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Emergency Department Design - Allie & Nurto
1
Transcript
Thank You!
Emergency Department Design
Facts of the case
- Priya Gosh: 31 year old female
- Came via ambulance
- Got hot by a car while on a family bike ride
- Husband and daughter seem healthy
- Slightly lowered blood pressure
- Complains of sharp ankle pain and tenderness in the abdomen.
Facts of the case
Ambulance
- Paramedics on scene about 5 minutes after the accident
- Examined the patient, took vitals, and started I.V. fluids
- Entered information about the case into an app for the hospitals ER to see
- Pulled into garage and unloaded patient
Ambulance
ER problem
Traditionally, traumas coming in are for the most part unknown to the ER. This slows down care of patients when traumas do arrive, which may worsen a case.
Problem
The app limits slowdown in care
Solution
- ER's know exactly what is coming in
- Can prepare the supplies before hand and prep scans and labs for faster response
- They can ensure the correct staff are present upon their arrival.
Triage & registeration
Triage
- Enteres through ambulance garage
- At front desk, receptionist gets the patients insurance
- Gives hospital bracelet to patient (which has a code for their chart & a tracker)
- Triage nurse takes vitals
- Since ankle is severely misformed, the triage nurse sends Priya straight to X-ray
X-ray
- Nurse prepares the X-ray of her right ankle
- Radiologist confirms that she has a broken ankle
X-ray
Patient room
Technology
- Sensors attached to her that make up electrical vital sign monitor
- Vitals will be portrayed on monitors surrounding the nurses station
Ankle treatment
- Orthopedic nurse wraps ankle in a cast
Labs
- A phlebotomist takes her blood to send to the labs to run a CBC
- She has a low hematocrit and hemoglobin (low red blood count and anemia)
Vitals
- During her time in the room, her vitals began to change
- Respiratory and pulse rate increase
- BP decreases
Patient room
ER problem
Nurses are busy people... they may not always be aware of subtle changes in the vitals of their patients.
Problem
Monitors surrounding nurses station
With these monitors stating patients vitals, it is easier for nurses to notice changes while they are doing paper work.
Solution
CT
* having a CT in an ED makes the imaging and getting the results much faster!
- She got preped for a CT of her abdomen
- Radiologist determined that she had traumatic hemoperitoneum (internal bleeding in peritoneal cavity)
CT
Operating room
- General surgeon is paged, and they determine she needs an exploratory laparotomy
- Patient was informed that all OR's are full for the day, so trauma room will be converted
- She is greeted by a surgical team consisting of the surgeon, anesthesiologist, OR nurse, etc.
- They find that bleeding is caused by the spleen, so the damage is repaired
Surgery
Post-surgery
- Admitted to the hospital, being monitored for surgical complications
- Discharged after 5 days
- When home, she is required to input her vitals and any new symptoms she was experiencing into an app, which was reviewed by professionals to look for any abnormalities (in which she should come back to the hospital)
Post-surgery
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