I/O in ER

[kool-aide, RN]

So I went to the ER to pick up my CHF exac. pt and found the nurse toileting her without a hat to measure urine output. I figure this is common place for ER but in my opinion if there's anyone who needs strict I/O it's a CHF pt in fluid overload. Thoughts?

And for the love of God please don't give me a lecture on how I don't know the plight of an ER nurse yada yada yada. Not interested. I'm not attacking, just throwing out a thought for conversation

[Esme12, ASN, BSN, RN]

Good point about dly wt-it is more important. Lol

Idk how ER nurses do it. I like knowing EVERYTHING about my pts in CCU. Saw you had surgery same, hope you're recovering well

Thanks I am They are supposed to remove half of my sutures tomorrow.....I have about 60....unbelievable.

IN the ED you really have a short crisis mentality. You put fires out to just smoldering embers and know that the floors can out out the whole fire. Some people never adjust to the ED and return to the floors/Units.

Very few ICU nurses can tolerate being ED nurses and very few ED nurses have the attention span to be good ICU nurses. I have done both they are a vastly different assessment focus.

[tarotale]

As a former floor nurse I will say "oh that's just the floor stuff"! Now let me go attend stemi activation while my charge works on trauma and friends on code stroke. O gee, we left ms mammoth on bed pan, and forgot to chart the ml of her urine. Well she will live

[ohiobobcat]

I agree with what others have said, in the ED we have patients for such a short amount of time that I&O just isn't a priority. The only time I am concerned about it is if I place a Foley cath in a patient with urinary retention, and then I only document the output. I also keep thinking this thread is about intraosseous access when I see the title of it, which also goes to show how far Is and Os are off my radar screen.

[wyosamRN]

We all save lives in the manner appropriate to our setting. If having every drop of urine counted is the method you employ, then quit stalling, take report, and start measuring urine so I can fill that room back up.

They measure it because on the floor it is a constant vigilance method of measuring kidney functions and fluid/electrolyte balances.

They can also use it to spot possible diagnoses. If someone with no diagnosed medical history is putting out 4L a day and is always complaining about how hungry and thirsty they are and how itchy and painful it is to urinate, they may be able to catch the signs of diabetes.

If someone NPO for surgery has been vomiting and dizziness with standing, they can spot the signs of dehydration and turn it around.

I/Os are evidence based practice (I saw you roll your eyes!) to monitor and heal a patient. In fact, i found a great post about it here! Nursing Review By Ozlek: INTAKE AND OUTPUT

[HikingEDRN, BSN, RN]

I also keep thinking this thread is about intraosseous access when I see the title of it, which also goes to show how far Is and Os are off my radar screen.

Haha - I thought the same thing. I actually do make every effort to document I/O (intake and output, that is) if I've given Lasix IVP. I try to leave a hat by the bedside and usually if they are short of breath, I leave them a commode at the bedside. That saying, if something crazy comes in, it may not happen.

[Christy1019, ASN, RN]

I agree with what others have said, in the ED we have patients for such a short amount of time that I&O just isn't a priority. The only time I am concerned about it is if I place a Foley cath in a patient with urinary retention, and then I only document the output. I also keep thinking this thread is about intraosseous access when I see the title of it, which also goes to show how far Is and Os are off my radar screen.

^^this. I clicked this thread thinking it was about Intraosseous access too lol.

[NickiLaughs, ADN, BSN, RN]

IF they want very strict I & Os the patient needs a foley, or needs to be in a unit where their pee can be closely monitored, as in not the ER.