This document provides an overview of triage in emergency departments. It defines triage as a process used to assess patients' severity of injury or illness upon arrival to prioritize treatment. The document outlines several challenges emergency departments face and the goals of triage to provide appropriate care in a timely manner. It then describes common triage systems and levels (critical, semi-critical, non-critical), the roles of triage officers, and the process involving assessment, priority assignment, and initial treatment or transport. The Malaysian Triage Category is presented as an example, detailing its levels and clinical descriptions to guide triage decisions.
This document discusses different aspects of a triage system used in a hospital emergency department. It begins by defining triage and explaining the objectives of triage in an emergency setting. It then describes different levels of triage conducted, including primary and secondary triage, field triage, and hospital triage. Details are provided on how patients are categorized into different triage categories based on the urgency of their condition. The document also discusses triage tools used in field settings like START and JumpSTART triage. Overall, the document provides an overview of an emergency department's triage process and categorization of patients based on clinical need.
This document provides information on conducting pre-treatment evaluations of patients to prevent medical emergencies during dental treatment. It outlines assessing a patient's medical history, vital signs, anxiety levels, and classifying them according to ASA guidelines. The goals are to determine a patient's ability to physically and psychologically tolerate treatment, need for modifications, and necessity of medical consultation. Common medical emergencies in dentistry and their prevention through patient evaluation and emergency preparedness are also discussed.
1. Ensure ABCs - provide oxygen, IV access, and cardiac monitoring.
2. Obtain history - medications, toxins, time of ingestion. Contact pharmacy for prescription history.
3. Perform rapid physical exam - vital signs, skin exam, odor detection, mental status.
4. Consider decontamination - activated charcoal or whole bowel irrigation for ingestions.
5. Administer antidotes as needed - naloxone, cyanide kit, acetylcysteine.
6. Order labs and tox screens to identify toxin and guide management.
The document discusses various aspects of emergency medical services and trauma systems including:
1. It describes the components of a comprehensive trauma system including prehospital care, acute care facilities, specialty care facilities, interfacility transfer, and rehabilitation.
2. It discusses triage principles and methods for single victims and mass casualty incidents including field triage criteria, triage tags, and priority categories.
3. It outlines the emergency department triage process and acuity scale used in Canada to prioritize patients into five levels from resuscitation to non-urgent, based on presenting complaints and sentinel diagnoses.
This document provides information on the Malaysian Triage Category (MTC) system used in emergency departments in Malaysia. The MTC system classifies patients into three categories - Red (Critical), Yellow (Semi-Critical), and Green (Non-Critical) - based on the urgency of their condition. The Red category includes life-threatening conditions requiring treatment within 5 minutes. Yellow indicates conditions that could become life-threatening without treatment within 30 minutes. Green covers non-emergent conditions treatable within 90 minutes. Each category has further subcategories to aid in prioritizing patient flow and resource allocation in emergency departments.
This presentation on Triage and transport deals with how we should we deal with the patients who are attending the emergency department and to provide best treatment for the needy patients at appropriate time.
I hope this will be helpful to nurses, paramedics, graduate and under graduate students and emergency doctors and team.
A 6-year-old child was injured while sledding using a car hood pulled by an ATV. The child collided with a tree. Upon arrival, responders found the child with a positive level of consciousness but increased work of breathing. The remote winter location and snowing conditions complicated the response. The child was packaged for transport back to the vehicles, as the terrain prevented vehicle access to the scene.
This document discusses different aspects of a triage system used in a hospital emergency department. It begins by defining triage and explaining the objectives of triage in an emergency setting. It then describes different levels of triage conducted, including primary and secondary triage, field triage, and hospital triage. Details are provided on how patients are categorized into different triage categories based on the urgency of their condition. The document also discusses triage tools used in field settings like START and JumpSTART triage. Overall, the document provides an overview of an emergency department's triage process and categorization of patients based on clinical need.
This document provides information on conducting pre-treatment evaluations of patients to prevent medical emergencies during dental treatment. It outlines assessing a patient's medical history, vital signs, anxiety levels, and classifying them according to ASA guidelines. The goals are to determine a patient's ability to physically and psychologically tolerate treatment, need for modifications, and necessity of medical consultation. Common medical emergencies in dentistry and their prevention through patient evaluation and emergency preparedness are also discussed.
1. Ensure ABCs - provide oxygen, IV access, and cardiac monitoring.
2. Obtain history - medications, toxins, time of ingestion. Contact pharmacy for prescription history.
3. Perform rapid physical exam - vital signs, skin exam, odor detection, mental status.
4. Consider decontamination - activated charcoal or whole bowel irrigation for ingestions.
5. Administer antidotes as needed - naloxone, cyanide kit, acetylcysteine.
6. Order labs and tox screens to identify toxin and guide management.
The document discusses various aspects of emergency medical services and trauma systems including:
1. It describes the components of a comprehensive trauma system including prehospital care, acute care facilities, specialty care facilities, interfacility transfer, and rehabilitation.
