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Thread: Emergency Assessment

  1. #1
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    Nov 2006
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    Default Emergency Assessment

    Emergency Assessment

    Assesstemic appraoch to the assessment of an emergency patient is essential
    primary an secondary surveys provide the emergency nurse with a methodological approach to help identify and prioritize patients needs>

    primary assessment
    The initial rapid ABCD (airway , breathing , circulation and disability resulting from spinal injuty )

    does the patient have an open airway ? is the patient able to speak ? Check for air way obstructons such as loose teeth , foreign objects , bleeding , vomitus or other secretions .
    Immediately treat anything that comprimise the airway

    is the patient breathing ?? Assess for equal rise and fall of the chest , respiratory rate and pattern , skin color , use of accessory muscles , integrity of the chest wall , and position of the tachea .
    All major trauma patients require supplemental oxygen via non breathing mask .

    Is circulation in immediat jeopardy ??can you palpate a central pulse ?? what is the quality (strong , weak , slow , rapid ) is the skin warm and dry ? is the skin colore normal ?? obtain blood pressure ..

    Assess level of consciousness and pupils using AVPU scale
    A ___is the patient alert ?
    V___does the patient respond to voice?
    P___does the patient respond to painfull stimuli ?
    U __the patient un responsive to painfull stimuli ??

    secondary assessment
    the steps include

    Expose / enviromental control

    it is necessary to remove the patient's clothing in order to identify all injuries >> you must prevent heat loss by using warm blankets .

    Full set of vital signs / five inteventions/ facilitate family presence

    a__ obtain full set of vital signs includin BP , HR , RR, temprture ..

    b__five interventions
    pulse oximetery for oxygen saturation
    indwelling urinary catheter>>don't insert if noted blood at the meatus , blood at the scrotum or if you suspected pelvic fracture
    gastric tube (if there is evidence of facial fracture insert the tube orally
    lab studies

    facilitate family presenc
    assess the familly needs and if any member of the family wishs to persent during CPR it is amperative to assign a staff member to that person to explain what is being done and offer support

    Give comfort measures
    include verbal reassurance as well as pain managment as appropriate

    Obtain prehospital information from emergency personal , patient , family using MIVT
    M_mechanism of injury
    I _ Injury sustained or suspected
    V__vital signs
    T__treatment befor arriving
    Head to toe assessment
    we know already how to do it
    focused assessment
    Any injuries that were identified during the primary and secondary survys require a detail assessment which include a team approach and radiographic studies ....

  2. #2
    Join Date
    Aug 2008
    The Big Apple, New York!
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    Pretty cool, thank you!

  3. #3
    Join Date
    Mar 2010
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    Thank you

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