principles of EMERGENCY CARE

Emergency care is that care must be rendered without delay.

1. Prepare by: RN Arpana Bhusal BNS

2. EMERGENCY CARE Emergency care is that care must be rendered without delay. 3.2 PRINCIPLE OF EM CARE: One of the first principle of emergency care is triage

3. Cont……. Emergent : Patients have the highest priority their conditions are life threatening and they must been immediately. Urgent : Patients have serious health problem but not immediately life threatening ones , they must be seen within 1 hour.

4. Cont….. Non urgent : Patients have episodic illness that can be addressed within 24 hours without increased morbidity.

5. TRAIGE

6. PURPOSES OF TRIAGE Triage is necessary for the following purposes: To separate out the minor injuries to reduced burden on the management of critical cases. To provide the equitable and rational distribution of resources. A “color code” will be given to establish the priority of access. To treatment on the basis of the seriousness of the cases.

7. Cont…. In an advanced triage process injured people are sorted into categories: RED: very critical , danger of death , immediate treatment , life threatening condition. Typical problems are: Respiration / airway Pulse

8. Cont….. Mental status Severe burn which compromise airway. YELLOW: Fairly critical , high level of risk , potential danger of death , treatment can not be delay, Typical problems are: Burn patient without airway problem Major bone and joint injuries.

9. Cont…… Back and spine injuries, GREEN: Not very critical , no risk of condition worsening , treatment can be delayed Typical problems are: Minor cuts Minor painful and swollen Minor soft tissue injuries.

10. Cont…. BLACK: Victim is extremely critical and dying. They are used for the decreased and for those whose injuries are so extensive. They are will not be able to survive given the care that is available.

11. PRINCIPLE OF TRIAGE SYSTEM Should be simple. Does not require advanced assessment skill. Does not specific diagnosis. Should be easy to perform. Should provide for rapid and simple life saving intervention. Should be easy to teach and learn.

12. BENEFITS OF TRIAGE Identify patients who requires rapid medical care to save life. Provides rational distribution of casaulties . By separating out the minor injuries , reduced urgent burden on each hospital.

13. GENERAL TRIAGE GUIDELINES Greet client and family in a warm manner. Perform brief visual assessment. Documents the assessment. Triages clients into priority group using appropriate guideline.

14. Cont…. Transport client to treatment area when necessary. Keeps patient / families aware of delays. Reassesses waiting client to is necessary. Instruct client to notify triage nurse of any change in condition.

15. TRIAGE TEAM MEMBERS Physician Nurses - junior and senior Student nurse Lab technician Sweeper Clearner Compounder Security guard Driver

16. TRIAGE SET- UP Ventilator Pulse oxymetery Defibrillator X – ray , scanning Oxygen , suction equipment Infusion pumps Emergency trolley with medication

17. Cont… Tracheostomy and intubation set Solution and instruments Ambulance

18. ROLE OF TRIAGE NURSES Greet patients and identify your self. Maintain privacy and confidentiality. Visualize all incoming patients even while interviewing other. Maintain good communication between triage and treatment team.

19. Cont…. Use all resources to maintain high standard of care. Teaching ….. Use of thermometer , first aid?? Avoiding lecturing. Crowd control. Telephone Communicate with team leader and seek feedback on decision.

20. D-I-S-A-S- T -E-R Triage For any hospital while responding to a mass casualty event; the goal is to save as many lives as possible with the available resources

21. D-I-S-A-S- T -E-R Triage This could mean application of the principles of field triage in casualty The purpose of which is to determine who gets what kind of care

22. D-I-S-A-S- T -E-R Triage The term comes from the French verb trier Meaning to separate, sort, sift or select

23. D-I-S-A-S- T -E-R Triage A process of prioritizing patients based on the severity of their condition, in order to treat as many as possible when resources are insufficient

24. D-I-S-A-S- T -E-R Triage All to be treated immediately is impossible, so one has to select the suitable patients for immediate care based on certain criteria ❏ Right Patient Right Place Right Time

25. Colour Category Time span Red Emergent Within 15 minutes Yellow Urgent Within 30 minutes Green Delayed Within 60 minutes Black Deceased Post mortem D-I-S-A-S- T -E-R Triage

26. Delayed Y es Open airway & Look for movements/ Respiration Able to walk No Look for Breathing No No Dead Immediate Y es Y es Normal Breathing ? No Yes Normal Capillary refill? No No No Yes Normal Capillary refill? Yes Follow commands? Yes Urgent Triage Sieve

27. D-I-S-A-S- T -E-R Triage - Badge It is selected by the Triage Nurse / officer and worn on each patient involved. It helps for any other staff to immediately identify seriousness of the case

28. D-I-S-A-S- T -E-R Triage - Tape Instead of the triage badge, one may use triage tape to be worn around the wrist

29. D-I-S-A-S- T -E-R Triage - Tag

30. D-I-S-A-S- T -E-R Triage - Nurse The triage nurse should be in view of the waiting area of the casualty at all times Prioritize the waiting patients periodically

31. D-I-S-A-S- T -E-R Triage - Nurse Greeting patients and families in a warm, empathetic manner Performing brief visual assessments Documenting the assessments triaging patients into priority groups using appropriate guidelines

32. THANK YOU