Handling Emergencies Outside the Unit

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Hi all. I have a question I was curious about after a lecture today on neonatal emergencies. I know NICU nurses can handle the emergencies in the NICU and babies don't leave until they're better generally.

What I wonder is how you handle emergencies in the community, like with adults and kids, given your experience of working mainly with neonates? Like people say that if a someone passes out at a store or there is a car crash on the road, and you're the only medically trained professional around, you should be able to do something (CPR, assessing airway, organizing bystanders). Would you feel like you could, or have you done something like that before, even though these are adults or kids and not babies?

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Specializes in NICU and neonatal transport.

This came up recently as mid-transfer an NNP was asked to help at a serious RTA that happened right in front of the ambo, well baby inside with RN looking after it.

This is WELL out of my comfort zone after not caring for adults since 2002 and kids since 2004. If you don't fit in an inc, I will struggle bar basic first aid. We get taught up to date BLS but nothing else.

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Specializes in NICU, PICU, educator.

You can provide BLS as we are all trained in it and most of us know basic first aid (applying pressure to bleeding wounds, etc), but beyond that call for help or

send someone. When a mom or visitor goes down in our unit that is what we do, after looking at each other for a second with the OH POOP look on our faces.

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Specializes in NICU.
You can provide BLS as we are all trained in it and most of us know basic first aid (applying pressure to bleeding wounds, etc), but beyond that call for help or

send someone. When a mom or visitor goes down in our unit that is what we do, after looking at each other for a second with the OH POOP look on our faces.

I know that look! We had a mom collapse -- seize? -- while visiting her grower-feeder once. Never seen that many people run into a room at once: between our whole team, then the adult crash team, then the obstetric team, there must have been thirty people in there. And forget the proper body mechanics they taught us -- when we went to get her out of her chair onto the floor, it was one person on each extremity, and HEAVE! :unsure:

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Specializes in NICU.

Yeah, when a mom feels faint or starts to get sick we all recoil in horror. Trying to determine why a big person feels faint is just not something I can reliably do. If I encountered an emergency outside the hospital I would probably pause to see if there was anyone more confident. If not, well I know CPR an could probably work an AED.

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I'm sure a lot of us get nervous around adult emergencies, but just about any nurse is going to be a little out of their element during a community emergency. Other than basics like calling for help, keeping an airway open, direct pressure for bleeding, compressions and maybe an AED, you're not likely to have the equipment to do anything else. In most situations, additional equipment is going to arrive at the same time as the personnel who are trained to operate it.

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I'm sure a lot of us get nervous around adult emergencies, but just about any nurse is going to be a little out of their element during a community emergency. Other than basics like calling for help, keeping an airway open, direct pressure for bleeding, compressions and maybe an AED, you're not likely to have the equipment to do anything else. In most situations, additional equipment is going to arrive at the same time as the personnel who are trained to operate it.

Yeah I'd imagine you wouldn't really have the equipment you need at hand. I mean, who carries an ambu bag around with them? Though i do know a NICU nurse who started an IV on an adult in an emergency (but don't really know why there was an IV lying around. Not sure what the setting was). Funnily enough, she was with two other adult nurses, but due to their fields, they practically forgot how to put in IVs.

It seems like a nurse in any field would be able to initially help out. Some just may be more comfortable than others (An ER nurse might be able to react more comfortably for example, or a peds nurse would handle a kid in trouble like having a seizure or having an allergic reaction). I mean we're not paramedics, but even if we were, we wouldn't have the equipment needed.

Always seems like the best thing to do it call 911. Unless you're somewhere you can't.

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Specializes in Private Duty Pediatrics.

I took a Medical First Responder course at the local Community College, to make me a better nurse. (Most of my nursing school experience was in the hospital, after the patient had been evaluated by the doctor.)

The class was intense. It was a one-semester class that was taught in half a semester. The amount of anatomy and physiology that was taught would have been difficult for me without my nursing background.

I learned a lot in the MFR course, and I got to practice first aide a lot. Trauma assessment, triage, bandaging, splinting, and transporting were some of the skills that I actually got to practice. (OK, triage was explored in a classroom setting; that's a little harder to simulate.)

My classmates knew I was a nurse. Some of them were firefighters, so they already knew a lot more than I did about emergencies. I respected their knowledge, they respected my knowledge, and we learned together.

I never did practice as a volunteer MFR - I'm too busy as a nurse - but I still go to MFR trainings and classes when I can.

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I took a Medical First Responder course at the local Community College, to make me a better nurse. (Most of my nursing school experience was in the hospital, after the patient had been evaluated by the doctor.)

The class was intense. It was a one-semester class that was taught in half a semester. The amount of anatomy and physiology that was taught would have been difficult for me without my nursing background.

I learned a lot in the MFR course, and I got to practice first aide a lot. Trauma assessment, triage, bandaging, splinting, and transporting were some of the skills that I actually got to practice. (OK, triage was explored in a classroom setting; that's a little harder to simulate.)

My classmates knew I was a nurse. Some of them were firefighters, so they already knew a lot more than I did about emergencies. I respected their knowledge, they respected my knowledge, and we learned together.

I never did practice as a volunteer MFR - I'm too busy as a nurse - but I still go to MFR trainings and classes when I can.

This is actually a great idea for nurses who want to do it. It is a decent time commitment it seems, but the extra training is good.

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Specializes in ICU, CVICU, E.R..

Basically all we can do in an emergent outpatient setting is call for help, secure airway, stop the bleeding and immobilize before considering any form of transport. At least when the EMTs or flight crew arrive, there's no time wasted.

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Specializes in NICU and neonatal transport.

I reckon I could get an IV in a gigantic vein ;)

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Specializes in NICU.
I reckon I could get an IV in a gigantic vein ;)

It'd be with a gigantic needle though. That's what I always have to remind myself when I get cocky about the idea of adult IVs :whistling:

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