

Immediate
Very urgent
Urgent
Semi-urgent
Non-urgent

20

Describe Immediate or Level 1 of ED Triage

Complaint or condition requires immediate assessment and intervention
ANY delay represents unacceptable risk

21

Examples of Immediate or Level 1 Status

Cardiac arrest
Anaphylaxis
Compromised airway

22

Describe Very Urgent or Level 2 Status of ED Triage

Complaint or condition require assessment and intervention within 10 minutes

23

Examples of Very Urgent or Level 2 Status

Chest pain
CVA
Significant bleeding
Major trauma

24

Describe Urgent or Level 3 Status in ED Triage

Complaint or condition require assessment and intervention within 30-60 minutes

25

Examples of Urgent or Level 3 Status

Toxic ingestions
Severely painful conditions
Multiple organ system involvement
Abnormal, non-emergency vital sign or test result

26

Describe Semi-Urgent or Level 4 Status in ED Triage

Complaint or condition require assessment and intervention within 1-2 hours

27

Examples of Semi-Urgent or Level 4 Status

Lacerations
Long bone fractures
Dislocations without neuromuscular compromise

28

Describe Non-Urgent or Level 5 Status in ED Triage

Complaint or condition requires assessment and intervention within 2-4 hours or longer

29

Examples of Non-Urgent or Level 5 Status

Suture removal
Wound recheck
Minor rash