Emergency Room Education - Essay Example

? EMERGENCY ROOM EDUCATION What does emergency mean? Emergency is easy to understand but difficult to deal with. When we are in an emergency we are in a situation wherein our lives are threatened. Emergency situations occur every now and then and most of the time, emergencies happen when we least expect it. Our best option is to prepare for these situations so that we incur the least damage or injury. A definition from the BusinessDictionary.com states that an emergency is unexpected and an impending situation that threatens life or can cause injury (BusinessDictionary.com). An emergency needs immediate attention or treatment in a hospital. There is greater damage or injury if the emergency is not acted upon immediately. In dealing with an emergency, there is a basic principle and that is not to do any further harm. This means that when a victim of a car accident is lying there in the middle of the road right after the accident, the person to administer first aid must be a qualified medic, else further damage might be inflicted on the patient or victim. Emergency medical care which refers to immediate care or treatment, should be provided by an experienced emergency medical team (EMT). (American Academy of Orthopaedic Surgeons, 2011, p. 79) Emergencies can be classified into several types. Medical emergencies are those caused by serious illnesses or injuries. An injury is acquired during accidents from car wrecks or from fall. Medical emergencies, such as serious illnesses, should be immediately acted upon. There are sudden illnesses that create emergency situations, but there are also illnesses which require a 24/7 watch by a specialized ER team. Emergency medical situations like stroke or cases caused by hypertension have to be handled by an ER team but some experienced ordinary people can handle them with ease. (Kalman, 2005, p. 6) Emergency may also refer to a natural disaster for which the people have to prepare. Preparedness is a must in answering an emergency such as a natural disaster. Good planning will provide an effective response when any crisis occurs. (Lebow, 2007, p. 5) On the other hand, emergency medicine is now a recognized specialty in medical practice. The personnel working for emergency medicine are highly skilled emergency personnel. Emergencies in hospitals are now highly regarded for treatment of sicknesses and emergency cases. Even families with personal physicians would usually bring their members to emergency treatment. Physicians also refer their patients who are in emergency situations to the nearest emergency facility. (Annas, 1992, p. 50) 2. When should we access emergency room? Emergency room, emergency department or trauma department – these all provide a successful health care. Having access to emergency room or emergency department of a hospital is part of health care that should be provided to any citizen. It’s a fact that everyone on this planet may encounter emergency situations, especially medical emergencies, and to be prepared for any eventuality, having access to an emergency room is part of the health care the state should provide. A state or community that can provide emergency room or emergency health care even to poor citizens has a very good health care and should be commended. Everyone should have access to emergency health care and this includes the emergency room or the emergency department of a clinic or hospital. Accessing emergency room should be an important first step to patient care in an emergency. All emergency cases should be provided emergency room or the emergency department of a hospital. Without this access, ED personnel such as nurses and physicians cannot provide emergency treatment. Moreover, important emergency equipments should be provided in the emergency room so that any emergency case can be effectively acted upon. Trauma patients require immediate emergency rooms or emergency departments. Many hospitals have improved their trauma care departments, for example, there is the Advanced Trauma Life Support (ATLS) manual. This is a model trauma care manual which improved trauma care and wherein clinicians and those in charge in emergencies have the chance of saving patients or prevent long-term disability and death. (Bisanzo et al., 2006, p. 1) Patients that are regularly monitored for emergency cases should have a prepared medical record with them, for example, a folder ready and to be carried with them during a sudden attack (heart attack or stroke). This should be a standard operating procedure for patients who must be briefed by their personal physician in case of any eventuality. The folder should include physician notes and visits, medical tests, list of allergies, medications, etc. The health insurance company should also be alerted in case of an emergency. (O’Brien, 2012) Situations occur in many areas of the world, for example in the United States, wherein emergency cases require regular access to emergency room or departments. In the United States, around 25 million people have diabetes, 20 million have asthma, 200,000 women have breast cancer, and 5 million have attention deficit hyperactivity disorder (ADHD). (Volsky, 2011) Emergencies arise from sudden attack or if patients cannot have access to regular medication. Diabetics need insulin that should administered in an emergency room. This is a matter of life and death for the millions of diabetic patients, asthmatic, women with breast cancer, and children with ADHD. Hospitals and clinics should have ready emergency room access for them, complete with emergency equipment, tools and paraphernalia for emergency treatment. Without emergency rooms, many would die. (Volsky, 2011) 3. What is emergency severity index? Emergency Severity Index (SEI) is most commonly used in the United States. In Canada, a common type of ESI is the Canadian Triage and Acuity Scale (CTAS). The Emergency Severity Index is a kind of algorithm which categorizes emergency department patients according to the severity of the illness and resource