Thursday, April 9, 2009

Emergency Nursing

Emergency can be stumbled upon everywhere, at the most unexpected instances. It is a sudden and urgent occurrence, usually unforeseen, requiring an immediate action. Emergency crisis refers to circumstances in which quick action and judgement is necessary. It may not prevent undesirable consequences but if some medical and nursing interventions are done, it may help save lives. Here are some emergency conditions and actions that we must remember:
No pulse and respiration:
Perform CPR or Cardio Pulmonary Resuscitation.

Choking and conscious:
Heimlich maneuver

Choking and unconscious:
Heimlich and finger sweep. Do not perform finger sweep to a child.

Choking conscious child:
5 back blows and 5 chest thrusts, remove object. Never perform finger sweep.

Choking unconscious child:
Give 2 slow breaths, 5 back blows and 5 chest thrusts, remove object

Motor vehicle accident:
Do not rush to get victim out. Contrary to opinion, most vehicle crashes do not involve fire.

Fires:
Do not let a person run if clothing is on fire. Do not get trapped while fighting a fire. Always keep a door behind you so that you can exit if the fire gets too big.

Farm animals:
Do not frighten an animal.

Hypovolemic shock:
Elevate leg 8-12 inches only if with no spinal cord injury. Do not raise legs if with chest injuries, breathing difficulty, or unconscious.

Anaphylactic shock:
Give Epinephrine

External bleeding:
Direct wound pressure, elevate, tourniquet.

Amputation:
Control bleeding; find severed part and seek medical attention immediately. Severed part – wrap in dry, sterile gauze or clean cloth; put in waterproof container; place wrapped part and container on bed of ice, but do not submerge in ice or cold water.

Eye injuries:
Seek medical attention immediately. Protect injured eye and patch unaffected eye to prevent movement. Do not remove an object stuck in the eye and do not apply hard pressure.

Chemical burns to eye:
Keep eye open and flush with water immediately.

Nose bleeding:
Sit upright, head bent slightly forward, pinch nostrils, breathe through mouth.

Chest injuries:
Check *ABCHs; stabilize chest using pillow, coat or blanket, and seek medical attention. Do not remove object because bleeding and entry of air in chest cavity will occur.

*Airway – head tilt, chin lift method or jaw thrust if with trauma
Breathing – look, listen, and feel for breathing
Circulation – check pulse at carotid artery
Hemorrhage – check for bleeding
Spinal cord injury – always assume a trauma to the head with spinal cord injury

Animal bites:
Wash with soap and water, control bleeding, and seek medical attention.

Insect stings:
Scrape stinger off, and wash with soap and water.

Snakebites:
Keep affected area below the heart level, clean with soap and water, splint part to reduce movement, and seek medical attention.

1st degree burn (painful with redness, mild swelling, and pain):
Apply cold wet dressing or soak in cold water. Do not cover with dressing after.

2nd degree burn (painful with deeper affection, blisters develop):
Apply cold dressing or soak in cold water. Cover with a dry, nonstick, sterile dressing or clean cloth.

3rd degree burn (not painful, deeper destruction, skin layers destroyed)
Cover with dry nonstick, sterile dressing or clean cloth; treat shock.

Hypothermia:
Get victim out of cold, replace wet clothes with dry warm clothes, keep flat and provide other sources of heat. Do not give warm drinks, they dilate the blood vessels more. Do not engage in physical exertion.

Heat stroke:
Assess for hot skin, high body temperature, altered mental status – seek medical attention immediately.

Heat exhaustion:
Move to cool place, raise legs 8 to 12 inches, remove excess clothing, sponge with cool water and fan.
Bruises, strains, sprains, dislocations, fractures:
Use R.I.C.E.
Rest
Ice (20-30 minutes every 2-3 hours during 1st 24-48 hours)
Compression (bandage 18-24 hours)
Elevation (but do not elevate fractures)

Swallowed poisoning:
Identify poison and how much and when taken. Call poison control center or seek medical attention immediately.

Heart attack:
Stop activity and place in half sitting position, with knees bent and padding under the knees.

Seizure:
Caution head; loosen tight clothing; turn to side; promote safety.

Asthma:
Sit upright, use asthma medication (inhaler, nebulizer), and seek medical help.

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