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Emergency nursing deals with human responses to any trauma or sudden illness that requires immediate intervention to prevent imminent severe damage or death 2. Care is provided in any setting to persons of all ages with actual or perceived alterations in physical or emotional health. 3. Initially, patients may not have a medical diagnosis. 4. Care is episodic when patients return frequently, primary when it is the initial option for health or preventive care, or acute when patients need immediate and additional interventions. 5. Emergency nursing is a specialty area of the nursing profession like no other. 6. Emergency nurses must be ready to treat a wide variety of illnesses or injury situations, ranging from a sore throat to a heart attack. Emergency Care Environment

1. Prehospital care by emergency medical services (EMS), emergency medical technicians, and paramedics provides initial stabilizations and transport of patients; personnel communicate with the emergency department during patient transport 2. The national emergency telephone number 911 is the result of an effort to improve access to EMS 3. The concept of the emergency room has expanded to that of the emergency department, which provides various levels of care 4. Specialized electronic technology and techniques are used to monitor patient status continuously; these may pose safety hazards to patients, such as possible exposure to electric shock D. Triage 1. Triage classifies emergency patients for assessment and treatment priorities 2. Triage decisions require gathering objective and subjective data rapidly and effectively to determine the type of priority situation present 3. Emergent situations are potentially life-threatening; they include such conditions as respiratory distress or arrest, cardiac arrest, severe chest pain, seizures, hemorrhage, severe trauma resulting in open chest or abdominal wounds, shock, poisonings, drug overdoses, temperatures over 105°F (40.5°C), emergency childbirth, or delivery complications 4. Urgent situations are serious but not life-threatening if treatment is delayed briefly; they include such conditions as chest pain without respiratory distress, major fractures, burns, decreased level of consciousness, back injuries, nausea or vomiting, severe abdominal pain, temperature between 102 and 105°F (38.9 and 40.5° C), bleeding from any orifice, acute panic, or anxiety 5. Nonemergency situations are not acute and are considered minor to moderately severe; they include such conditions as chronic backache or other symptoms,

upper respiratory or urinary infections. Provides support and protection for the patient and family G.moderate headache. issues. 2. Uses triage to determine priorities based on assessment and anticipation of the patient’s needs 2. Educator: provides patient and family with education based on their learning needs and the severity of the situation and allows the patient to assume more responsibility for meeting health care needs 3. Negligence 2. After successful completion of this exam they are certified in emergency nursing. An emergency nurse is a registered nurse with specialized education and experience in caring for emergency patients. Provides preliminary care before the patient is transferred to the primary care area 4. Legal issues affecting the provision of emergency nursing 1. Advanced directives. Roles of the Emergency Nurse 1. Informed consent 5. Qualifications of an Emergency Nurse 1. be aware of hospital policy and state laws for evidence collection 8. or instances in which a patient is dead on arrival E. Many take a special examination that proves their level of knowledge. Provides health education to the patient and family 5. . Implied consent 6. if necessary 3. Supervises patient care and ancillary personnel 6. Emergency nurses continually update their education to stay informed of the latest trends. 2. and procedures in medicine today. Advocate: ensures protection of the patient’s rights F. including durable power of attorney and living wills H. Care provider: provides comprehensive direct care to the patient and family. 3. Malpractice 3. fractures. Manager: coordinates activities of others in the multidisciplinary team to achieve the specific goal of providing emergency care 4. minor burns. sprains. Duty to report suspected crimes to the police 7. Functions of the Emergency Nurse 1. Provides direct measures to resuscitate. Duty to gather evidence in criminal investigations. Good Samaritan Laws (these statutes may protect private citizens but usually do not apply to emergency personnel on duty or in normal emergency situations) 4.

II. Equipping individuals to deal with the whole situation. The annual cost of medical attention. Many emergency nurses acquire additional certifications in the areas of trauma nursing. accidents are the leading cause of death. loss of earning ability due to temporary or permanent impairment. Statistics show that among persons from age 1 to age 38. Caring for persons caught in a natural disaster or other catastrophe 3. pediatric nursing. b. and the injury 4. The difference between rapid recovery and long hospitalization B. Some emergency nurses also acquire additional certifications in the areas of trauma nursing. evidence of willingness to help. nurse practitioner. Distinguishing between what to do and what not to do C. Reasons For First Aid A. If includes self-help and home care if medical assistance is not available or is delayed. The difference between temporary and permanent disability 3. It includes well-selected words of encouragement. First aid knowledge and skill often mean— 1. . and various areas of injury prevention 5. The death rate is twice as high among males as females. First aid training is needed because— 1. Preventing and caring for accidental injury or sudden illness 2. and thereafter they remain one of the leading causes. and promotion of confidence by demonstration of competence. and direct property damage and insurance costs amount to many billions of dollars each year. The difference between life and death 2. First aid training is of value in— 1.4. nurse practitioner. the person. pediatric nursing. a. and various areas of injury prevention First aid is the immediate care given to a person who has been injured or has suddenly taken ill.

