Emergency nursing

Emergency nursing is a nursing specialty in which nurses care for patients in the emergency or critical phase of their illness or injury.
While this is common to many nursing specialties, the key difference is that an emergency nurse is skilled at dealing with people in the phase when a diagnosis has not yet been made and the cause of the problem is not known.

1. Introduction to Emergency
Prepare by:
RN Arpana Bhusal
BNS

2. Emergency medicineisamedical
specialtyinwhichphysicianscarefor
patientswithacuteillnessesorinjuries
whichrequireimmediatemedicalattention.
Whilenotusuallyprovidinglong-termor
continuingcare,emergencymedicine
physiciansdiagnoseavarietyofillnesses
andundertakeacuteinterventionsto
stabilizethepatient.

3. Emergencymedicinephysicianspractice
inhospitalemergencydepartments,in
pre-hospitalsettingsviaemergency
medicalservices,otherlocationswhere
initialmedicaltreatmentofillnesstakes
place,andrecentlytheintensive-care
unit.Justascliniciansoperateby
immediacyrulesunderlargeemergency

4. systems,emergencypractitioners
aimtodiagnoseemergent
conditionsandstabilizethepatient
for definitive care.

5. AnEmergencyDepartment(ED),also
knownasAccident&Emergency
(A&E),Emergency Room (ER),
EmergencyWard(EW),orCasualty
Departmentisamedicaltreatment
facility,specializinginacutecareof
patientswhopresentwithoutprior
appointment,eitherbytheirownmeans.

6. Theemergencydepartmentisusually
foundinahospitalorotherprimarycare
center.
Duetotheunplannednatureofpatient
attendance,thedepartmentmustprovide
initialtreatmentforabroadspectrumof
illnessesandinjuries,someofwhichmay
belife-threateningandrequireimmediate
attention.

7. Insome countries,emergency
departmentshavebecomeimportant
entrypointsforthosewithoutother
meansofaccesstomedicalcare.
Theemergencydepartmentsofmost
hospitalsoperate24hoursaday,
althoughstaffinglevelsmaybevariedin
anattempttomirrorpatientvolume.

8. History
Thefirstspecializedtraumacarecenterin
theworldwasopenedin1911intheUnited
StatesattheUniversityofLouisvilleHospital
inLouisville,Kentucky,andwasdeveloped
bysurgeonArnoldGriswoldduringthe
1930s.Griswoldalsoequippedpoliceandfire
vehicleswithmedicalsuppliesandtrained
officerstogiveemergencycare.

9. Department Operation
Aspatientscanpresentatanytime
andwithanycomplaint,akeypartof
theoperationofanemergency
departmentistheprioritizationof
casesbasedonclinicalneed.Thisis
usuallyachievedthoughthe
applicationoftriage.

10. Objectives of Emergency Department
Quick assessment of the client’s need
Prompt diagnosis
Right intervention
Prompt evaluation of condition
Necessary action for referral
Admission, discharge and follow up
Maintain individuality of the client
Maintain safety/comfort of the client

11. Objectives contd.
Maintain therapeutic effectiveness
(preventive,promotive,curative and
rehabilitative)
Cost effectiveness
Economy of man, money, material
and time

12. Emergency Department
Location –near main gate
Emergency mobile –ambulance/air(well
equipped with trained manpower)
Population coverage –15 bed for 500
bedded hospital
Floor –preferably antistatic
Area required –reception, waiting hall,
nsg/Dr’s duty station
Examination table for 50 client = 1,400 = 8
Operation table = 4

13. Contd.
Dressing room/procedure room –1
Rest room –1, Tea room –1
Sluice room –1, Store –sterile
-Nonsterile
-Regular
-Disaster
Observation room –10-12 beds
Police office room –1, Social service
room-1
Record room –1, Administrative room -1

14. Contd.
Lab /x-ray services, Blood bank,
Ambulance,Murtruy,Postmortom,
Equipment supplies –ECG machine,
defribilater, oxygen, suction machine,
emergency light, bed pan/urinal
Emergency cart
Pharmacy

15. Emergency Nursing
Prepare by:
RN Arpana Bhusal
BNS

16. Definition
Emergencynursingisanursingspecialtyin
whichnursescareforpatientsinthe
emergencyorcriticalphaseoftheirillnessor
injury.
Whilethisiscommon tomanynursing
specialties,thekeydifferenceisthatan
emergencynurseisskilledatdealingwith
peopleinthephasewhenadiagnosishas
notyetbeenmadeandthecauseofthe
problemisnotknown.

17. Scope of Emergency Nursing

18. The Principles of Emergency Nursing

19. The Principles of Emergency Nursing

20. General Principles of EMC

21. General Principles of EMC

22. Approach to patient
Assessment of psychological
functioningincludesevaluationof
emotionalexpression,degreeof
anxietyandcognitivefunctioning
Rapid physical assessment
(Problem solving in limited time and
pressured environment)

23. To prevent
deterioration
Major goals of
priorities of
emergency care
To preserve
life
To restore
the patient
for useful
living
Injuries to face, neck and chest that impairs respiration are the
highest priorities

24. Component of emergency nursing care
•Empathy
•End-of life planning and choices
•Evidence-based practice
•Experimental research
•Exploratory study
•Family health
•Family satisfaction with end of life care
•Mission, vision, value and beliefs,
objectives, activities
•Code of ethics

25. Component of the nursing role include
Expertise in rapid assessment and
assimilation of information often beyond
the presenting problem
Establishment of priorities
Intervention based on the assessment
An ongoing evaluation
Supporting and attending to family
Supervising allied health personnel and
teaching patient and their family
Discharge or referral to other sources of
care according to agency policy

26. Issue in emergency nursing care
Numerous multifaceted issues such as:
1.The shortage of nursing personnel, nursing
job satisfaction, staffing
2.ED overcrowding, number of beds
3.Interpersonal violence
4.Need for new technology

27. Major emergency conditions
Amajoremergency isanyevent
(happeningwithorwithoutwarning)
causingorthreateningdeathorinjury,
damagetopropertyortheenvironment
ordisruptiontothecommunitywhich,
becauseofthescaleofitseffects,cannot
bedealtwithbytheemergencyservices
andlocalauthorityaspartoftheirday-
to-dayactivities.

28. Types of major emergency
Severe weather conditions/flooding
Major structural collapse
Major fire or explosion
Threats to public health
War or terrorism
Major public disorder or criminal
activity

29. Contd….
Earthquake
Armed suspects/Active Shooter
Bomb threats
oMedical Emergency
Suicide
oHazardous material leak or spill
Flood
Aircraft Crash

30. Contd….