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NURS 4628 Chapter 68 Emergency And Disaster Nursing

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John Marsh
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Chapter 68 Emergency and Disaster Nursing

Texas A&M University-Corpus Christi

Nursing Care of Adults II (NURS 4628 )

Chapter 68 Emergency and Disaster Nursing
CARE OF EMERGENCY PATIENT
Triage
-rapid determination of pt acuity
-nontrauma: primary survey → focused assessment
Primary Survey
Alertness & Airway
-APVU
-A: alert
-P: responsive to voice
-V: responsive to pain
-U: unresponsive
-jaw-thrust maneuver: avoid hyperextension of the neck
-w/ possible neck or spinal injury
-grasp the angles of the patient’s lower jaw & lift the jaw forward w/ both hands w/o
lifting the head
-insertion of a nasopharyngeal or an oropharyngeal airway (unconscious pt only), ET
-if intubation impossible b/c airway obstruction → emergency cricothyroidotomy or
tracheotomy
-Rapid-sequence intubation
-requires sedation, anesthesia, & paralysis
-cervical spine is immobilized w/ a rigid cervical collar (C-collar) & cervical immobilization
device (CID)
Breathing
-adequate airflow doesn’t mean adequate ventilation
-every critically injured pt has an increased metabolic and O2 demand
Circulation
-check central pulse
-cold temperature delays refill
-life-threatening = O negative
-consider pelvic splint or belt in the presence of pelvic fracture w/ hypotension
Facilitate Adjuncts and Family
-FP during resuscitation or invasive procedures
Get Resuscitation Adjuncts
“LMNOP”
L: Laboratory tests
M: Monitor ECG
N: NG tube
O: Oxygenation
P: Pain assessment & management

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NURS 4628 Chapter 68 Emergency And Disaster Nursing

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