2. It discusses triage principles and methods for single victims and mass casualty incidents including field triage criteria, triage tags, and priority categories.
3. It outlines the emergency department triage process and acuity scale used in Canada to prioritize patients into five levels from resuscitation to non-urgent, based on presenting complaints and sentinel diagnoses.
This document provides information on the Malaysian Triage Category (MTC) system used in emergency departments in Malaysia. The MTC system classifies patients into three categories - Red (Critical), Yellow (Semi-Critical), and Green (Non-Critical) - based on the urgency of their condition. The Red category includes life-threatening conditions requiring treatment within 5 minutes. Yellow indicates conditions that could become life-threatening without treatment within 30 minutes. Green covers non-emergent conditions treatable within 90 minutes. Each category has further subcategories to aid in prioritizing patient flow and resource allocation in emergency departments.
This presentation on Triage and transport deals with how we should we deal with the patients who are attending the emergency department and to provide best treatment for the needy patients at appropriate time.
I hope this will be helpful to nurses, paramedics, graduate and under graduate students and emergency doctors and team.
A 6-year-old child was injured while sledding using a car hood pulled by an ATV. The child collided with a tree. Upon arrival, responders found the child with a positive level of consciousness but increased work of breathing. The remote winter location and snowing conditions complicated the response. The child was packaged for transport back to the vehicles, as the terrain prevented vehicle access to the scene.
Geriatric Population. Geriatric Clinician Practice. Your Medicare, Long-Term ...Michelle Peck
Michelle Peck | Legal Nurse Consultant | Adult & Geriatric Nurse Practitioner | Health Care | Consultant | Speaker | Educator | Researcher
Enjoy your journey through this slide deck of Geriatric Population. Geriatric Clinician Practice. Your Medicare, Long-Term Care Documentation.
Imagine if writing a progress note was really as simple as the note featured on the title slide. This physician progress note style filled the charts of a 120 bed nursing facility in rural Texas. Walking down the facility hallways I observed many unstable conditions and behaviors. Staff were numb to the yelling. When I questioned about the yelling "we don't medicate behaviors" was the most popular response. I needed to be medicated after a few hours of being there. Collecting data had never been this difficult. Stable and clinical documentation now had a whole new meaning.
This month I am instructing Nurse Practitioner students on Medicare and Long-Term Care Coding and Documentation. Revising this lecture reminds me of all of the clinician types I have met during my long-term care travels.
1. Amazing Clinicians
◾ They know state and federal regulations and practice perfectly.
◾ They don't cross your path very often.
◾ When you meet them you must stop, listen and absorb all their knowledge.
2. So-So Clinicians
◾ They don't know that there are regulations on state and federal levels.
◾ They are pretty common and are doing enough with meaningful practices.
◾ When you meet them you must stop, talk and they absorb your knowledge.
3. Corner Cutters
◾ They are not doing enough and practice out of compliance.
◾ Their colleagues are also clueless, there is guilt by association.
◾ When you meet them, run in the opposite direction.
What types of geriatric clinicians are crossing your path? The documentation is very telling as to the practice type. Are they awesome, so-so, or of the corner cutter breed?
Learn it-Live it-Love it-Your path for a more informed life!
Michelle Peck | Legal Nurse | Nurse Practitioner | Health Care | Geriatric | Consultant | Speaker | Educator | Researcher
This document provides information on triage and EMTALA regulations. It discusses the following key points:
1. EMTALA requires hospitals to provide a medical screening exam and stabilizing treatment to anyone who presents with an emergency medical condition. Triage does not constitute a medical screening exam which must be done by an ED MD or PA.
2. EMTALA regulations apply to anyone seeking emergency care on hospital property, including areas within 250 yards. Hospitals can face penalties for violating EMTALA.
3. The ESI triage system categorizes patients into 5 levels based on acuity - from level 1 requiring resuscitation to level 5 for non-urgent conditions. It considers factors like life threats, resources needed
The triage protocol creates an objective process to guide healthcare professionals in making the difficult determination of how to allocate resources to critically ill adult and pediatric patients when there are not enough critical care resources for everyone.
The document discusses triage in emergency nursing. It defines triage as sorting patients based on acuity to provide the most urgent care first when resources are limited. A triage nurse must quickly identify life-threatening issues and determine each patient's priority level using standardized rating systems. The document outlines the primary and secondary assessments emergency nurses conduct to evaluate patients and identify issues requiring immediate treatment versus those that can wait. The goal of triage is to do the greatest good for the greatest number.
Deterioration of a patient can occur at any time in the patient’s journey and eventually they may need critical care intervention or worse. Hear about NHS Ayrshire & Arran’s rescue system and how their model for improvement was used to design, implement and sustain reliable care processes that facilitated a reduction in mortality rates.
