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Flashcards in Introduction Deck (29)
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1
Q

Approach to the Emergency Patient

A
Pressures of time and volume
Variety of conditions faced
Paucity of information available
Limitation of therapeutic options
Constraints of disposition
2
Q

Pressures of Time and Volume

A

Turbulent flow
Treat first, ask questions later
May have 15 minutes total with each patient
Be aware of priorities among patients

3
Q

Variety of Conditions

A

Be ready to shift domains rapidly

4
Q

Paucity of Information

A

Old records unavailable
Poor historians or unable to speak and family unavailable
Information gathering limited

5
Q

Limited Therapeutic Options

A

Provide symptomatic treatment
Tolerance for mistakes is very low
“Treat and street”

6
Q

Constraints of Disposition Components

A

Sick or not?
Treat or not?
Admit or discharge?

7
Q

Bedside Evaluation

A
Build working relationship with patient
Get on patient's level
Think aloud
Listen to your patient, don't interrupt
Watch out for the helpful family member
8
Q

3 Options of Patient Disposition

A

Admit
Discharge
Transfer

9
Q

3 Common Pitfalls to the Approach of the Emergency Patient

A

Tunnel vision
Inability to see “forest for the individual trees”
Failure to attend to the patient

10
Q

Define Triage

A

To sort or choose

11
Q

Define Disaster Triage

A

Where casualties overwhelm the ability to provide care

12
Q

Routine ED Triage

A

Goal is to sort according to priorities of medical need

13
Q

4 Categories in Disaster Triage

A

Immediate
Delayed
Minimal
Expectant

14
Q

Describe the Immediate Category in Disaster Triage

A

Life threat that is easily addressed

15
Q

Describe the Delayed Category in Disaster Triage

A

Patient can wait without risk

16
Q

Describe the Minimal Category in Disaster Triage

A

Patient requires little intervention

17
Q

Describe the Expectant Category in Disaster Triage

A

Patient will likely die with or without any interventions

18
Q

Goals of Routine ED Triage

A

Define and classify urgency based on complaint and presentation
Ensure patient safety
Facilitate care and flow through ED
Satisfy legal requirements for “screening”

19
Q

5 Levels of Routine ED Triage

A
Immediate
Very urgent
Urgent
Semi-urgent
Non-urgent
20
Q

Describe Immediate or Level 1 of ED Triage

A

Complaint or condition requires immediate assessment and intervention
ANY delay represents unacceptable risk

21
Q

Examples of Immediate or Level 1 Status

A

Cardiac arrest
Anaphylaxis
Compromised airway

22
Q

Describe Very Urgent or Level 2 Status of ED Triage

A

Complaint or condition require assessment and intervention within 10 minutes

23
Q

Examples of Very Urgent or Level 2 Status

A

Chest pain
CVA
Significant bleeding
Major trauma

24
Q

Describe Urgent or Level 3 Status in ED Triage

A

Complaint or condition require assessment and intervention within 30-60 minutes

25
Q

Examples of Urgent or Level 3 Status

A

Toxic ingestions
Severely painful conditions
Multiple organ system involvement
Abnormal, non-emergency vital sign or test result

26
Q

Describe Semi-Urgent or Level 4 Status in ED Triage

A

Complaint or condition require assessment and intervention within 1-2 hours

27
Q

Examples of Semi-Urgent or Level 4 Status

A

Lacerations
Long bone fractures
Dislocations without neuromuscular compromise

28
Q

Describe Non-Urgent or Level 5 Status in ED Triage

A

Complaint or condition requires assessment and intervention within 2-4 hours or longer

29
Q

Examples of Non-Urgent or Level 5 Status

A

Suture removal
Wound recheck
Minor rash