Besides patients with trauma, difficulty breathing, chest pain, and cardiac related/hx...what other kinds of patients do you hook them up 12-lead to? And when would 5-lead monitoring be incorporated?
We hook tele to our CP, SOB (CHF and Resp Distress), OD, Trauma, bad GI, Stroke sx, anytime something just doesn't "feel" right. We don't have to have an order to put tele on a patient.
Our tele is only 3 leads. We do 12-lead ekg's on CP, OD, Stroke sx, Trauma, bad GI, and as ordered by the MD.
PO/IV contrast. MDs are always ordering different CTs depending on the patients presenting problem. With which CTs do you give patients PO/IV contrast to, and which CT scans require no contrast? It's been difficult in trying to anticipate this.
The only CT's we do without contrast are: Head, cervical, facial bones, and abd for stone
. The majority of our other scans are with IV contrast, and at our facility the CT Techs give the IV contrast. It's rare that we have to use oral, but if we do, the CT Techs come over to do the teaching on it, and get them started on it.
If we suspect the patient might get a scan with IV contrast then we always get a saline lock size 20g or bigger (of course when we start locks we always go for 20g or bigger anyway - if they're "sick" enough to be there, then they "need" the lock). But I'd estimate that about 95% of our patients get locks regardless...
How did any of you ER nurses get better in utilizing PCTs/CNAs in delegating tasks without being rude or being seen as overdemanding?
I usually say, "Hey Fred (whatever the name is) - when you're finished with what you're currently doing, would you be able to do me a HUGE favor and do 'X' for me? Thank you."
They are very quick to pick up on rudeness or pick out what nurse is being just plain lazy (I know - I went from tech to nurse)! Most of them (but not all), have the basics down and can also anticipate what you might need on your patient so they won't be surprised by the requests.
A question to all of you. Is your ER department a learning type of environment.
Ours is a teaching hospital so we have students of all kinds at all hours. It gets kind of interesting trying to meld all these different approaches, patient needs, and helping the students (of all disciplines) get in the tasks they need to get done.