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Discussion

Common things in ER

I am applying for an ER position and whether I get this one or not, I will continue to try. Before going into a job, I tend to study the most common things seen in that field And common meds given, etc. Coming from my first year as a nurse being in NICU and my 2nd year at a preschool for special needs, my knowledge is limited. I would love to start looking into preparing for the ER!! I know you see and hear everything there, but what is the first thing that pops in your mind that I should refresh on, or know!! Meds, diagnosis, whatever you think needs attention :) if you were my preceptor, what would you expect of me? :) thanks for any help!

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    • Featured Replies

    Many, many threads on this subject.

    You will see everything from aardvarks to zebras, but mainly horses.

    Be engaged, proactive, eager to learn, accepting of constructive criticism, ask questions, know that you don't know what you don't know and have a sense of humor.

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    • Author

    Thanks! I will try a more specific search on the threads!!

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    Common E.R. medications to know or know the toxic effects of:

    Lidocaine, epinephrine, atropine, vasopressin, magnesium, bicarb, ativan, keppra, narcan, succicholine, etomidate, flumazenil, cardizem, nitro, any blood thinner, propofol, versed, fentanyl, morphine, dilaudid, ibuprofen, acetaminophen, magnesium, calcium, potassium, valium, clonidine, zofran, reglan, solumedrol, zantac, benadryl, ... there are more, but that's off the top of my head.

    (from a previous post)

    Here's my list...

    Toe pain. Ankle pain. Knee pain. Hip pain. Back pain. Abdominal pain. Chest pain. Shoulder pain. Neck pain. Tooth pain. Eye pain. Ear pain. Headache. Cough. Dizziness. Bloody nose. Flash burns (eyes). Rash. Allergic reaction.

    Wound discharge/infection. STDs. Cellulitis. DVTs. MI/Heart attack. Bowel obstruction. Nausea/vomiting/diarrhea. Constipation. GI bleed. Bloody urine. Urinary problems. UTI. Catheter problems (PICC, port, PEG, foley, etc). Sepsis. Syncope. Seizures. Miscarriage. lady partsl discharge. lady partsl bleeding. Post operative problems. Fever. General illness. Foreign body (throat, stomach, airway, rectum, etc). Lonely/bored/attention. Altered mental status. Palpitations. Anxiety. Suicide attempt. Psychiatric. Shortness of breath. Abnormal lab (sent by primary care physician). Stroke. Conjunctivitis. Post fall evaluations. Broken bones. Dislocated joints. Motor vehicle collisions. Trauma. Fist fight. Gunshot. Stabbing. Assault. Rape. Homeless/Hungry. Lacerations. Burns. Animal/bug bite. Ring stuck on extremity. Detox evaluation. Overdose. Drug seekers. Prescription refills. Found unresponsive/Mega code. Hypo/hypertension. Hypovolemia. Hyperventilation. Hypo/hyperglycemia. Lice/scabies/ticks/etc. ETOH.

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    • Author

    Thank you so much nurseonamotorcycle!! I appreciate that a lot!!!!

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    Start with the seconds-to-minutes count stuff:

    1) ACLS...

    2) Hemorrhage... (think "four and the floor")

    3) Respiratory distress...

    4) Circulatory compromise...

    5) Traumatic head injuries...

    Take ACLS/PALS/NRP/STABLE/TNCC...

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    To the list of NurseOnAMotorcycle, I'd also add: TB and meningitis... It took me a little while to develop my Spidey Senses to be immediately suspicious of these and get good at immediately implementing precautions.

    And, at the top of the list of ALL emergency nurses and docs: Staff-directed violence

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    • Author

    I appreciate your response!! It is helping my studying and "refreshing" go a lot smoother :)

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    • Experts

    2) Hemorrhage... (think "four and the floor")

    Hi, I work in an ED in the UK, I got the rest of your post but don't understand "four and the floor".

    To me this is a hypoglycaemia thing; below 4 mmols of glucose and it's the floor, so don't get how it fits in with haemorrhage.

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    Hi, I work in an ED in the UK, I got the rest of your post but don't understand "four and the floor".

    Five places where the blood goes...

    Chest, retro peritoneum, abdomen, pelvis... And the floor.

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    • Experts
    Five places where the blood goes...

    Chest, retro peritoneum, abdomen, pelvis... And the floor.

    Thanks, never heard of that - must be a US thing. I have done ATLS, TNCC, ALS so wondered what I was missing.

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    Five places where the blood goes...

    Chest, retro peritoneum, abdomen, pelvis... And the floor.

    That's creative! I was thinking you meant when Hgb is less than four they are more likely to fall on the floor lol

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    Thanks, never heard of that - must be a US thing. I have done ATLS, TNCC, ALS so wondered what I was missing.

    I learned it from a trauma surgeon who was teaching ATLS.

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