Triage is the process of sorting patients based on the urgency of their condition to provide the right care to the right patient at the right time. It involves initially assessing patients at arrival to identify those needing immediate care, determine the appropriate treatment area, and avoid congestion. The goals are to treat the most severely injured first while maximizing survival in a mass casualty event. Triage categories range from resuscitation to non-urgent to ensure critical patients receive rapid medical attention. Reassessment is important as a patient's condition may deteriorate while waiting.
prevention & management of medical emergencies in dental office.pptAdirikak
This document discusses the prevention and management of medical emergencies in the dental office. It begins by emphasizing the importance of prevention through thorough patient assessment and history. It then reviews common types of emergencies seen in dental offices, which are most often altered consciousness, cardiovascular, allergic reactions, and respiratory. The document provides detailed guidance on managing specific emergencies such as adrenal crisis, airway obstruction, anaphylaxis, local anesthesia reactions, angina, and asthma. It stresses the importance of recognition, preparation, basic life support skills, and knowing when to refer patients to advanced medical care.
Triage is the term derived from the French verb trier meaning to sort or to choose
It’s the process by which patients classified according to the type and urgency of their conditions to get the Right patient to the Right place at the
Right time with the
Right care provider
Coding Lecture 2013 Zesut for learning how to codeSDanishHasan1
This document provides guidance on proper documentation for medical coding and billing. It emphasizes that documentation must support the level of service provided and justify medical decision making. Key elements discussed include a detailed history and physical exam, review of systems, past medical history, and medical decision making components. The document also provides examples of procedures and conditions that could be undercoded without thorough documentation of extent, location, complications, and clinical decision making involved. Proper documentation is crucial for accurate coding and ensuring reimbursement.
the emergency assessment to be done carefully and immediately .the emergency nurse have quick review and deliver the health carein the quality manner in all the fields of health care as medical,surgical, paediatric ,and obstertics .
02. Diagnosis and Treatment Manual author Patestos Dimitrios.pdfsarfaraz ahmed
This document is the 2016 Diagnosis and Treatment Manual from Doctors of the World Greece. It was edited by Dr. Patestos Dimitrios and represents the views and recommendations of the organization. The manual provides guidelines for health professionals to use in making treatment decisions for patients, while allowing for clinical judgment based on each individual case. It includes protocols, definitions, and summaries of diagnosis and treatment for various medical conditions like shock, seizures, and status epilepticus.
This document summarizes common clinical presentations related to mobility issues, falls, dizziness, and blackouts in elderly patients. It outlines important history, exam findings, and investigations for different causes. Specific conditions discussed include orthostatic hypotension, vertigo including benign paroxysmal positional vertigo (BPPV), and osteoporosis. The role of a multidisciplinary team in developing comprehensive management plans is emphasized. Examples are provided of potential case discussions focusing on problem lists, differential diagnoses, and coordinated care plans.
This document outlines the course content for a 9th semester differential diagnosis and clinical decision making course. It discusses topics like intro to medical screening, differential diagnosis of various body systems, the process of differential diagnosis, screening and its purpose, reasons for medical disease screening, red and yellow flags, and the physical therapist's role in disease diagnosis, prevention, and clinical reasoning. Key terms like quicker, sicker, and signed prescription in relation to medical screening are also defined. A case example demonstrates recognition of red flags that warrant physician consultation.
emergency nursing (management in emergency) pptNehaNupur8
complete information about the emergency care provided to the
patients, in emergency ward, after accident, in life and death condition this contain definition, process, system nursing management, medical management, research.
The internal educational program (IEP) of Vanderbilt University's Division of Trauma, Emergency Surgery and Surgical Critical Care aims to provide educational opportunities on topics related to trauma care from pre-hospital care to post-discharge requirements. The IEP will outline the care provided to trauma patients from point of injury through completion of care. The trauma team includes surgeons, nurses, and liaisons from emergency medicine, orthopedics, neurosurgery, anesthesia, and radiology, with the shared goal of improving trauma patient care in a consistent and caring manner and preventing injuries in the local region. Participants are asked to review provided materials and complete an evaluation.
The internal educational program (IEP) of Vanderbilt University's Division of Trauma, Emergency Surgery and Surgical Critical Care aims to provide educational opportunities on topics related to trauma care from pre-hospital care to post-discharge requirements. The IEP will explore various areas of interest throughout the year and outline the full continuum of care provided to trauma patients. The IEP involves the trauma team, which consists of physicians, nurses, and other specialists from various departments. The overall goal is to continuously improve trauma patient care and reduce injuries in the local region.
This document provides an overview of emergency medicine as a specialty. It discusses the top causes of death, the reception process in emergency departments, how cases are triaged from life-threatening to non-urgent, and examples of common illnesses and injuries seen in emergency medicine including chest pain, fractures, seizures, and psychiatric illnesses. It also outlines both the appeals and challenges of working in emergency medicine as well as potential career paths within the specialty.
