NCM 118: Emergency Nursing (Lec) Emergency NSG is demanding bc of the
diversity of conditions and situations = UNIQUE
CHALLENGES or ISSUES:
one of the most challenging specialties in Legal issues: documentation of consent &
NSG privacy
Requires nurses to manage ambiguity & Occupational health and safety risk
rapid changes in pace in work. Violence of ED staff
Providing holistic care in the context of
fast-paced and technology driven
Emergency Management
environment.
Care given to Px’s with urgent & critical
Principles of Emergency Care
needs
Emergency is whatever the patient or the A. Traige; B. Assess & Intervene
family considers it to be.
A. Triage
Roles of nursing and medical
French word “trier” meaning “to sort”
management are complimentary in an
To sort Pxs in groups based on:
emergency.
o Severity of health problem
Care must be rendered without delay.
o Immediacy with these problems
much be treated.
Emergency Nurse
The word originated during the
Expert in assessing and identifying
Napoleonic war from the work of
patients’ health care problems in crisis
Dominique Chin Laring.
situations.
Further used on WWI by French doctors
Establishes priorities
treating on the battle field, wound station
Monitors acutely ill and injured Pxs
behind the front and dividing the
Supports and attends to families
wounded into (3) three:
Supervises allied health personnel
o Unlikely to live regardless of what
Teaches Pxs and families within a time-
care
limited, high-pressured care environment.
o Likely to live regardless of what
NSG interventions: are achieved
care
interdependently that’s ordered by a
o Immediate care
physician or advanced practitioner.
Seek Emergency Care for: Objectives of Triage
1. Cardiac Dysrhythmias 1. Ensure early recognition & assessment &
2. Acute coronary syndrome prioritize
3. Acute heart failure 2. Reduce unnecessary delay
4. Pulmonary edema 3. Give brief First-Aid advice
5. Stroke 4. Initiate immediate Diagnostic tests
, 5. Allow effective utilization of staff & III. Urgent Pxs have non-life-
resources threatening
6. Relieve congestion & confusion conditions but require
7. Improve patient-staff relationship 2 or more resources to
8. Immediare interview w/ Px provide care.
9. Enable direct communication (sedation)
10. Provide documentation (Px’s condition,
time of triage, prelim treatment) If it drops abnormally
11. To produce staff training & decision the it may need up
making triaging emergent
IV. Nonurgent Non-life threatening
Basic Triage System (Berner, 2005) and need 1 resource
A. Emergent to provide for their
Highest prio needs
Life-trethening conditions V. Minor Have no life-
Must be seen immediately threatening
conditions an likely
B. Urgent require NO resource.
Has serious health problems but not Assists the triage nurse more precisely
immediately life-threatening determine the needs of Px and urgency of
Must be seen within 1 hr the condition
Used worldwide (US, UK, Australia, and
C. Non-urgent Canada)
Episodic illness Resources:
Can be address within 24hrs without o Imaging
increased morbidity o IV/IM meds
o Invasive procedure
Comprehensive Triage System
5-Level System Triage is an Advance Skill
I. Resuscitation need tx immediately 1. Proper classification of different illnesses
to prevent death. 2. Follow protocols to initiate lab studies
II. Emergent Pxs may deteriorate 3. Develop collaborative protocols
rapidly & develop 4. Collect additional crucial baseline data
major life-thretening
situation of require
time-sensitive
treatment
diversity of conditions and situations = UNIQUE
CHALLENGES or ISSUES:
one of the most challenging specialties in Legal issues: documentation of consent &
NSG privacy
Requires nurses to manage ambiguity & Occupational health and safety risk
rapid changes in pace in work. Violence of ED staff
Providing holistic care in the context of
fast-paced and technology driven
Emergency Management
environment.
Care given to Px’s with urgent & critical
Principles of Emergency Care
needs
Emergency is whatever the patient or the A. Traige; B. Assess & Intervene
family considers it to be.
A. Triage
Roles of nursing and medical
French word “trier” meaning “to sort”
management are complimentary in an
To sort Pxs in groups based on:
emergency.
o Severity of health problem
Care must be rendered without delay.
o Immediacy with these problems
much be treated.
Emergency Nurse
The word originated during the
Expert in assessing and identifying
Napoleonic war from the work of
patients’ health care problems in crisis
Dominique Chin Laring.
situations.
Further used on WWI by French doctors
Establishes priorities
treating on the battle field, wound station
Monitors acutely ill and injured Pxs
behind the front and dividing the
Supports and attends to families
wounded into (3) three:
Supervises allied health personnel
o Unlikely to live regardless of what
Teaches Pxs and families within a time-
care
limited, high-pressured care environment.
o Likely to live regardless of what
NSG interventions: are achieved
care
interdependently that’s ordered by a
o Immediate care
physician or advanced practitioner.
Seek Emergency Care for: Objectives of Triage
1. Cardiac Dysrhythmias 1. Ensure early recognition & assessment &
2. Acute coronary syndrome prioritize
3. Acute heart failure 2. Reduce unnecessary delay
4. Pulmonary edema 3. Give brief First-Aid advice
5. Stroke 4. Initiate immediate Diagnostic tests
, 5. Allow effective utilization of staff & III. Urgent Pxs have non-life-
resources threatening
6. Relieve congestion & confusion conditions but require
7. Improve patient-staff relationship 2 or more resources to
8. Immediare interview w/ Px provide care.
9. Enable direct communication (sedation)
10. Provide documentation (Px’s condition,
time of triage, prelim treatment) If it drops abnormally
11. To produce staff training & decision the it may need up
making triaging emergent
IV. Nonurgent Non-life threatening
Basic Triage System (Berner, 2005) and need 1 resource
A. Emergent to provide for their
Highest prio needs
Life-trethening conditions V. Minor Have no life-
Must be seen immediately threatening
conditions an likely
B. Urgent require NO resource.
Has serious health problems but not Assists the triage nurse more precisely
immediately life-threatening determine the needs of Px and urgency of
Must be seen within 1 hr the condition
Used worldwide (US, UK, Australia, and
C. Non-urgent Canada)
Episodic illness Resources:
Can be address within 24hrs without o Imaging
increased morbidity o IV/IM meds
o Invasive procedure
Comprehensive Triage System
5-Level System Triage is an Advance Skill
I. Resuscitation need tx immediately 1. Proper classification of different illnesses
to prevent death. 2. Follow protocols to initiate lab studies
II. Emergent Pxs may deteriorate 3. Develop collaborative protocols
rapidly & develop 4. Collect additional crucial baseline data
major life-thretening
situation of require
time-sensitive
treatment