Emergency Surgery Risk NSG233.01.02.01
Factors
Fluid Management of NSG233.01.02.01 Medical Management:
hypovolemic Shock Major goals of treatment
1. Restore intravascular volume
2. Correct underlying cause
- 2 large gauge IV lines
- Intraosseous if unable to obtain IV
- Crystalloid (Normal Saline, actate Ringer)
- Blood transfusion
- Oxygen
Prioritizing Patients in the ED NSG233.01.01.02 Goal is to assign patient priority to treatment based on patient acuity and need
for care
Patients with life threatening injuries are given highest priority
Di昀昀erent triage systems for di昀昀erent situations (EMS (emergency medical
services) vs inpatient)
Triage Systems:
Basic system three categories:
Emergent: highest priority
Urgent: serious health problems but not life threatening
Nonurgent: episodic illness
Emergency severity index (ESI) assigns patients to 昀椀ve levels:
Level 1 (most urgent- for example, cardiac arrest) to Level 5 (least urgent –
client has hypertension and needs medication).
Emergency Severity Index:
1. Resuscitation
2. Emergent
3. Urgent
4. Non-urgent
5. Referred
Level 1:
, lOMoAR cPSD| 20026151
Requires immediate life-saving interventions
Unresponsiveness
Level 2:
Potential major life or organ threat
Unsafe to remain in waiting room for any length of time
Need for care is immediate
High priority and care should be initiated within 10 minutes of arrival
Levels 3-5:
Level 3 requires 2 or more resources
Level 4 requires 1 resource
Level 5 requires no resources
Priority Emergency Measures:
Airway obstruction and establishing an airway and ventilation
Hemorrhage
Hypovolemic shock
Wounds
Trauma and multiple trauma
Primary Survey:
Airway
Breathing
Circulation
Disability
Exposure and Environmental control
Facilitate adjuncts and family
Get resuscitative adjuncts
LMNOP
Secondary Survey:
Starts after the Primary Survey is completed
Health history
Head-to-toe assessment: reassess airway, breathing, VS
Diagnostic and lab testing
Monitoring devices: ECG, arterial lines, urinary catheters
Splinting of fractures
Wound care
Other interventions based on condition
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