1. The document outlines the initial assessment and management of multiply injured patients, including preparation, triage, primary survey, resuscitation, secondary survey, and definitive care.
2. The primary survey focuses on the ABCDEs - Airway, Breathing, Circulation, Disability, and Exposure/Environmental control to identify life-threatening conditions.
3. The secondary survey includes a full physical exam and history taking to identify additional injuries before transferring the patient to definitive care. Continuous reevaluation is important to detect any deterioration.
1) The document discusses disaster triage methods START and SAVE which are used to prioritize patients with limited resources. START uses respiratory rate, pulse, and mental status to categorize patients as red, yellow, black. SAVE provides a more thorough secondary exam of red-tagged patients.
2) A case example demonstrates START and SAVE triage in action. A head injury patient is initially red-tagged but deemed unsalvageable on secondary exam due to low GCS. A shortness of breath patient is found to have inhalation injuries and is deemed unsalvageable. A crushed leg patient is red-tagged and prioritized for immediate intervention.
Advanced control scheme of doubly fed induction generator for wind turbine us...IJECEIAES
This paper describes a speed control device for generating electrical energy on an electricity network based on the doubly fed induction generator (DFIG) used for wind power conversion systems. At first, a double-fed induction generator model was constructed. A control law is formulated to govern the flow of energy between the stator of a DFIG and the energy network using three types of controllers: proportional integral (PI), sliding mode controller (SMC) and second order sliding mode controller (SOSMC). Their different results in terms of power reference tracking, reaction to unexpected speed fluctuations, sensitivity to perturbations, and resilience against machine parameter alterations are compared. MATLAB/Simulink was used to conduct the simulations for the preceding study. Multiple simulations have shown very satisfying results, and the investigations demonstrate the efficacy and power-enhancing capabilities of the suggested control system.
Geriatric Population. Geriatric Clinician Practice. Your Medicare, Long-Term ...Michelle Peck
Michelle Peck | Legal Nurse Consultant | Adult & Geriatric Nurse Practitioner | Health Care | Consultant | Speaker | Educator | Researcher
Enjoy your journey through this slide deck of Geriatric Population. Geriatric Clinician Practice. Your Medicare, Long-Term Care Documentation.
Imagine if writing a progress note was really as simple as the note featured on the title slide. This physician progress note style filled the charts of a 120 bed nursing facility in rural Texas. Walking down the facility hallways I observed many unstable conditions and behaviors. Staff were numb to the yelling. When I questioned about the yelling "we don't medicate behaviors" was the most popular response. I needed to be medicated after a few hours of being there. Collecting data had never been this difficult. Stable and clinical documentation now had a whole new meaning.
This month I am instructing Nurse Practitioner students on Medicare and Long-Term Care Coding and Documentation. Revising this lecture reminds me of all of the clinician types I have met during my long-term care travels.
1. Amazing Clinicians
◾ They know state and federal regulations and practice perfectly.
◾ They don't cross your path very often.
◾ When you meet them you must stop, listen and absorb all their knowledge.
2. So-So Clinicians
◾ They don't know that there are regulations on state and federal levels.
◾ They are pretty common and are doing enough with meaningful practices.
◾ When you meet them you must stop, talk and they absorb your knowledge.
3. Corner Cutters
◾ They are not doing enough and practice out of compliance.
◾ Their colleagues are also clueless, there is guilt by association.
◾ When you meet them, run in the opposite direction.
What types of geriatric clinicians are crossing your path? The documentation is very telling as to the practice type. Are they awesome, so-so, or of the corner cutter breed?
Learn it-Live it-Love it-Your path for a more informed life!
Michelle Peck | Legal Nurse | Nurse Practitioner | Health Care | Geriatric | Consultant | Speaker | Educator | Researcher
This document provides information on triage and EMTALA regulations. It discusses the following key points:
1. EMTALA requires hospitals to provide a medical screening exam and stabilizing treatment to anyone who presents with an emergency medical condition. Triage does not constitute a medical screening exam which must be done by an ED MD or PA.
2. EMTALA regulations apply to anyone seeking emergency care on hospital property, including areas within 250 yards. Hospitals can face penalties for violating EMTALA.
3. The ESI triage system categorizes patients into 5 levels based on acuity - from level 1 requiring resuscitation to level 5 for non-urgent conditions. It considers factors like life threats, resources needed
The triage protocol creates an objective process to guide healthcare professionals in making the difficult determination of how to allocate resources to critically ill adult and pediatric patients when there are not enough critical care resources for everyone.
The document discusses triage in emergency nursing. It defines triage as sorting patients based on acuity to provide the most urgent care first when resources are limited. A triage nurse must quickly identify life-threatening issues and determine each patient's priority level using standardized rating systems. The document outlines the primary and secondary assessments emergency nurses conduct to evaluate patients and identify issues requiring immediate treatment versus those that can wait. The goal of triage is to do the greatest good for the greatest number.
