Test 5 Emergency Shi Flashcards
(22 cards)
Primary survey for emergency
A- Airway
B- Breathing
C- Circulation
D- Disability ; determine neruologic status , AVPU mnemonic (alert, verbal, pain, unresponsive)
E- Exposure : undress to assess wounds or injuries
Secondary survey for emergency
Health history
Head to toe assessment
Labs
ECG
Splinting fractures
Wound care
Priorities of care for pt with multiple trauma
Mult trauma: Single catastrophic event that causes life threatening injuries to at least 2 organs
Assume cervical spine injury
Management of pt with intraabdominal injuries
Ensure abc’s
Immobilize cervical spine
Continually monitor the patient
Document woounds
If viscera are protruding, cover with sterile slaine gauze
Hold oral fluids
NG tube to aspirate stomach contents
Tetanus and antibiotic prophylaxis
Crush injury complications
Hypovolemic shock
Spinal cord injury
Erythema and blistering
Fractures
Acute kidney injury
Heat stroke
Failure of heat regulating mechanisms
Nonexternal: Prolonged exposure to environmental temp (102.5)
Exertional: Caused by strenous activity
Manifestations: CNS dysfunction, elevated temp 105, hot skin, tachypnea, hypotensiojn, tachycardia
Management of heat stroke
Reduce temp as quick as possible
Coolionig methods
* Cool sheets, towels, sponges
* Ice to neck, groin, chest
* Cool blanket
* Immersion in cold water bath
Monitor temp, Vital, ECG, I and O
IV fluids
Hypothermia
Internal core temp of 35 celcius or less
Older mf’s, infants, ppl with illeness, hoemless, trauma victims at risk
Alc ingestion icreases susceptibility
May be seen with frostbite, treat hypothermia first
Management of hypothermia
Use ABC
Remove wet clothes, rewarm
Rewarming
*Active core rewarming: Cardiopulmonary bypass, warm fluid administration, warm humidified oxygen
* Passive external rewarming: Warm blankets and over head heater
Cold blood returning has high levels of lactic acid and can cause cardiac problems and electrolye problems
Assessment of ingested poison
ABC
Vitals, LOC, ECG
Labs
Determine what, when , and how much was ingested
Signs and symptoms of poisoning and tissue damage
Age and weight
Management of ingested poison
Use of emetics
Gastric lavage
Activated charcoal
Cathartic when appropriate
Corrosive agents like acids and alkaline cause tissue damage. Do not induce vomiting with corrosive agents
Management of carbon monoxide poisoning
Get fresh air
CPR
Administer oxygen ; 100% or oxygen under hyperbaric pressire
Managemnt of patient with Chemical Burns ?
Immediately flush the skin with running water from shower, house, or faucet
Lye or white phosphorus should be brushed off the skin dry
Determine the substance
Management of pt with food poisoning
ABC’s and supportive measures
Food poisoning, such as botulism or fish poisoning, may result in resp paralysis and death
Treat fluid and electrolyte imbalances
Control nausea and vomiting
Clear liquid diet and progression of diet after nausea and vomiting subsides
Management of patient with drug overdose
Support resp and cardio fx
Enhance clearance of agent
Provide safety and staff
IV users high risk for HIV, Hep B and C, tetanus
Managment of Pt with acute alcohol intoxication
Maintain airway and observe for CNS depression and hypotension
Rule out other potential causes of the behaviors before it is assumed the pt intoxicated
Use nonjudgemental calm manner
May need sedation if noisy or belligerent
Examine for withdrawel delirium, injuries, and evidence of other disorders
Management of pt with SA
Provide support
Reduce emotional trauma
Gather evidence for legal shi
Physical exam
Specimen collection
Treating consequences: STI, preg
Human trafficking
Common behaviors: Cowering, frightened, agitated, deferring to the person accompanying them
Common complaint: Injuries, poor healing, abd pain, dizziness, headaches, rashes or sores
Behaviors: addiction, panic attacks, impulse control, hostility, suicide
Nurse interventions for human trafficking
Use targeted, appropriate questions:
* Are you in control of your own money?
* Are you able to come and go as you please
* Who is the person accompanying you
Psychiatric Emergencies
Overactive patients, violent behavior, underactive, depressed pt’s
Management:
* Maintain safety of everyone
* Determine if pt is at risk of harming themself or any other
* Maintain person self esteem while providing care
* Determine if person has a psychiatric history or is currently under xare to contact that therapist
PPE categories
A: Self contained breathing apparatus and vapor tight chemical resistant suit, gloves, and boots
B: High level of respiratory protection but lesser skin and eye protection ; chemical resistant suit
C: Air purified respirator, cover with splash hood, chemical resistant gloves and boots
D: Typical work uniform
