Emergency medicine lecture 1 dr- smaah al haatab

Emergency medicine lecture

1. Emergency Medicine

2. ED Responsibilities
Stabilization of unstable patients through live saving
interventions.
Recognition of potentially unstable patients.
Diagnose undifferentiated cases.
Put a plan for farther management, consultation and
disposition.

3. Emergency Triage

4. RED FLAGS
1.Respiration.
2.Circulation.
3.Mental status.

5. To prioritize incoming
patients and to identify
those who cannot wait
to be seen.
Organize ED work and
Decrease
crowdedness.
Unstable and very ill
patients first.
Priority considers the
resources needed.

8. Triage

9. 5 level triage

37. Trauma

70. ESI exam
1. A 44-year-old female is retching continuously
into a large basin as her son wheels her into the
triage area. Her son tells you that his diabetic
mother has been vomiting for the past 5 hours
and now it is “just this yellow stuff.” “She hasn't
eaten or taken her insulin,” he tells you. No
known drug allergies (NKDA). VS: BP 148/70, P
126, RR 24.
Level 1 Level 2 Level 3
Level 4 Level 5

71. 2. “I have this infection in my cuticle,”
reports a 26-year-old healthy female. “It
started hurting 2 days ago and today I
noticed the pus.” The patient has a small
paronychia on her right 2
nd
finger. NKDA, T
98.8°F, RR 14, HR 62, and BP 108/70.
Level 1 Level 2 Level 3
Level 4 Level 5

72. 3. A 17-year-old handcuffed male walks into the ED
accompanied by the police. The parents called 911
because their son was out of control: verbally and
physically acting out and threatening to kill the
family. He is cooperative at triage and answers your
questions appropriately. He has no past medical
history (PMH), allergies, and is currently taking no
medications. Vital signs are within normal limits.
Level 1 Level 2 Level 3 Level 4
Level 5

73. 4. “I should have paid more attention to what I
was doing,” states a 37-year-old carpenter
who presents to the ED with a 3-cm laceration
to his right thumb. The thumb is wrapped in a
clean rag. “I know I need a tetanus shot,” he
tells you. BP 142/76, P 88, RR 16, T 98.6°F.
Level 1 Level 2 Level 3
Level 4 Level 5

74. 5. “My mother is just not acting herself,” reports
the daughter of a 72-year-old female. “She is
sleeping more than usual and complains that it
hurts to pee.” VS: T 100.8°F, HR 98, RR 22, BP
122/80. The patient responds to verbal stimuli
but is disoriented to time and place.
Level 1 Level 2 Level 3
Level 4 Level 5

75. 6. EMS arrives with a 75-year-old male with a
self-inflicted 6-cm laceration to his neck.
Bleeding is currently controlled. With tears in his
eyes, the patient tells you that his wife of 56
years died last week. Healthy, NKDA, baby ASA
per day, BP 136/82, HR 74. RR 18 and SpO2 96%
RA.
Level 1 Level 2 Level 3
Level 4 Level 5

76. 7. “My dentist can't see me until Monday and
my tooth is killing me. Can't you give me
something for the pain?” a 38-year-old healthy
male asks the triage nurse. He tells you the pain
started yesterday and he rates his pain as
10/10. No obvious facial swelling is noted.
Allergic to Penicillin. VS: T 99.8°F, HR 78, RR 16,
BP 128/74.
Level 1 Level 2 Level 3
Level 4 Level 5

77. 8. “My doctor told me to come to the ED.
He thinks my hand is infected,” a 76-year-
old female with arthritis, chronic renal
failure, and diabetes tells you. She has an
open area on the palm of her left hand
that is red, tender, and swollen. She hands
you a list of medications and reports she
has no allergies. She is afebrile. VS: HR 72,
RR 16, BP 102/60.
Level 1 Level 2 Level 3
Level 4 Level 5

78. 9. A 76-year-old male is brought to the ED because
of severe abdominal pain. He tells you “it feels like
someone is ripping me apart.” The pain began
about 30 minutes prior to admission and he rates
the intensity as 20/10. He has hypertension for which
he takes a diuretic. No allergies. The patient is sitting
in a wheelchair moaning in pain. His skin is cool and
diaphoretic. VS: HR 122, BP 88/68, RR 24, SpO2 94%.
Level 1 Level 2 Level 3 Level 4
Level 5

79. 10. A 16-year-old male wearing a swimsuit
walks into the ED. He explains that he dove into
a pool and his face struck the bottom. You
notice an abrasion on his forehead and nose
as he tells you that he needs to see a doctor
because of tingling in both hands.
Level 1 Level 2 Level 3
Level 4 Level 5