Right Decision during Emergency Situation

ExtremeRecluse · Jan 31, 2009

During emergencies, you must assume that there is risk to the patient via compromised airway, breathing or circulation. All other situations pertain to metabolic problems. These are top priority in Hierarchy of Care. These of course can present themselves as a myocardial infarct (airway, breathing or circulation), Cerebral Vascular Accident (circulation), Trauma to the chest, throat, face, mouth or nose (Airway or circulation). Your response will vary depending on the crisis at hand. Remember the pecking order is ABC (airway, breathing and circulation), Without a pathway for air to move you starve the body of oxygen, so even with systole (heart beat) you still will die if the airway remains shut. Breathing (think about CPR) you look, listen and feel; look for chest excursion, listen for breathing, feel for a pulse (carotid). Once you have an airway you then can have breathing; without airway no breathing. Look up advanced first aid and CPR. Other tell tail signs could be cyanosis, choking on something or chest pain (the fifth vital sign). You must also consider no code status with terminal diseases. What will be allowed in an emergency. Rescue breathing, chest compressions, cardiac drugs etc.. If on a floor you might consider equipment available such as ambu bag, demand valve, oxygen, artificial airways, pocket masks. Most nurses work on the floor. Is their proper training taking place. If the crash team were not available, what limitations would you face such as manpower. Maybe a patient slips and needs immobilization (backboard and c-collar, safety straps). Maybe you are a bystander and witness someone go down without vitals. how long could you properly give CPR before EMS arrives. Remember that the ABCs dominate and everything else takes a back seat. You can't really expect to be prepared for every emergency, but you are able to prioritize. That is called critical thinking; I bet you remember that from way back when. I hope this proves to be of some help.

cak1219 · Feb 1, 2009

Critical Care/Emergency nursing is really mastered with experience. Being able to prioritize is the most important thing. I'm sure you've been taught the ABCs in BLS. When I prioritize at work, I always keep one thing in mind - "What's the first thing that's going to kill this patient?" That is the right decision - take care of what will be the first thing to kill him/her. Everything else can wait.