Deterioration of a patient can occur at any time in the patient’s journey and eventually they may need critical care intervention or worse. Hear about NHS Ayrshire & Arran’s rescue system and how their model for improvement was used to design, implement and sustain reliable care processes that facilitated a reduction in mortality rates.
Triage is the process of sorting patients based on the urgency of their condition to provide the right care to the right patient at the right time. It involves initially assessing patients at arrival to identify those needing immediate care, determine the appropriate treatment area, and avoid congestion. The goals are to treat the most severely injured first while maximizing survival in a mass casualty event. Triage categories range from resuscitation to non-urgent to ensure critical patients receive rapid medical attention. Reassessment is important as a patient's condition may deteriorate while waiting.
prevention & management of medical emergencies in dental office.pptAdirikak
This document discusses the prevention and management of medical emergencies in the dental office. It begins by emphasizing the importance of prevention through thorough patient assessment and history. It then reviews common types of emergencies seen in dental offices, which are most often altered consciousness, cardiovascular, allergic reactions, and respiratory. The document provides detailed guidance on managing specific emergencies such as adrenal crisis, airway obstruction, anaphylaxis, local anesthesia reactions, angina, and asthma. It stresses the importance of recognition, preparation, basic life support skills, and knowing when to refer patients to advanced medical care.
Triage is the term derived from the French verb trier meaning to sort or to choose
It’s the process by which patients classified according to the type and urgency of their conditions to get the Right patient to the Right place at the
Right time with the
Right care provider
Coding Lecture 2013 Zesut for learning how to codeSDanishHasan1
This document provides guidance on proper documentation for medical coding and billing. It emphasizes that documentation must support the level of service provided and justify medical decision making. Key elements discussed include a detailed history and physical exam, review of systems, past medical history, and medical decision making components. The document also provides examples of procedures and conditions that could be undercoded without thorough documentation of extent, location, complications, and clinical decision making involved. Proper documentation is crucial for accurate coding and ensuring reimbursement.
the emergency assessment to be done carefully and immediately .the emergency nurse have quick review and deliver the health carein the quality manner in all the fields of health care as medical,surgical, paediatric ,and obstertics .
02. Diagnosis and Treatment Manual author Patestos Dimitrios.pdfsarfaraz ahmed
This document is the 2016 Diagnosis and Treatment Manual from Doctors of the World Greece. It was edited by Dr. Patestos Dimitrios and represents the views and recommendations of the organization. The manual provides guidelines for health professionals to use in making treatment decisions for patients, while allowing for clinical judgment based on each individual case. It includes protocols, definitions, and summaries of diagnosis and treatment for various medical conditions like shock, seizures, and status epilepticus.
This document summarizes common clinical presentations related to mobility issues, falls, dizziness, and blackouts in elderly patients. It outlines important history, exam findings, and investigations for different causes. Specific conditions discussed include orthostatic hypotension, vertigo including benign paroxysmal positional vertigo (BPPV), and osteoporosis. The role of a multidisciplinary team in developing comprehensive management plans is emphasized. Examples are provided of potential case discussions focusing on problem lists, differential diagnoses, and coordinated care plans.
This document outlines the course content for a 9th semester differential diagnosis and clinical decision making course. It discusses topics like intro to medical screening, differential diagnosis of various body systems, the process of differential diagnosis, screening and its purpose, reasons for medical disease screening, red and yellow flags, and the physical therapist's role in disease diagnosis, prevention, and clinical reasoning. Key terms like quicker, sicker, and signed prescription in relation to medical screening are also defined. A case example demonstrates recognition of red flags that warrant physician consultation.
emergency nursing (management in emergency) pptNehaNupur8
complete information about the emergency care provided to the
patients, in emergency ward, after accident, in life and death condition this contain definition, process, system nursing management, medical management, research.
The internal educational program (IEP) of Vanderbilt University's Division of Trauma, Emergency Surgery and Surgical Critical Care aims to provide educational opportunities on topics related to trauma care from pre-hospital care to post-discharge requirements. The IEP will outline the care provided to trauma patients from point of injury through completion of care. The trauma team includes surgeons, nurses, and liaisons from emergency medicine, orthopedics, neurosurgery, anesthesia, and radiology, with the shared goal of improving trauma patient care in a consistent and caring manner and preventing injuries in the local region. Participants are asked to review provided materials and complete an evaluation.
The internal educational program (IEP) of Vanderbilt University's Division of Trauma, Emergency Surgery and Surgical Critical Care aims to provide educational opportunities on topics related to trauma care from pre-hospital care to post-discharge requirements. The IEP will explore various areas of interest throughout the year and outline the full continuum of care provided to trauma patients. The IEP involves the trauma team, which consists of physicians, nurses, and other specialists from various departments. The overall goal is to continuously improve trauma patient care and reduce injuries in the local region.
