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Foundations of ED Nursing

Foundations of ED Nursing

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Foundations of ED Nursing

  1. 1. Foundations of ED Nursing Overview EMS Culture
  2. 2. What it takes <ul><li>Multi-tasking </li></ul><ul><li>Stress handling </li></ul><ul><li>Competent </li></ul><ul><li>Quick thinking </li></ul><ul><li>Team Player </li></ul><ul><li>Confident decision maker </li></ul><ul><li>Strong advocate for your patient </li></ul>
  3. 3. What do we do <ul><li>Witness and intervene from Birth to Death </li></ul><ul><li>Jack of all trades </li></ul><ul><li>Treat homeless to heiress </li></ul><ul><li>Stabilize and transfer </li></ul><ul><li>Broken fingernails to cardiac arrest </li></ul><ul><li>Simple fever to MASSIVE trauma </li></ul>
  4. 4. ED Nursing Positions <ul><li>Staff Nurse </li></ul><ul><li>Charge Nurse </li></ul><ul><li>Case Manager </li></ul><ul><li>Researcher </li></ul><ul><li>Flight Nurse </li></ul><ul><li>Pre-Hospital </li></ul><ul><li>Nurse Practitioner </li></ul>
  5. 5. ED Flow
  6. 6. ESI Triage Score Sheet
  7. 7. Case Example (Triage) <ul><li>50 y.o Male with Chest Pain </li></ul><ul><li>20 y.o Female with chest pain </li></ul><ul><li>3 week old with fever </li></ul><ul><li>37 y.o with suicidal ideation </li></ul>
  8. 8. EMTALA <ul><li>Emergency Medical Treatment and Active Labor Act </li></ul><ul><li>All patient must have medical screening exam regardless of ability to pay </li></ul><ul><li>“ NO ONE CAN BE TURNED AWAY” </li></ul>
  9. 9. EMS System (Brief Overview) ED care initiated
  10. 10. EMS Types <ul><li>Ground Transport </li></ul><ul><ul><li>Ambulance </li></ul></ul><ul><li>Air Transport </li></ul><ul><ul><li>Air Evac, </li></ul></ul><ul><li>Transfers </li></ul><ul><ul><li>Ground or Air </li></ul></ul>
  11. 11. Things to think about with EMS <ul><li>Usually limited information </li></ul><ul><li>See it before you believe it </li></ul><ul><li>Prepare for the worst </li></ul><ul><li>Test ALL THE IV’s </li></ul><ul><li>Act quickly, work as a team. </li></ul>
  12. 12. ED patient Assessment <ul><li>Focused </li></ul><ul><ul><li>But complete </li></ul></ul><ul><li>History means everything </li></ul><ul><li>Get the story </li></ul><ul><ul><li>It tells you a lot </li></ul></ul>
  13. 13. ABCDEFGHI <ul><li>An easy way to prioritize assessment in the ED </li></ul><ul><ul><li>We will go more in depth in TRAUMA </li></ul></ul>
  14. 14. Team Work <ul><li>MD- Nurse working relationship </li></ul><ul><ul><li>Trust is key </li></ul></ul><ul><ul><li>Know your stuff </li></ul></ul><ul><li>Tech- nurse </li></ul><ul><ul><li>Don’t over delegate </li></ul></ul><ul><ul><li>Use their expertise </li></ul></ul><ul><ul><li>Check their work </li></ul></ul><ul><li>Nurse-Nurse </li></ul><ul><ul><li>Trust is Key </li></ul></ul><ul><ul><li>Know your teams strengths and weaknesses </li></ul></ul><ul><ul><li>Work together </li></ul></ul>
  15. 15. Patient Cultural Considerations <ul><li>Essential to understand culture </li></ul><ul><ul><li>Quick emergent interventions depend on this knowledge </li></ul></ul><ul><li>Talk to the family, but get an interpreter </li></ul><ul><ul><li>Hear the story from the patients mouth </li></ul></ul><ul><li>Different treatments at home </li></ul><ul><ul><li>Herbs/blessings </li></ul></ul>
  16. 16. Course organization <ul><li>Top complaints in each system </li></ul><ul><li>Top interventions for each complaint </li></ul><ul><li>Nursing considerations </li></ul><ul><li>Quiz </li></ul>

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