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Emergency

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by

karson ferrell

on 25 August 2016

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Transcript of Emergency

Emergency
Definition
A person with a medical condition requiring immediate treatment.

Open definition?
The Parkview Excellent Care Process
Triage:

check the patient in

get the story

FIND a room and get them what they need
What do they need?
Call light
Blanket
Gown
EKG
Monitor
Module 1
Monitor rooms: 1, 2, 25-30
Trauma room: 24
Isolation rooms: 6, 28
Pelvic rooms: 3, 9
Nonmonitor rooms: 3-10

Open 24 hours, can accept any level emergent patient, pink team/orange team/red team nursing, "Fish bowl"

Tech duties: transporting, cleaning, stocking
Patients we see on Mod 1
Chest pain
SOB
Vaginal Bleeding
Rectal Bleeding
Abdominal pain
Lacerations
Fever
Fall
Pancreatitis
Cellulitis
Etc.
Module 2
Monitor rooms: 15-19
Trauma rooms: 20, 21
Pediatric trauma room: 23
Isolation rooms: 13, 22
Nonmonitor rooms: 11-13, 22
Grieving room: 19

Open usually from 11 am to 10 pm, can accept any level emergent patient, blue team/purple team/red team nursing, specialized for trauma

Tech duties: transporting, cleaning, stocking, traumas, flights
Patients we see on Mod 2
Level 1-2 traumas
Code blue/AMI/Stroke
Chest pain
SOB
Abdominal pain
Lacerations
Fever
Fall
Pancreatitis
Cellulitis
Etc.
Module 3
No monitor rooms
Pelvic rooms: 40
Nonmonitor rooms: 31-40
Two nurses: five patients each at max

Open if we have enough staffing, usually from 1 pm to 11 pm, no patients allowed to be placed on the unit past 9 pm, accepts only the lowest level of emergent patients
Previously known as "Fast track"

Tech duties: Transporting, cleaning, stocking
Patients we see on mod 3
Minor lacerations
Absominal pains (age restriction: above age 3 and below age 60)
Fever (age restriction)
Headache/Migraine
Extremity pain
EKG
Get the EKG for any:
Chest pain
SOB
Weakness
Stroke
AMI
Medical Team Activate
Syncope
Dizziness

Must be done within 10 min of patient arrival by national standard
At PRMC our standard is 6-7 minutes of patient arrival
Process in less than 6 minutes!
No shirt, bra, etc.
10 stickers:
one on each leg, each arm, and six across the chest (two third intercostal space, fifth intercostal space below lead 2, fifth intercostal space midclavical, fifth intercostal space midaxillary, and one between midclavical and midaxillary
Connect the leads:
RA- white
RL- green
Chest (left to right)- I, II, III, IV, V, VI
LA- black
LL- red
Snap the picture and get to the doc ASAP!
Transmit and chart
Desk
Charge Nurse:
center of the department, runs all three Mods, watches after triage, assists EVERYWHERE they are needed.

Desk Tech:
Answers every phone call, makes phone calls for doctors, answers the radio for medic runs, makes announcements over head (for: phone calls, traumas, medicals, huddles), keeps log of consult calls, keeps paper work in order for all activates, directs techs to where they are needed, etc.
Something to think about
Code purple

12 Patients in the lobby, 5 medic run calls, no open rooms, no flow

Contaminated rooms

Staffing

Patient/Nurse/Doctor ratios

Running out of supply

Short staffed

Multiple high level traumas at one time
What Makes us Faster?
Triage:
one tech and one nurse
portable vitals machiene
triage rooms for quick test access
beds in the triage rooms
Valet
Traumas:
rapid infusers/stock cabinets/IV poles already waiting in the room
Beds with wheels/slippy sheets
Regular rooms:
Beds with wheels
Glass doors
Medication dispenser (PYXIS)
Portables
EPIC
Tech Features
Glidescope
Portable Xray
CT/MRI
Ultrasound
Rapid Infusers
Monitors (Central Monitoring)
Track Badges/Cell Phones/ Pagers
PYXIS
EPIC
Call Light System
EKG
Change?
Easier EKG process (wireless)
Shorter lobby wait times
Having an ER overflow unit with just as many beds as the ER
Better floor communication
Having a cut off number and utilizing other area hospitals
Hospital/Nation wide charting system
More accomodating beds
Easier transport beds
MORE STAFF
Unit SPECIFICALLY for EMS runs
Common Employee Complaints
We need a transport team
We need better staffing
better nurse/patient ratio
On-call TECHS!
8 hour shifts rather than 12
We don't get the 30 minute break that other departments get
New equipment
X2, TeleBoxes, Beds, Ceiling lifts
More medics
Better pay
Walk In Clinic: either do something or send them home! Get too many non-emergent patients from the clinic.
Similar and Different: Parkview Randalia vs PRMC
Similar
procedures
policies
Staffing
Pay
Requirements
Different- PRMC
much bigger building
More specialized units
Updated
Newer equipment
Different- Randalia
Smaller building
remodeling
less units
Different types of trauma
Karson Ferrell
Full transcript