This document provides an overview of emergency medicine as a specialty. It discusses the top causes of death, the reception process in emergency departments, how cases are triaged from life-threatening to non-urgent, and examples of common illnesses and injuries seen in emergency medicine including chest pain, fractures, seizures, and psychiatric illnesses. It also outlines both the appeals and challenges of working in emergency medicine as well as potential career paths within the specialty.
1. The document outlines the initial assessment and management of multiply injured patients, including preparation, triage, primary survey, resuscitation, secondary survey, and definitive care.
2. The primary survey focuses on the ABCDEs - Airway, Breathing, Circulation, Disability, and Exposure/Environmental control to identify life-threatening conditions.
3. The secondary survey includes a full physical exam and history taking to identify additional injuries before transferring the patient to definitive care. Continuous reevaluation is important to detect any deterioration.
1) The document discusses disaster triage methods START and SAVE which are used to prioritize patients with limited resources. START uses respiratory rate, pulse, and mental status to categorize patients as red, yellow, black. SAVE provides a more thorough secondary exam of red-tagged patients.
2) A case example demonstrates START and SAVE triage in action. A head injury patient is initially red-tagged but deemed unsalvageable on secondary exam due to low GCS. A shortness of breath patient is found to have inhalation injuries and is deemed unsalvageable. A crushed leg patient is red-tagged and prioritized for immediate intervention.
Similar to Triage-in-Emergency-Department.pptx (20)
Advanced control scheme of doubly fed induction generator for wind turbine us...IJECEIAES
This paper describes a speed control device for generating electrical energy on an electricity network based on the doubly fed induction generator (DFIG) used for wind power conversion systems. At first, a double-fed induction generator model was constructed. A control law is formulated to govern the flow of energy between the stator of a DFIG and the energy network using three types of controllers: proportional integral (PI), sliding mode controller (SMC) and second order sliding mode controller (SOSMC). Their different results in terms of power reference tracking, reaction to unexpected speed fluctuations, sensitivity to perturbations, and resilience against machine parameter alterations are compared. MATLAB/Simulink was used to conduct the simulations for the preceding study. Multiple simulations have shown very satisfying results, and the investigations demonstrate the efficacy and power-enhancing capabilities of the suggested control system.
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Optimizing Gradle Builds - Gradle DPE Tour Berlin 2024Sinan KOZAK
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The CBC machine is a common diagnostic tool used by doctors to measure a patient's red blood cell count, white blood cell count and platelet count. The machine uses a small sample of the patient's blood, which is then placed into special tubes and analyzed. The results of the analysis are then displayed on a screen for the doctor to review. The CBC machine is an important tool for diagnosing various conditions, such as anemia, infection and leukemia. It can also help to monitor a patient's response to treatment.
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Finally, the document concludes by providing a link to a reference blog. This blog offers additional information and guidance on configuring the remote Python interpreter in PyCharm, providing the reader with a well-rounded understanding of the process.
ACEP Magazine edition 4th launched on 05.06.2024Rahul
This document provides information about the third edition of the magazine "Sthapatya" published by the Association of Civil Engineers (Practicing) Aurangabad. It includes messages from current and past presidents of ACEP, memories and photos from past ACEP events, information on life time achievement awards given by ACEP, and a technical article on concrete maintenance, repairs and strengthening. The document highlights activities of ACEP and provides a technical educational article for members.
Embedded machine learning-based road conditions and driving behavior monitoringIJECEIAES
Car accident rates have increased in recent years, resulting in losses in human lives, properties, and other financial costs. An embedded machine learning-based system is developed to address this critical issue. The system can monitor road conditions, detect driving patterns, and identify aggressive driving behaviors. The system is based on neural networks trained on a comprehensive dataset of driving events, driving styles, and road conditions. The system effectively detects potential risks and helps mitigate the frequency and impact of accidents. The primary goal is to ensure the safety of drivers and vehicles. Collecting data involved gathering information on three key road events: normal street and normal drive, speed bumps, circular yellow speed bumps, and three aggressive driving actions: sudden start, sudden stop, and sudden entry. The gathered data is processed and analyzed using a machine learning system designed for limited power and memory devices. The developed system resulted in 91.9% accuracy, 93.6% precision, and 92% recall. The achieved inference time on an Arduino Nano 33 BLE Sense with a 32-bit CPU running at 64 MHz is 34 ms and requires 2.6 kB peak RAM and 139.9 kB program flash memory, making it suitable for resource-constrained embedded systems.
2. Introduction
Definition
French noun derived from the verb trier, which
means to sift or sort.
the methods used to assess patients’ severity of
injury or illness within a short time after their
arrival, assign priorities, and transfer each patient
to the appropriate place for treatment.
3. Problems Faced in ED
The volume of admissions to a given emergency
department cannot be predicted with any great
accuracy.