The concept of massive numbers of casualties has become a reality with the advent of the nuclear age. and allied health workers. 3. control. at play. Prevention A better understanding of the overall accident problem is developed if all the circumstances surrounding various types of accidents are carefully studied. it becomes possible to determine what can be done to eliminate. it becomes obvious why every possible effort should be taken to eliminate. 5. Motor vehicle accidents account for approximately half of all accidental deaths. Effect When analysis carefully considers both immediate and longrange. disability. or avoid a situation that is hazardous to oneself or to others 3. controlled. 4. Preventive measures should include consideration of how accident-causing conditions and activities can be eliminated. 2. nurses. at work. The growing population and expanding health needs have not been balanced by a proportional increase in numbers of doctors. Cause When in-depth study of an actual or hypothetical accident situation identifies all the causative factors. or avoid the hazards. In the promotion of such awareness. 1. or permanent. control. effect. The pattern of medical care has changed. and on streets and highways. and prevention. and personal tragedy. d. The limitation of time in case of an accident or sudden illness may be so critical in terms of minutes or even seconds that only a person with first aid knowledge and skills who is on hand has any opportunity of preventing a fatal outcome. Accidents take their toll in pain and suffering. D.c. . effects of injury or sudden illness. First aid training promotes safety awareness in the home. it is important to closely relate three terms: cause. or avoided. 2.

. to give them instruction in first aid. floods. or life-threatening illness. and efforts will be directed toward preventing further injury. or a stranger. Self-help In being prepared to help others. It also may take the form of a single accidental death. and reassuring the victim. You will need to adapt what you have learned to the situation at hand. a coworker. an acquaintance. the first-aider is better able to care for himself in case of injury or sudden illness. Help for others Through the study of first aid. as well as in pain. On a humanitarian basis. Your decisions and actions will vary according to the circumstances that produced the accident or sudden illness. Value of First Aid Training A. you may encounter a variety of problem situations. Knowledge of first aid is a civic responsibility: It not only helps to save lives and prevent complications from injuries but also helps in setting up an orderly method of handling emergency problems according to their priority for treatment so that the greatest possible good may be accomplished for the greatest number of people. Preparation for disaster First aid training is of particular importance in time of catastrophe. the number of persons involved. there is always an obligation to assist the stricken and the helpless. who may be emotionally upset and apprehensive. General Directions For Giving First Aid As a first-aider. At other times there is no need for haste. the availability of medical assistance. Catastrophe may taken the form of well-publicized disasters. and fires. earthquakes. IV. when medical and hospital services are limited or delayed. and help from others. B. Knowing what to do in an emergency helps to avoid the panic and disorganized behavior characteristic of unprepared persons at such times. tornadoes. C. and to promote among them a reasonable safety attitude. Even when his condition is so bad that he is unable to care for himself.III. There is no greater satisfaction than that of relieving suffering or saving the life of a member of your family. the immediate environment. such as hurricanes. he can direct others in the correct procedures to be taken in his behalf. emergency dressings and equipment. Sometimes prompt action is needed to save a life. or to improvise. obtaining assistance. a person is prepared to assist others wisely if they are stricken.

