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(Editor's note: This is the third of a three-part series on trauma care in the ED. This story covers self-inflicted trauma. Previous issues covered neurological assessment of children involved in motor vehicle accidents and violence-related trauma.)
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Patients with chemical exposure "should be quarantined from the rest of the department, medically stabilized, and decontaminated," says Theresa Patrick, RN, BSN, clinical resource nurse for the ED at University of North Carolina Chapel Hill. Patrick gives these tips:
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After ED nurses received an emergency medical services call of an "asthma attack" in a pregnant woman, suddenly multiple patients arrived in respiratory distress. It turned out that someone had sprayed pepper spray in a nightclub.
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Almost the entire ED staff at St. Joseph's Hospital in St. Paul, MN, just went through a contamination recognition "skills camp" given by Joan Somes, PhD, MSN, RN, CEN, FAEN, ED educator. Somes covered signs and symptoms of possible contamination, how to decontaminate patients, and how to route them through the hospital.
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(Editor's note: We sent an e-mail alert about the recent incident of chemical exposure at EDs in the St. Louis area. If you didn't receive it, we don't have your e-mail address. Please contact customer service at
[email protected] or (800) 688-2421 so you won't miss out on future alerts.]
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As soon as the triage nurse suspects life-threatening pneumonia, the ED nurse stops his or her assessment, moves the patient to a treatment room, and notifies the ED physician, says Amanda Person, RN, an ED nurse at Methodist North Hospital in Memphis, TN.
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In 2004, The Joint Commission issued a standard requiring that ED patients be given an antibiotic within four hours of presentation if they are discharged with a diagnosis of pneumonia. As of October 2007, the time frame has since been increased to six hours. Also, The Joint Commission is allowing EDs to document "diagnostic uncertainty" to indicate that the diagnosis of pneumonia was not clear at the time of the patient's arrival in the ED.
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An elderly man says he's "not quite himself." Would you suspect pneumonia if this was your patient's only symptom? Even if your patient doesn't have a respiratory complaint, that does not mean they do not have pneumonia, says Cheryl Webber, RN, MS, CEN, nurse manager of the ED at Tufts Medical Center in Boston.
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More than 1.2 million Americans were hospitalized for pneumonia in 2006, with 71% of those cases admitted through the ED, according to a new analysis using data from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project.
