Emergency Nursing is a nursing specialty in
which nurses care for patients in the emergency or
critical phase of illness or injury.
What is Emergency Nursing?
Define the assessment process
Describe the components of a Primary & Secondary
assessment
Appropriately implement nursing care of the emergency
patient.
Assist with common emergency department procedures.
Communicate effectively with the local EMS agency.
Describe the critical thinking process and nursing
interventions for the Emergency patient.
Objectives
Florence Nightingale was the first emergency nurse,
providing care to the wounded in the Crimean War in 1854.
The Emergency Department Nurses Association (EDNA) was
organized in 1970.
A competency-based examination, first administered in 1980,
provides Certification in Emergency Nursing; certification is
valid for 4 years.
EDNA developed Standards of Emergency Nursing Practice,
published in 1983, to be used as a guideline for excellence
and outcome criteria against which performance is measured
and evaluated.
In 1985, the Association name was changed to Emergency
Nurses Association (ENA), recognizing the practice of
emergency nursing as role-specific rather than site-specific.
Historical Development of Emergency Nursing
Think like an ED nurse
Assess like an ICU nurse
Organize like a Med-Surgnurse
Connect like a psych nurse, and
Implement like an expert.
Who is the Expert nurse in giving
emergency care?
.
How will prepare
and train the
Emergency Nurse?
Strong medical-surgical, critical-
care, or cardiac background.
Broad clinical knowledge, excellent
skills, flexible and adaptable
approach, and strong inter-
personal and teaching ability.
Certification courses in adult
advanced life support, and core-
curricula in Emergency Nursing.
Continues education and training
throughout the career.
Advanced degrees are available.
❖High degrees of knowledge and skills with diagnostic and
decision-making power.
❖Perform urgently needed activities in autonomous fashion.
❖Collaborative team approach with other health professionals.
❖Capable of providing a broad spectrum of skills in other
settings.
❖Providing care and treatment of those injuries or illnesses.
❖Providing the educational and psychosocial evaluations and
support to return the patient successfully.
How is "Emergency Nursing" different from
other nursing?
Triage is a
sorting process
designed to assure that
the sickest patients get
the proper resources
first.
Objective is
rapid recognition of
quickly deteriorating
conditions.
Triage
Class I -Immediate life-
threatening.
Class II -Stable, but needs to
taken care of patient. This
patient is in no acute distress.
Class III -Stable reassessment
every 30 minutes.
Class IV -Stable in no acute
distress.
Comprehensive Triage: Four Urgency Categories
Level I: Requires
resuscitation.
Level II: Emergent
Level III: Urgent
Level IV: Less Urgent
Level V: Non-urgent
Five Level Triage
Clinical assessment and Priority Setting
Primary assessment.
Life-threatening conditions should be detected
immediately.
Physician-nurse communication is vital to the
patient’s positive outcome.
Ongoing patient assessment.
Patient Assessment
Patient presents
1. RAPID PRIMARY ASSESSMENT
Life threatening condition? / Non-life threatening condition?
Basic life support
Once patient is stable
2. INITIAL ASSESSMENT
3. FOCUSSED ASSESSMENT
If the patient has trauma then a TRAUMA ASSESSMENT
is required before the focused assessment.
4. Contact MEDICAL OFFICER
To follow Medical consultation flowchart.
UNIVERSAL ASSESSMENT PROCESS
✓Assesses the patient, prepares the room with
necessary equipment, documents, coordinates care
and gives medications.
✓Manage airways and ventilators.
✓Obtain lab specimens, assist with removal of
clothing to facilitate the secondary survey, do
EKGs, dressings to wounds, splint application, and
urethral catheterization.
✓Do the necessary requested x-rays and procedures.
✓Contact family members and assist with transfer
arrangements if necessary.
Guidelines for Effective Management of the
Patient
Patient Care—Care for patients and families in hospital
emergency departments, ambulances, helicopters, urgent
care centers, ships, sports areas, industry, government, and
anywhere someone may have a medical emergency or
where injury prevention is a concern.
Education—Programs to promote wellness and prevent
injuries, such as alcohol awareness, child passenger safety,
gun safety, bicycle and helmet safety and domestic violence
prevention.
Leadership and Research—Work as administrators,
managers, and researchers in emergency health care.
Role of emergency nurse
The research process has
stimulated nurses to seek
answers to problems directly
visible in their own clinical
environment.
Evidence-based Practice
Several federal organizations
that advise research topics like
Emergency Nurses Association (
ENA), American Association of
Critical Care Nurses (AACN),
American Nurses Association
(ANA), & National Institute of
Health (NIH). These organizations
encourage research in areas of
emergency nursing.
Con.