ER Care Study Tool

Emergency care

identifying and responding to emergency situations

Basic Principles of Emergency Care

-be prepared
-remain calm and avoid panic
-evaluate situation
-the treatment you can provide depends on the type of equipment available, type of injury or illness, and availability of medical help

Providing care

ask victims permission (if able to respond)

Triage

a method of prioritizing treatment to determine which person needs treatment first

General Principles

-obtain qualified help ASAP
-avoid unnecessary movement of victim
-reassure victim and remain calm
-provide care that you are qualified to provide

Breathing Difficulties

-look for SOB
-restlessness, confusion, anxiousness
-slow or fast breathing
-dyspnea
-apnea

Breathing Difficulties: what do to

-notify provider... call 911 as requested
-apply oxygen
-try to calm patient
-allow them to get into a position of comfort
-no physical exertion (no walking)

Choking

-universal choking sign
-ineffective or quiet cough
-high- pitched wheeze
-cannot talk
-ASK, "are you choking?" If yes, perform heimlich maneuver, notify provider, & document

Allergic Reaction

-symptoms of mild allergic reaction
*urticaria
*stuffy nose, sneezing
*itching around the eyes

Anaphylaxis

-severe allergic reaction with circulating shutdown and respiratory distress resulting in shock (low BP, sweating, cold, clammy, decreased LOC, SOB)
-provide basic life support, oxygen, epinephrine (based on provider order and availability)
-call 911 as requested

Heart Attack

-might see chest attack
-pressure, squeezing, fullness, or pain "heartburn"
last for 5 minutes OR goes away and comes back
-other body discomforts (one or both arms, back, neck, jaw, or stomach pain)
-SOB
-cold sweat
-nausea

Heart Attack: what to do

-have the victim sit or lie in a comfortable position
-apply oxygen (if available)
-prepare a copy of important information to accompany patient to hospital (med list, PMHx, emergency contacts)
-tell someone to start CPR and get an AED if needed

Fainting/ Syncope

-might see victim feeling dizzy or lightheaded
-victim feels weak

Fainting/ Syncope: what to do

-help victim to floor to lie flat
-if victim has already fainted, ask them to stay on the floor until no longer dizzy
-look for any injuries from fall
-encourage victim to sit up slowly
-notify provider and document

Diabetes and Low Blood Sugar- Hypoglycemia Low Blood Sugar in a person with Diabetes

-has not eaten or has vomited
-has not eaten enough for the level of activity and insulin in bloodstream
-has

Diabetes and Low Blood Sugar- Hypoglycemia Low Blood Sugar in a person with Diabetes: what you might see

-a change in behavior (confusion or irritability)
-sleepiness or unresponsiveness
-hunger, thirst, or weakness
-sweating, pale skin

Diabetes and Low Blood Sugar- Hypoglycemia

- what to do if victim is responding and can sit up and swallow
*give them glucose
*have the victim sit or lie quietly
-if victim is not responding or is unable to swallow
*call 911
* do not try to give anything to eat or drink
*roll patient onto their side
*monitor vital signs

Diabetes and Hyperglycemia

-malaise
-polyphasia
-nausea/vomiting
-dyspnea
-treatment (insulin per provider order)

Stroke

results from hypoxia in brain due to blood clot or rupture of a blood vessel
- what you might see
*aphasia or dysphasia
*sudden numbness of the face, arm, or leg, especially on one side of the body
*sudden confusion and trouble speaking or understanding

Stoke: what to do

-call 911
-give oxygen
-take vital signs
-obtain medical history
-FAST acronym

FAST

face, arm, speech, time to call 911

Seizures/Convulsions

-some causes of seizures are head injury, alterations in metabolism such as low blood sugar, fever, heat-related injury

Seizures /Convulsions: what you might see

-may be generalized or focal
-loss of muscle control
-fall to floor or ground
-unresponsiveness

Seizures/ Convulsions: what to do

- protect the victim from injury (move objects out of the way, place a pad under head)
-note the time that the seizure started, if lasts over 5 minutes, call 911

Seizure/ Convulsions: what not to do

-do not hold the victim down
-do not try to put anything in the mouth

Bleeding and Wounds (key terms)

Abrasion- skin is scraped off
Incision- cut caused by a sharp object
Laceration- a tearing of tissue by force
Avulsion- tissue to torn or separated from victims body
Puncture- caused by an instrument that delivers a stab

Bleeding and Wounds

amputation- body part cut off and separated from body
*pressure the amputated part if possible
-wrap part in cold moist dressings and place in plastic
bag
-put plastic bag on ice. never play the body part directly on
ice
-transport part with patient to hospital

Control Bleeding

-direct pressure to wound
-consider applying ice pack
-limit movement
-elevation
-arterial injuries will pulsate and require more pressure to control then venous bleeding

Epistaxis (nosebleed)/ tooth injuries

-if tooth is still in the socket, have the person lay down on a piece of gauze
-if tooth has come out, place the tooth in a cup of milk or clean water and go immediately to the emergency dept. or dentist
-do not touch roots of the tooth

signs of head injury- concussion

-no response or only moaning
-acts sleep or confused
-vomits
-complains of a headache
-trouble walking or moving any body part
seizure

Fractures

-cover open wound with a dressing; open fracture no break in skin- closed fracture
-apply ice bag
-don't push an exposed bone back through the skin cover with a clean dressings
-keep elevated

Sprains and strains

strain- stretching or tearing of a muscle or tendons that connects a muscle to bone
sprain- stretching or tearing of a ligament that connects bone to bone
treatment RICE (rest, ice, compression, elevate)

Contusion

-closed injury (bruise)
-caused by blunt trauma
-ranges in severity based on trauma received and location
-treatment (cold pack, elevation)

1st degree burn-superficial

-least severe (involves only top layer of epidermis)
-reddened skin (sunburn)
-painful

2nd degree burn-partial thickness

-involves the epidermis and dermis
-blisters from swelling
-surface appears moist

3rd degree burn- full thickness

-most severe type of burn
-injury to all layers of skin
-has a white or charred appearance
-can be life threatening due to fluid loss, shock, or infection

Rule of Nines- burn first aid

-remove from source
-monitor vital signs
-cover with clean dressing or sheets
-DO NOT apply at home remedies, ointments, etc
-keep victim calm
-watch for respiratory distress
-call 911 if needed
-remain calm

Acute Abdominal Pain

-obtain detailed chief complaint
-keep patient NPO
-have emesis basin available
-keep patient warm
-monitor vital signs and observe for signs of shock
document the severity, location, radiation, time and circumstances of onset

Eye and Ear Injuries

-foreign bodies (FB) most common cause
-trauma
-symptoms include... pain, decrease or sensitivity in hearing or vision
-treament... prevent further trauma, cover eye or ear

Wound care Follow Up

-patient documentation
-lock for signs of infection
-feeling hot to the touch
-drainage
-foul odor from the site
-fever
-red streaks extending from wound

Sterile Dressing Changes

-wash hands
-apply gloves
-dressing= sterile bandage= non sterile
-discard soiled dressings
do not contaminate the dressings