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
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* Patients with mild hypothermia (93.2º F-96.8º F [34º C-36º C]) have shivering, lethargy, confusion, rational to irrational behavior, and minor heart rate changes. * Moderate hypothermia (86º F-93.2º F [30º C-34º C]) causes rigidity, bradycardia, slowed respiratory rate, blood pressure only by Doppler, metabolic and respiratory acidosis, and hypovolemia. Shivering diminishes or disappears at temperatures ≤86º F (30º C). * Severe hypothermia (<86º F [30º C]) is a severe and potentially life-threatening situation that makes the person appear dead. Profound bradycardia, ventricular fibrillation, or asystole may be present. Every effort is made to warm the patient to at least 86º F (30º C) before the person is pronounced dead. The cause of death is usually refractory ventricular fibrillation. Treatment of hypothermia focuses on managing and maintaining ABCs, rewarming the patient, correcting dehydration and acidosis, and treating cardiac dysrhythmias. * * SUBMERSION INJURIES Submersion injury results when a person becomes hypoxic because of submersion in a substance, usually water. Drowning is death from suffocation after submersion in water or other fluid. Near-drowning is defined as survival from potential drowning. Immersion syndrome occurs with immersion in cold water that leads to stimulation of the vagus nerve and potentially fatal dysrhythmias. * Treatment of submersion
Patient within this category, such as cardiac arrest, respiratory arrest, extreme respiratory distress are imminent risk of deterioration. Thus, these types of patient must be seen immediately. (Hodge et al., 2013)
Shivering is an indication that hypothermia is on the rise (Giesbrecht and Wilkerson 24). In order to increase Elaine’s body heat, her body resorted to shivering. When shivering, “80 percent of the consumed energy is given off as heat allowing for the heat production to be five times as much as the heat production of the body at rest,” (Giesbrecht and Wilkerson 24). This is able to happen because her skeletal muscle is able to expand and contract to allow for normal body activities to
A patient who becomes unresponsive may be experiencing arrhythmia. If a patient has fainted and there is no response immediately notify the physician also provide oxygen. loosen any tight clothing, cover the patient with a blanket for warmth. Once the emergency passes,obtain a set of vital signs and document all activities in the patient's medical
Triage is the categorizing of patients by order of who needs to be seen most urgently. It can be broken into three stages; emergent, urgent, and non-urgent. Emergent is immediately life or limb threatening. An example of an urgent case would be a dog that ingested half a bag of grapes 45 minutes ago or a male cat with a suspected blocked urinary tract with no urination for the past 12 hours or more. Urgent needs to be treated but is not life threatening or limb threatening if left untreated for several hours. An example of an urgent case would be a puppy that jumped off the couch and is now lame on its front right leg or a bird that comes in with a broken wing after a brief scuffle with the household cat.. Non-urgent should be treated but time is not a factor. An example of a non-urgent case would be
The clinical ECG findings of hypothermia include reversible and temperature-dependent abnormalities: morphology (Osborn waves), rhythm (bradycardia, premature atrial and/or ventricular beats, atrial fibrillation, VT/VF), time (prolonged PR, QRS, and QT intervals ) and conduction (AV-block)[14, 15].
Purpose: The purpose of this speech is to educate and inform my audience of the risks inherent from unintended hypothermia. I’m eager to alert perioperative staff of the potential dangers as well as the preventative measures that can be taken in order to avoid complications associated with unintended hypothermia. My central idea is hypothermia management saves lives.
Triage is usually the first step of the emergency room and helps determine severity of each patient. Once through triage, the patient
He then took samples of urine, blood, and mucous as body temperatures lowered. Through this tortured, Rascher used the data to create the hypothermia treatment called "active rapid rewarming." More than 90 people lost their lives for this medical advancement (Adams).
Factors that are indications of a crisis include dehydration, infection and cold weather, but in many patients the exact cause is unknown. Awareness of these factors should be known by the patient. Patients with sickle cell anemia have a reduced ability to conserve water and a defect in renal concentrating. They should be told to wear warm clothing during cold weather, hydrate in hot weather and limit exercising to avoid fatigue and dehydration. In addition, avoiding hypoxemia before anesthesia or when a procedure involves hypertonic radiographic
Lowered body temperature and stiffness are also expected to appear, followed later by bloating and signs of decomposition” (Kastenbaum, Page 42). However, even with these listed, it is still quite possible for a person not be dead, if they’ve been electrocuted, suffered from a heart attack, or drowned. So, there is a list of prerequisites that the medical field must follow in order to declare someone
Triage derived from a French word meaning “to sort.” Triage is a golden assessment tool used to determined patient acuity (Lewis, Heitkemper, Bucher, & Harding, 2014). The process of triage works by allowing treatment to the patient of medical urgent conditions before other patients. In order to determine the order of care to healthcare system use the Emergency severity Index which is a five-level triage that categorize patients according to the acuity of their illness and need for resources (Lewis, Heitkemper, Bucher, & Harding, 2014). The five-levels vary from level one which requires immediate care to level five whom is a patient doesn’t require immediate attention (Lewis, Heitkemper, Bucher, & Harding, 2014).
Suffocating is very dangerous and can show signs of damage hours or even days after the incident. Drowning victims can suffer headaches much longer after the fact.
Your body goes through hypothermia when the body temperature is under 95 F or 35 C. When experiencing hypothermia the organs, heart, and other body functions don’t work properly. Hypothermia can lead to death if left untreated for a certain amount of time. Like frostbite, hypothermia is caused from being exposed to dangerously cold weather. Signs that you’ve caught hypothermia are shivering, confusion/memory loss, weakness, slurred speech, loss of consciousness, and clumsiness. When the body catches hypothermia he/she isn’t aware of it since the since the signs gradually affect the body more and more. If the body is suspected to have hypothermia call emergency services immediately to cancel any life threatening
The cryotherapy process involves you standing in a tank or a whole-body cryotherapy chamber. Your body will then be bathed with liquid nitrogen or freezing air for several minutes. The temperature can get close to 200 degrees below zero. In most cases, this step will last for between two and four minutes. You will be wearing minimal clothing.
The human body has several amazing systems that help keep us running smoothly through varied conditions. Our body has functions that automatically watch, adjust and maintain our necessary systems while not our even knowing it. Breathing, heart rate, weight management and blood pressure are all maintained subconsciously. Shivering is simply one of these functions our body makes use of to keep up our blood heat at a temperature of 98.6°F (37°C).