Welcome to the ER

Meet Your Team: Trauma Surgeon ________________ Flight Crew ________________ ER Nurses ER Technicians Radiology Techs ________________ Medical Secretary

Three ways of entrance… __________ Ambulance __________

TRIAGE… The most common method of triage is a numeral classification system in which a number is given based on the services needed. Examples of services include IV’s, labs, x-rays, scans, small procedures, etc. Class 1 (__________________) TO Class 5 (___________________________________)

Class 5: Will need ______ services Class 4: Will possibly need _____ service Class 3: Will most likely need _________ services Class 2: Will need services __________________ Class 1: Will need services ____________________

Let’s Practice… A patient arrives at triage complaining of a minor toothache. He denies any fever. His vital signs are stable and has no previous medical conditions. A patient arrives at triage complaining of burning and frequency when she urinates. She states she has had a low grade fever. Her vital signs are stable. Her only past medical history is hypertension. A patient arrives at triage complaining of nausea and vomiting for 2 days. His blood pressure is elevated at 170/95 with no previous history of hypertension. His only past medical history is an ACL repair 2 years ago.

A patient arrives at triage with a family member. The family member explains that the patient will not eat or drink and has very little urine output. The patient is pale with tenting skin turgor. The patient’s mucous membranes are dry. The vital signs show an increased heart rate. The patient is 8 months old that was born prematurely. A patient arrives at triage with a family member. The family member explains that they were eating breakfast 45 minutes ago and she became very confused. She lost use of her right arm and had difficulty walking. Her vital signs show increased heart rate and blood pressure. Her history is that 1 year ago she had a heart attack.

SECOND NURSING ASSESSMENT __________________________________________ Prepare the patient for treatment Get equipment if possible ____________________________ Educate the Patient (especially of wait times) Notify the ______________________________ Beyond the curtain

Important Lab Values: Complete Blood Count (CBC): Includes: WBC, RBC, Hemoglobin (Hgb), Hematocrit (Hct) and Platelets Purpose: to identify an _________________ to diagnose _____________ to identify acute and chronic illness, bleeding tendencies, and white blood cell disorders such as ______________ Coagulation Panel: Includes: PT, PTT, INR Purpose: These identify coagulation defects, based on time required for _______________________________.

Important Lab Values: Chemistry Panel: Includes: Glucose, Calcium, Sodium, Potassium, Chloride, CO2, BUN & Creatinine, ALT/AST, Total Protein Purpose: Gives you important information about the current status of your ______________, __________, and electrolyte and acid/base balance as well as of your ________ _______________ and blood proteins.

TESTS/PROCEDURES… __________ X-Ray CAT Scan ______ _________ ___________ Central Line Arterial Line

Common Equipment Used… Defibrillater Laryngoscope _________________ Rapid Infuser ___________________ Backboard _____________ IV Kits Pyxis or Omnicell ____________ Casting Materials ___________________

COMMON DIAGNOSIS: ______________________ Stroke Seizure Headaches ___________________________ NauseaA/vomiting Abdominal pain _________ Fever ________________________ Kidney Stones Behavioral Health Miscarriage

TRAUMATRAUMA Diagnosis: MVA ____________________ High Level Fall ______________ Equipment: Let’s discuss Procedures: Let’s discuss

Fast Track (___________________): Small __________________ Sprains Minor Fractures ____________________ Tooth Aches Can you think of any more???

A look at real trauma!

What’s Next? ____________ Transfer ____________

What do you think are problems or concerns that face the Emergency Room?