Only a certain proportion of the patients have life
endangering or medically urgent conditions.
Patients with life-threatening injuries or illnesses
need to be reliably identified within minutes of
arrival.
Patient overcrowding.
The demand for medical treatment significantly
outstrip available resources.
4. Aim
To ensure that the patient receives the level
and quality of care appropriate to clinical need
(clinical justice).
Reduce unnecessary delay of treatment.
Departmental resources are most usefully
applied (efficiency).
5. Triage in Emergency
Department
ED triage systems
Designed to identify the most urgent (or
potentially most serious) cases.
To ensure that they receive priority treatment,
followed by the less urgent cases.
First-come, first-served basis
Triage officers routinely assess all patients
who present for treatment to sort and prioritize
them.
6. Types of Triage in ED
3-level triage system:
Level 1 = emergent
Level 2 = urgent
Level 3 = non-urgent
→ Lack of specificity and prone to subjectivity
5-level triage systems
Eg: Australian Triage Scale (ATS), Manchester
Triage Scale (MTS), Canadian Triage Acuity
Scale (CTAS), Emergency Severity Index (ESI)
7.
8. Art of Triage
Complex and dynamic process
Obtaining adequate and relevant information
in a short amount of time
Decisions are made in a time-sensitive
environment with limited manpower and
information.
Decision made based on pre-existing
guidelines and patient’s condition.
9. Roles of Triage Officer
Allocate triage category bases on patient
assessment
Initiate appropriate nursing interventions
First aid
Initiation of organizational guidelines, eg: x-ray,
analgesia.
Liaise with members of the public and other
healthcare professionals.
Escort patient and pass over relevant information
Provide patient and public education where
necessary
documentation
10. Process of Triage
Main complaint and brief history
Vital signs
Physical findings seen, heard, felt or smelt
Setting the priority status of the patient
Decision of preliminary diagnostic testing
should be done
Decision whether treatment should be started
at triage
11. SOAP System
Larry-Weed SOAP system
S (Subjective) – main complaint and brief
history
O (Objective) – physical finding and vital signs
A (Assessment) – setting of the priority status
based on subjective and objective finding
P (Plan) – preliminary diagnostic and
treatment
12. Malaysian Triage Category
MTC is designed for use in hospital
emergency services throughout Malaysia.
A scale for rating clinical urgency.
Directly relates triage category with a range of
outcome measures (inpatient length of stay,
ICU admission, mortality rate) and resource
consumption (staff time, cost).
Provides an opportunity for analysis of a
number of performance parameters in the
Emergency Department.
14. Critical (RED)
Conditions that are threats to life (or
imminent risk of deterioration) and
require immediate aggressive
intervention.
The patient's condition is serious enough or
deteriorating so rapidly that there is the potential
of threat to life, or organ system failure, if not
treated within 15 minutes of arrival
The potential for time-critical treatment (e.g.
thrombolysis, antidote) to make a significant
effect on clinical outcome depends on treatment
commencing within a few minutes of the patient's
arrival in the ED
15. Critical (RED)
Patients with life threatening injuries or illness
which require immediate attention.
Assessment and treatment simultaneously
within 5 minutes.
Subcategories:
R1 (immediate life-threatening)
R2 (life-threatening)
16. Clinical Descriptions
1. Code arrest (cardiac/ respiratory) or impending arrest
2. Hypoventilation: RR< 10/min
3. Shock state SBP < 80 (adult)or severely shocked child/infant
4. Airway compromise or immediate risk to airway
5. Severe respiratory distress. Tachypnoea and/or dyspnoea with SpO2 <95%
6. Seizuring patient (ongoing/prolonged) and post-ictal states with neurological deficits
7. Coma/ unconscious or responds to pain only (GCS<9/15)
8. Alleged poisoning or drug overdose with impairment of conscious level and need urgent intervention
9. Head injury with GCS 13/15 and below
10. Exsanguinating limb injuries (massive blood loss)
11. Severe crush injuries to limbs
12. Other immediate life threatening conditions
1. Severe or moderate asthma/ COAD
2. Polytrauma/ major trauma
3. Burns to more than 25% BSA regardless of depth and/ or more than 20% 2nd degree burns
4. Alleged near-drowning
5. Gun-shot/ stab wounds to head, neck, trunk or abdomen or trajectory undetermined
6. Arrhythmia with tachycardia/ bradycardia and unstable.
7. Hypertensive emergencies: SBP> 220 or DBP >120 with systemic symptoms
8. Chest pain – visceral, non-traumatic associated with parasympathetic and sympathetic symptoms
9. Acute MI/ unstable angina diagnosed by referral
10. Acute abdomen, hemodynamically unstable
11. Hyperglycemia or hypoglycemia with altered conscious level or neurological/ systemic deficit
12. Baby< 3 months with fever > 38°C
13. Other life threatening conditions
14. Obstetric emergency (Hamodynamically unstable)
17. Semi-Critical (YELLOW)
The patient's condition may progress to life or
limb threatening, or may lead to significant
morbidity, if assessment and treatment are
not commenced within thirty minutes of arrival
There is potential for adverse outcome if
time-critical treatment is not commenced
within thirty minutes
Humane practice mandates the relief of
severe discomfort or distress
18. Semi-Critical (YELLOW)
Assessment and treatment starts within 30
minutes.