needs. The triage nurse is responsible to assessing the acuity level of the patient. The nurse determines the acuity level criteria by evaluating the resource needs. The nurse who performs the evaluation should have attended a comprehensive tirage educational program. The nurse determines the acuity which is based on the patient’s stability of vital functions and the potential threat to life, limb, or organ. (Emergency Severity Index, p. 7) Basically, the ESI divides patients into five levels that not only determining intervention situations but on resource utilization. The nurse answers the questions and the triage decision is based on the answers. There are life-saving interventions based on the answers which may include assisting ventilations, defibrillation, or other medications dealing with life-threatening cardiac rhythms. The levels that classify the patient are based on the answers provided by the triage nurse. (Beebe and Jeffrey Myers, 2012, p. 469) In other countries, hospitals refer to quality control requiring hospital staff the necessary skill in providing quality medical care standards for patients. A system called continuous quality improvement (CQI) has been introduced in the United States which provides continuous internal and external reviews and auditing. Assessment and positive feedback are discussed and required. (American Academy of Orthopedic Surgeons, 2011, p. 17) The figure above shows the Emergency Severity Index developed by The Agency for Healthcare Research and Quality (AHRQ). ESI is designed to help tirage nurses in the speedy categorization of emergency patients by acuity and resource needs. It helps ED staff members in quickly triaging of patients, for example, a nurse can discuss with the physician and other staff members that he/she has a level 1 or level 2 patient. ESI can provide easy and quick decisions. The physician only needs to see the answers to the questions in determining the patient level of severity. It is known as decision tree, a part of a comprehensive educational program for staff nurses and health workers. The nurse handling this is trained in triage. (Joint Commission Resources, 2003, p. 1991) 4. What are patient rights in emergency room? Patients in the emergency room or department of a hospital have the right to privacy and such other rights as: The right to effective communication with the people in charge of emergency in the hospital or clinic; The right to informed consent; The right to consent for recordings or filming on any matter not related to the patient’s sickness or to patient’s care; Knowledge of the persons or professionals providing care and treatment; The right to refuse care and treatment; Access to all services necessary for treatment of his/her sickness; Confidentiality and security; End-of-life care; The right to air complaints and the resolution to the complaints; Patients and their family members should also have the right to access, amend, and receive any disclosure of their health information. (McNew, 2011, p. 3-5) Patients have rights in the field of medicine and law. “Rights” is defined as “legally protected interests” (Ihering cited in Carmi, 2002, p. 1). On the other hand, a legal right means we have the permission to practice or exercise certain natural powers with limitations, “to obtain protection, restitution, or compensation” with the public enforcement system helping us. (Carmi, 2002, p. 1) Inside the emergency room, patients have rights that should be followed and afforded by nurses and physicians. First, the patient should be relieved of pain because this can create adverse physical and psychological effects. Nurses and physicians should respect and support the patient’s right to pain management. The emergency department should all possible means by using its resources in addressing patients’ rights to pain management. (Joint Commission Resources, 2003, p. 58) 5. What can you do to prevent disease? Health care providers should be responsible enough to prevent the spread of disease. The simplest way of preventing the transfer of microorganisms is by washing of hands. This simple way can help eliminate the spread of diseases. Routine washing of hands before doing the daily routine in school and offices and especially in hospitals should be done to protect one’s self and the people around us from the transfer of microorganisms. (Keir et al., 1998, p. 435) Health and safety hazards in hospitals and emergency clinics should be assess to avoid accidents on the patients and health care providers. Health workers also face considerable health and safety risks. Assessing the situation, identifying the possible risks, and applying remedies before accidents happen, could help in reducing injury and applying adequate health care. Health workers must wear appropriate protective clothing such as disposable aprons and gloves when dealing with sick people and in handling body waste. Disposable aprons, which have been already worn in helping clients with elimination, should be changed when serving food. Health workers should have expert knowledge of the various equipments in the hospital or in the emergency room. Personal hygiene, regular exercise or physical activity and wholesome living are some of the ways to protect ourselves from acquiring disease. We can do more by preventing stress or cope with the daily stress in life. Identifying the source of stress is one way of dealing with it. (Hoeger and Hoeger, 2011, p. 346) There are many benefits for regular exercise; some of these include weight loss, muscle mass gain, burned cholesterol and lower cholesterol level, protection from stroke and cardiovascular arrest (CVA), protection from hypertension and diabetes, and so forth. (Blatner, 2010, p. 242) 6. What is first aid? What can you do before you reach emergency room? First aid is the first treatment administered when sudden injury or illness happens on a person. First aid is temporary assistance until a proper medical care can be given to the person. This is done to avert grave consequence or major