Chapter 69: Nursing Management: Emergency, Terrorism, and Disaster Nursing
Lewis: Medical-Surgical Nursing, 8th Edition
Chapter 69: Nursing Management: Emergency, Terrorism, and Disaster Nursing
Key Points – Printable
CARE OF EMERGENCY PATIENT * Triage refers to the process of rapidly determining the acuity of the patient’s problem. It works on the premise that patients who have a threat to life must be treated before other patients. * The Emergency Severity Index (ESI) is a five-level triage system that incorporates concepts of illness severity and resource utilization to determine who should be treated first. * After the initial assessment to determine the presence of actual or potential threats to life, appropriate interventions are initiated for the patient’s condition. * The primary survey focuses on airway, breathing, circulation (ABCs), disability, and exposure/environmental control. It serves to identify life-threatening conditions so that appropriate interventions can be initiated immediately. * The secondary survey is a brief, systematic process that is aimed at identifying all injuries. Ongoing patient monitoring and evaluation of interventions are critical, and the nurse is responsible for providing appropriate interventions and assessing the patient’s response. Depending on the patient’s injuries and/or illness, the patient may be transported for diagnostic tests or directly to the operating room; admitted to a general unit, telemetry, or intensive care unit; or transferred to another facility. * * Post-Cardiac Arrest Hypothermia * Patients with nontraumatic, out-of-hospital cardiac arrest benefit from a combination of good chest compressions, rapid defibrillation, therapeutic hypothermia, and supportive care postarrest. * Therapeutic hypothermia involves the three phases: induction, maintenance, and rewarming. * * Death in the Emergency Department The emergency nurse should recognize the importance of certain hospital rituals in preparing the bereaved to grieve, such
Chapter 69: Nursing Management: Emergency, Terrorism, and Disaster Nursing
Key Points – Printable
CARE OF EMERGENCY PATIENT * Triage refers to the process of rapidly determining the acuity of the patient’s problem. It works on the premise that patients who have a threat to life must be treated before other patients. * The Emergency Severity Index (ESI) is a five-level triage system that incorporates concepts of illness severity and resource utilization to determine who should be treated first. * After the initial assessment to determine the presence of actual or potential threats to life, appropriate interventions are initiated for the patient’s condition. * The primary survey focuses on airway, breathing, circulation (ABCs), disability, and exposure/environmental control. It serves to identify life-threatening conditions so that appropriate interventions can be initiated immediately. * The secondary survey is a brief, systematic process that is aimed at identifying all injuries. Ongoing patient monitoring and evaluation of interventions are critical, and the nurse is responsible for providing appropriate interventions and assessing the patient’s response. Depending on the patient’s injuries and/or illness, the patient may be transported for diagnostic tests or directly to the operating room; admitted to a general unit, telemetry, or intensive care unit; or transferred to another facility. * * Post-Cardiac Arrest Hypothermia * Patients with nontraumatic, out-of-hospital cardiac arrest benefit from a combination of good chest compressions, rapid defibrillation, therapeutic hypothermia, and supportive care postarrest. * Therapeutic hypothermia involves the three phases: induction, maintenance, and rewarming. * * Death in the Emergency Department The emergency nurse should recognize the importance of certain hospital rituals in preparing the bereaved to grieve, such