Usual presentation:
Unable to walk but airway is secure,
hemodynamically stable and on trolleys
19. Clinical Descriptions
1. Altered conscious level but not comatose. Head injury = 14/15 or GCS full but pupils unequal
2. Fractures of long bones of lower limbs/ pupils
3. Open fracture of upper limbs
4. Spine injuries (not in shock, no neurological deficit)
5. Eye injury with loss or impaired vison
6. Dislocation of major joints
7. Limb amputation: total or/ near-total (haemodynamically stale)
8. Burns 15-25% of BSA regardless of depth and/or 10-20% 3rd degree burns with no compromise to
airway and circulation
9. Vascular injuries but hemodynamically stable
10. Patients with acute abdomen but hemodynamically stable
11. Chemical exposure involving eyes
12. Alleged poisoning/ drug overdose – patient conscious and need no intervention
13. Severe pain:
• Trauma: pain score: 8-10
• Non-trauma: pain score 4-7/10
14. Allergic reaction – moderate
15. Mild to moderate dyspnoea with saturation >95% and/or rate <40/ min
16. Hyperventilation and unable to maintain posture
17. Cheat pain – visceral and not associated with other symptoms
18. Hepertensive urgencies: elevated SBP < 220mmHg or DBP <120mmHg with minimal systemic
symptoms but no neurological deficit.
19. Baby > 3 months with fever > 38°C
20. Infant < 1 month regardless of any symptoms
21. Significant per vaginal bleed with hemodynamically stable
22. Other medical urgencies requiring intravenous intervention and intermittent monitoring only:
• Dehydration, diarrhea with vomiting, pyrexia >40°C, signs of infection, dialysis problem, acute
psychotic episodes, chemotherapy or immunocompromised, acute urinary retention.
20. Non-Critical (GREEN)
The patient's condition may deteriorate, or adverse
outcome may result, if assessment and treatment is not
commenced within one hour of arrival in ED. Symptoms
moderate or prolonged.
There is potential for adverse outcome if time-critical
treatment is not commenced within hour
Likely to require complex work-up and consultation
and/or inpatient management
Humane practice mandates the relief of discomfort or
distress within one hour
21. Non-Critical (GREEN)
Assessment and treatment starts within 90
minutes
Usual presentation:
Airway secure, hemodynamically stable patients
not in any distress and ambulant
Subcatagories:
G1 (fast line)
G2 (require initial management or first aid before seen
by doctor)
G3 (patients who can wait)
G4 (triage away to primary care or another center)
G5 (not seen in ED)
22. Non-Critical (GREEN)
G1 (Fast Lane)
Children < 2 years old
Senior citizen > 65 years old
Acute pain (trauma): pain score <4/10
Chest pain – non-visceral, musculoskeletal and not associated with other symptoms
but with history of heart disease
Abuse/neglect/assault – stable
Post seizure – alert on arrival
POP complications
Elevated blood sugar without any major symptoms
Mild asthma
Closed fracture of upper limbs or ankle with major angulations
Dislocation of small joints
Foreign body
Hemodynamically stable per vaginal bleed
23. Non-Critical (GREEN)
G2 (Require initial management or 1st aid
before seen by doctor)
Chest pain – non-visceral, musculoskeletal
and not associated with other symptoms and
no previous heart disease
Minor allergic reaction
24. Non-Critical (GREEN)
G3 (patients who can wait)
Burn < 15% of BSA regardless of depth and/or
<10% 3rd degree burns
Minor trauma
Head injury – alert, no vomiting
Bumps and bruises
Closed fracture of upper limbs
Controllable bleeding with closed fracture of upper
limbs or ankle without major angulations
Nail prick
Simple cut
25. Non-Critical (GREEN)
G4 (for LOCUM or triage away to OPD or another center)
Chronic trauma injuries > 6 months
Diarrhea alone (no dehydration)
Vomiting alone (normal mental status with no dehydration)
Acute pyrexia <38°C for adult < 65 years old or child between
2-12 years old
Simple skin diseases – chronic
Menses related complaints
Chronic psychiatric complaints
General medicine conditions or minor illness not requiring
monitoring
Sore throat – no respiratory symptoms
Earache
Infective eye conditions
26. Non-Critical (GREEN)
G5 (not seen in ED)
Missed appointment
Medications exhausted
Second opinion seeking
STO
Medical certificate
Specialist clinic cases