damage to an injury or sickness, or, it can be the difference to what can be said as life and death or temporary and permanent disability. First aid is immediate care and is an important step before proper medical care is administered. (American Academy of Orthopaedic Surgeons (AAOS) et al., 2011, p. 1) Different kinds of first aid are administered in different circumstances, for example there is first aid for drowning, for suffocation, for burn injuries, etc. The primary aim is to prevent grave injury or loss of life. In case of suffocation for example, quick and immediate response should be administered to prevent brain damage. Speed here is very important. (Ramaiah, 2008, p. 16) This is also true in the case of drowning. Any delay in action may cause permanent brain damage on the victim. A method of first aid is artificial respiration, and the most common is the mouth-to-mouth method. Mouth-to-mouth respiration is done to put the person back to normal breathing again. This has the following steps: 1. The victim should be allowed to lie on his/her back with a rolled up towel placed at the neck. Thus, the neck is extended while the head is tilted backwards. 2. In applying mouth-to-mouth, you should sit at the right side of the victim as you use your left hand thumb and forefinger in pinching the nostrils shut. 3. The air then will not escape from the nose as you blow down into the victim’s mouth. 4. The next step is to place your right hand thumb on the victim’s chin, open the mouth by pulling down the lower jaw. 5. Take a deep breath, mouth open, and clamp your mouth to the victim’s mouth while you blow hard enough to make the victim’s chest wall rise. 6. Be sure that there is no chance of leakage of air as you blow. 7. Withdraw your mouth and watch the victim’s breathing. This should be repeated continuously at a rate of about fifteen to twenty times per minute. To be hygienic in the process, you can use a handkerchief to cover the victim’s mouth as you blow down. (Ramaiah, 2008, p. 20) Accidents that result in a fall can cause heavy damage. One common accident is a fall of an elderly person. The risk of falling should first be recorded in the mobility assessment for future precaution. In case of accident, we should make the person who has fallen as comfortable as possible, and ensure that the injury is immediately treated, and when ready the patient can be carefully transported to the nearest hospital. In case of sudden illness, we have to make sure that the patient gets the right medicine. Figure shows an example of a mouth-to-mouth respiration administered by a health worker. Another important first aid that must be mentioned here is CPR for hypothermia victims. Hypothermic victims suffer from extreme cold environments – the heart rate is extremely low and the rescuer may have cold fingers. In this situation, the American Heart Association instructs that health care providers or first aid medics should take 30 to 45 seconds to feel for a pulse of a hypothermic victim. CPR should immediately be administered if the victim is not breathing or if a pulse is not felt. In hypothermia, CPR should be given and continued for more than 30 minutes. (Thygerson et al., 2007, p. 355) References American Academy of Orthopaedic Surgeons (AAOS) et al., 2011. First aid. Canada and London: Jones & Bartlett Learning. American Academy of Orthopedic Surgeons, 2011. Emergency: care and transportation of the sick and injured. Sudbury, MA; Ontario, Canada; London, UK: Jones and Bartlett Publishers. Annas, G., 1992. The rights of patients. Totowa, NJ: Humana Press Inc. Beebe, R. and Jeffrey, Myers, M., 2012. Trauma care & EMS operations (Volume III). USA: Delmar Cengage Learning. Bisanzo, M. et al., 2006. Emergency management of the trauma patient: cases, algorithms, evidence. Baktimore, MD: Lippincott Williams & Wilkins. Blatner, D., 2010. The Flexitarian diet: the mostly vegetarian way to lose weight, be healthier, prevent disease, and add years to your life. United States of America: The McGraw-Hill Companies. BusinessDictionary.com. Definition of emergency. Available from: http://www.businessdictionary.com/definition/emergency.html [Accessed 3 February 2012]. Carmi, A., 2002. Human rights in medicine and law. In: A. Carmi and H. Wax, eds. 2002. Patients’ rights. Israel: Yozmot Pub. Ltd. Emergency Severity Index (ESI). A triage tool for emergency department care (version 4), implementation handbook, 2012 edition. Available from: http://www.ahrq.gov/research/esi/esihandbk.pdf [Accessed 1 February 2012]. Hoeger, W. and Hoeger, S., 2011. Lifetime physical fitness & wellness: a personalized program. USA: Wadsworth Cengage Learning. Joint Commission Resources, 2003. Accreditation issues for emergency departments. USA: Joint Commission Resources on Accreditation of Healthcare Organizations. Kalman, B., 2005. Hospital workers in the emergency room. Oxford, UK: Crabtree Publishing Company. Keir, L., 1998. Medical assisting: administrative and clinical competencies (4th edition). New York: Thomson Learning, Inc. Lebow, S., 2007. “We’re ready”: The importance and need for an effective emergency preparedness and response plan in the Kansas City, Missouri school district. Ann Arbor, MI: ProQuest. McNew, R. (ed.), 2011. Emergency department compliance manual. USA: Aspen Publishers. O’Brien, S., 2012. Emergency room tips: plan ahead for your visit to an emergency room: some advance planning can make your emergency room visit safer and less costly. About.com.Senior Living. Available from: seniorliving.about.com/od/doctorshospitals/a/emergency_room.htm [Accessed 2 February 2012]. Ramaiah, S., 2008. First aid: health solutions. New Delhi: Sterling Publishers Pvt. Ltd. Thygerson, A. et al., 2007. First aid, CPR, and AED. Canada and London: Jones and Bartlett Publishers. Volsky, I., 2011. Why emergency room access is not the same thing as access to health care. Thinkprogress Health. Available from: http://thinkprogress.org/health/2011/04/25/172047/barbour-emergency-room/?mobile=nc [Accessed 2 February 2012] Read More