learning Objectives - Describe the role of nurse in medical surgical emergencies Demonstrate skill in meeting medical surgical emergencies.
Hours - 10
Teaching and Learning Activities - Lecture cum discussion Demonstration Preparing emergency trolley - Demonstration of CPR - Defibrillation Videos & Films Simulation Roleplay
Assessment Methods - Short answer Objective type Essay type Return demonstration
Content of the chapter
a) Scope and practice of emergency nursing
– Principles of emergency care
– Triage
b) Medical Surgical Emergencies
c) Airways obstruction
– Hemorrhage
– Shock, Anaphylactic reaction, Allergies
– Trauma – intra abdominal, crush injuries,
multiple injures fractures
– Poisoning
– Ingested poisoning
– Inhaled poisoning
– Food poisoning
– Injected poisons – Stinging insects
– Snake bites Chemical burns
– Environmental emergencies:
– Heat stroke
– Frost bite.
– Near drowning
– Hanging
Emergency Management in Nursing
Emergency nursing focuses on rapid assessment, prioritization, and intervention for patients experiencing life-threatening or urgent conditions. The goal is to preserve life, prevent complications, and stabilize patients for definitive care.
a) Scope and Practice of Emergency Nursing
Principles of Emergency Care
- Rapid assessment: Quick evaluation of airway, breathing, circulation, disability, and exposure (ABCDE)
- Prioritization: Identify life-threatening conditions first
- Timely intervention: Administer emergency treatments immediately
- Patient safety: Minimize risk of further injury
- Documentation: Record interventions, vital signs, and response
Triage
- Definition: Systematic process of determining priority of care based on the severity of the patient’s condition
- Categories:
- Immediate (Red): Life-threatening, needs immediate care (e.g., airway obstruction, shock, severe trauma)
- Urgent (Yellow): Serious but not immediately life-threatening
- Delayed (Green): Minor injuries, can wait
- Expectant (Black): Very severe injuries with poor prognosis
b) Medical and Surgical Emergencies
- Conditions requiring immediate intervention include:
- Cardiac arrest
- Respiratory failure
- Seizures or status epilepticus
- Acute abdominal emergencies (ruptured appendix, perforation)
- Severe bleeding
Nursing role: Rapid assessment, monitoring, stabilization, and preparation for surgical intervention if required.
c) Airway Obstruction
- Causes: Foreign bodies, swelling, trauma, anaphylaxis
- Management:
- Maintain airway patency (head tilt, chin lift, suction)
- Heimlich maneuver for choking
- Endotracheal intubation if severe
- Oxygen therapy
d) Hemorrhage
- Types: Arterial (bright red, spurting), venous (dark red, steady), capillary (oozing)
- Management:
- Direct pressure, elevation, pressure dressings
- Tourniquet if uncontrolled
- IV fluids and blood transfusion
- Monitor for shock
e) Shock
- Types: Hypovolemic, cardiogenic, septic, anaphylactic, neurogenic
- Management:
- Ensure airway and oxygenation
- IV fluid resuscitation
- Monitor vitals, urine output, consciousness
- Treat underlying cause (antibiotics, epinephrine for anaphylaxis)
f) Anaphylactic Reaction and Allergies
- Signs: Swelling, urticaria, hypotension, respiratory distress
- Management:
- Immediate epinephrine administration
- Oxygen therapy
- IV fluids, antihistamines, corticosteroids
- Close monitoring of vitals
g) Trauma
- Intra-abdominal injuries: Monitor for bleeding, pain, and shock; prepare for surgery
- Crush injuries: Maintain airway, fluids, monitor for rhabdomyolysis
- Multiple injuries & fractures: Stabilize fractures, control bleeding, monitor vital signs, prevent infection
h) Poisoning
1. Ingested Poisoning
- Examples: Pesticides, drugs, household chemicals
- Management: Gastric lavage, activated charcoal, antidotes if available, supportive care
2. Inhaled Poisoning
- Examples: Carbon monoxide, chemical fumes
- Management: Remove from source, oxygen therapy, supportive care
3. Food Poisoning
- Management: Hydration, electrolyte replacement, antibiotics if bacterial, monitor vitals
4. Injected Poisons
- Examples: Snake bites, stings, insect bites
- Management: Antivenom, wound care, immobilization, monitoring for shock
5. Chemical Burns
- Immediate irrigation with water, neutralization if indicated, pain management, wound dressing, monitor for systemic effects
i) Environmental Emergencies
1. Heat Stroke
- Signs: High fever, altered mental status, dehydration
- Management: Rapid cooling, fluids, electrolyte correction, monitor vitals
2. Frostbite
- Signs: Cold, pale, numb extremities
- Management: Gradual rewarming, pain management, wound care, prevent infection
3. Near Drowning
- Management: Airway maintenance, oxygen therapy, CPR if required, monitor for hypothermia and aspiration
4. Hanging
- Management: Immediate airway management, CPR, cervical spine stabilization, monitoring for hypoxic brain injury
Conclusion
Emergency nursing requires:
- Rapid assessment and decision-making
- Prioritization of life-threatening conditions
- Implementation of evidence-based interventions
- Monitoring, documentation, and patient/family support
- Preparation for advanced care or surgery if needed
Effective emergency management saves lives, prevents complications, and stabilizes patients for definitive treatment.