Emergency Nursing - Science topic

Thank you so much Ahmad Mohamadi . It seems very interesting. I already registered!

I will share with some of my colleagues.

In children, any case with respiratory symptoms are considered suspects of COVID-19; preventive isolation is performed until the test results are obtained. However, a problem becomes relevant in this case and consists of the limitation of companions in specialized units, in some cases promoting the dehumanization of services and reducing the provision of services that could improve their immune response.

@Aldo P. Thank you. I think Health care workers around the world should be saluted and appreciated in many ways for the selfless acts of humanity we have all illustrated during these unspeakable times. Thank you for your service.

Make a CV and personal letter for yourself and send it to the hospitals you want to work at. I know they hired an italian doctor where I worked and they gave him some months around the hospital to learn swedish better before he was fit to work alone.

In our Hospital we have implemented the Manchester triage system with very good results. From 51 reasons of consultation and through some questions addressed in a diagram. That is, according to the answer yes / no, classification occurs, with 5 severity levels. It also has a digital version.

Hi James,

Unfortunately, there is no "one size fits all" answer. It really depends on the specific patient and the specific emergency department. If peripheral access is easily and quickly obtained, then accessing the IVAD should not be performed. However, most patients with IVADs generally have poor peripheral access. In this case, it would be appropriate to access the IVAD only if the staff is adequately trained in doing so. The department should have a policy for accessing these devices along with a good training program so that they are accessed safely and sterile.

Condom catheters can be utilised in males that are not sedated/confused, without urinary obstruction or spinal cord injury.

The Perceived Stress Scale (PSS) is one of the best. Please see in the following link

http://www.mindgarden.com/documents/PerceivedStressScale.pdf 

thanks you very much Richard!!! I'll read with very attention all files. I'll send you my feedbach. See you soon. Nicola

I can recommend Antonovsky's theory as a theoretical foundation. Sence of coherence. Best wishes for you in your process. 

Dr. Richardson's comments are excellent!!  I work on the west coast in the USA we do have plenty of patient who present to the ED with the final diagnosis of miscarriage.  Many of these patients are frightened and unsure of what the sudden onset of vaginal bleeding means.  Many of these patient may call their OB/GYN or PCP but many times are sent to the ED for actual evaluation and treatment.  Some of the patients have had profuse bleeding necessitating an emergent trip to the OR for a D&C as well as a transfusion of O negative un-crossmatched PRBCs.  In my career I have personally cared for three patients who were in hemorrhagic shock.  The importance of determining if an ectopic pregnancy is present also necessitates emergent evaluation in the ED.  Some patient have some vaginal bleeding with a viable and healthy fetus necessitating pelvic rest.  Great question--hope that helps!

Hello Victoria, I do perceive that emergency nurses are more likely to participate in furthering their education formally and informally.  Such nurses realize their responsibility to patients, and gaining more relevant knowledge and skills will equip them with the ability to do the right thing in an emergency.  I have noticed that nurses are very independent self-directed learners.  The nature of the job of an emergency nurse requires the ability to think and act logically, correctly based on some specialized knowledge, when human lives are at stake.  In an emergency, the  nurse may have no time to refer to the specialist doctors.  (So, knowledge empowers right deeds.  Let's pursue education.)

Structurally it appears that the radial artery is occluded sacrificing arterial supply to the thumb, index, and middle finger.  Without more history or more information, etiology may be difficult to ascertain.

Dear Hilary,

Are you familiar with the Danish record label Quiet Please, which has been developing optimal relaxing music with doctors? This music has been used widely e.g. in ambulances. The record is “15 Minutes of Peace”, and it can be found on Spotify. There is some information about this project on the internet, but I am not sure if there is any in English.

Best regards

Anne

The on scene senior clinician, usually paramedic, follows local and national (NICE) guidelines to terminate on scene. This is where ALS has proven to be without positive effect and no ROSC achieved but there are also other factors. Children, hypothermic patients etc are conveyed to an appropriate facility for further intervention and are very rarely, if at all, pronounced 'life extinct' on scene.

As to BLS terminating on scene without an ALS provider attending; I feel that is an awkward and maybe a little dangerous situation, to be caught up in.

Personally, I would not cease CPR if only BLS was being attempted.

Greetings,

The document below might be of interest to you. It represents a collected body of operating room crisis checklists and is available for download as PDF free of charge.

All too often, I find that even directed searches return a plethora of useless or unrelated articles and other publications. It may be a good idea to put together a resource like the one referenced above for all to download and use.

Regards,

Stan.

In addition to what has been mentioned:

There is the revised trauma score which is actually calculated in the large trauma registries that are kept at level 1 trauma centers: RTS=0.9368(GCS)+0.7326(SBP)+0.2908(RR)

The Denver TOF (Trauma Organ Failure) Score to predict multi-organ failure during hospitalization. Annals of Emergency Medicine. Volume 62, Issue 4, Supplement, Pages S4–S5, October 2013

During clinical practice most people work off the actual vital signs, physical exam, and bedside ultrasound findings. NIRS is still experimental within the emergency department, no standard of care.

Should not move unnecessarily, Careful position in transferring the patient, prevent further damage, There are aides to assist with the moving of the

spine-injured patient. Then take him for surgery.

"CA survivors represent an important potential source for development of PTSD."

A bigger team as you suggested is not cost effective and may delay rather expedite being seen and discharged. Remember, this is triage. A quick assessment and disposition is what should happen. Assign patients where they need to go in the quickest way possible.

Hello everyone, I published our experience in the NICU of Perugia Hospital about the newborn with surgical problems on Connect (Neonatal Surgical Intensive Care: "Bifocal Clinical Nursing Model" approach. Connect, 2011, 8 (3), 91 - 94.). The approach used was the Carpenito's Bifocal Model and Gordon's Functional Health Patterns.

I have witnessed this first hand as triage nurse. In our ED we have our security right in the front of triage which does have a definite effect on calming the overall milleu of triage. Continual observance of any questionable behavior in order to intervene earlier than later has also been very effective in stifling escalating and even combative behaviors.

Investigating any consistent themes of why patients became irritated, aggressive, and combative is also important. Patient perception of long wait-times to see the physician, ED overcrowding, and even lack of information are contributing factors. This is why many of us continually try to improve and expedite the wait times and all of the factors that may cause ED overcrowding as well as prolonged length of stays.

Frequent rounding on patients in triage as well as those patients in the treatment area sends a message of caring, but also increases patient safety, but it also specifically improves patient information. I have also felt that for most patients and families, rapid building of a relationship with the patient sis helpful.

For our behavioral health population, close and even continual observation for any and all patients that raise concern will allow for early detection of any patients which present with any escalating behaviors. As in any other medical condition, early detection and thus early intervention can and most of the time will prevent the disease from escalating.

As far as the question of defending ourselves during a time of an aggressive attack by a patient or a visitor, I feel that defensive tactical maneuvers are warranted but as much as possible without any deleterious affects to the patient. After that said, state legislators in the United States need to reconsider laws regarding assaultive behavior against health care providers. Many states consider an assaultive behavior towards law enforcement, fire fighters, or paramedics a felony wheras assaultive behavior towards physicians, nurses, technicians, or registration personnel merely a misdemeanor providing that the assault does not result in death to that individual.

Simulation exercises- linked with schools of nursing, PA schools, etc.