Effect a prompt rescue. and request the assistance needed. or noxious fumes. priorities must be set. A. Telephone. the number of persons involved.) 2. do not let him get up or walk about. (For example. if necessary. Ensure that the victim has an open airway and give mouth-to-mouth or mouth-to-nose artificial respiration. 3. Keep the victim in the position best suited to his condition or injuries. the location of the accident. Enlist the help of bystanders to make telephone calls. to position safety flares in case of highway accidents. Do not hang up the receiver until after the other party hangs up because he may wish to clarify some information. or from a garage or room containing carbon monoxide. Control severe bleeding. indicate what is being done. the following procedures should be carried out: 1. and the telephone number where you can be reached. ask the telephone operator for assistance. The police department or the highway patrol is a good first contact: but the circumstances surrounding the accident should be a guide as to whom to call. Describe the problem.First aid begins with action. which in itself has a calming effect. to direct traffic. the fire department. Urgent care In case of serious injury or sudden illness. Give first aid for poisoning. and perform similar duties. B. 4. from a fire. . or utility company personnel. if the numbers are not readily available. Provide life support to victims with life-threatening injuries. or ingestion of harmful chemicals. Give your name. or have someone else telephone. to keep others at a distance if necessary. Do not move a victim unless it is necessary for safety reasons. the rescue squad. 2. Protect the victim from unnecessary manipulation and disturbance. If there are multiple injuries or if several persons are hurt. smoke. Always have a list of emergency numbers available. Additional first aid directions Once emergency measures have been taken to ensure the victim’s safety. give immediate attention to the following first aid priorities: 1. while help is being summoned. then care for those with less critical injuries. such as an ambulance. the appropriate authorities regarding an accident. remove an accident victim from water.

. Look for an emergency medical identification. if available. Have a reason for what you do. Determine the injuries or cause for sudden illness.) 5. Note the victim’s general appearance. If the victim is exposed to cold or dampness. b. change in skin color may be difficult to note. which may provide a clue to the victim’s condition. or inner surface of the lips. In the case of a victim with dark skin. or saw the individual collapse in the case of sudden illness. try to obtain proper identification either from papers carried in a billfold or purse. so that relatives may be notified. mouth. (It is advisable to have a witness when searching for identification. such as a card or bracelet. c. Clothing may be cut away or ripped at the seams. 4. and check all symptoms that may give a clue to the injury or sudden illness. b. Find out exactly what happened. or from bystanders. Examine the victim methodically but be guided by the kind of accident or sudden illness and the needs of the situation. and use discretion if clothing must be removed. but utmost caution must be used or added injury may result. After immediate problems are under control— a.3. including skin discoloration. c. Loosen constricting clothing but do not pull on the victim’s belt in case spinal injuries are present. place blankets or additional clothing over and under him. Do not expose the victim unduly without protective cover. It may then be necessary to depend upon change in the color of the mucous membrane. and eyelids. and if the above methods fail to provide identity. Information may be obtained from the victim or from persons who were present and saw the accident. If the victim is unconscious and has no sign of external injury. Open or remove clothing if necessary to expose a body part in order to make a more accurate check for injuries. a. Avoid or overcome chilling by using blankets or covers.

i. If the victim is unconscious. b. (He may have bitten his tongue. and splints. Check the victim’s pulse. Check the front of the victim’s neck to determine whether he is a laryngectomy. and ambulance crew. bandages. Carry out the indication first aid: a. or a police officer). In a conscious person. under the circumstances. producing a laceration. Example the victim’s trunk and limbs for open and closed wounds or for signs of fractures. a rescue squad. household chemicals. j. If poisoning is suspected. Utilize proper first aid measures and specific techniques that. Plan action according to the situation. or until the victim can take care of himself or can be placed in the care of relatives. check for a pulse of the carotid artery at the side of his neck.d. e. d. look for evidence of head injury. Does he respond to questions? f. look for paralysis of one side of the face or body. 6. Remain in charge until the victim can be turned over to qualified persons (for example. e. Check the expression of the victim’s eyes and the size of his pupils. Do not move the victim unless absolutely necessary. a physician. stuporous.) g. check for stains or burns about the victim’s mouth and a source of poisoning nearby. appear to be reasonably necessary. (Most laryngectomys carry a card or other identification stating that they cannot breathe through the nose or mouth. such as pills. or unconscious. as indicated. or pesticides. h. c. Check to see if the victim is awake. . since blockage could cause death from asphyxiation.) Do not block the stoma (air inlet) of a laryngectomy when carrying out other first aid. and the availability of human and material resources. Apply emergency dressing. See if the victim shows evidence of a recent convulsion. medicine bottles. If you cannot feel it at the wrist.

g.f. Do not attempt to make a diagnosis of any sort or to discuss a victim’s condition with bystanders or reporters. Above all. . as a first aid worker. you should know the limits of your capabilities and must make every effort to avoid further injury to the victim in your attempt to provide the best possible emergency first aid care.

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