This is for all you Trauma/ER-ED Nurses

Published

Specializes in Cardiac Telemetry, ED.

I was just curious, how many of you all have put your expertise to use outside of the hospital setting? As in like one fine day someone collapses and you have to you use your clinical judgement to help this person? Or maybe someone has a MVA and you have to use your nursing knowledge. And I am not talking about first-aid or what have you. I am talking about stuff you actually have to critically think about and use you "Trauma-esque" expertise to help save this person's life or stabilize their health.

I was just curious since I recently have transferred down to the ED at my hospital after 2.5 years in Cardiac Tele and currently in nursing school. Of course I would be prepared with the knowledge, but does it happen often that you put it to action outside of the hospital setting. And once again, no first-aid stuff, more critical, emergent, and urgent cases.

Thanks yall!!!

Up Vote Up Vote ×
Specializes in Pediatric Endocrinology and Diabetes.

Me. Never. Not once. My husband however, a non-healthcare person of any kind, has been in more trauma situations than I can count. I've met one person who's life he saved and I know he's been at the scene of a MVA where there were serious injuries and a loss. It boggles my mind sometimes that he always seems to be there as it happens and everything I have seen was after the fact or in the hospital...

Anyway, my point is that it happens and it happens frequently. Whether or not you happen to be there when it does... well you can't really put a label of "often or not" on that.

Up Vote Up Vote ×
Specializes in Critical Care.

Even if you find yourself in that event, you won't have any equipment or supplies to do anything about it. Best thing you can do is call 911, check on # of patients and how stable they are, hold C-spine, and maybe control some bleeding with pressure.

Edit: Also, give the 911 dispatcher a calm and clear picture of what is in front of you, and please quietly get out of the way when help arrives. Its nice to give a quick little update of what you found and did, but don't expect the responders to be able to give you much more time then that.

Up Vote Up Vote ×
Specializes in Cardiac, ER.

I've been on the scene for two serious MVI's. To be honest with you it was very frustrating for me. These folks needed blood and to get to the OR and all I could do was sit with them by the side of the road until EMS could transport! All of my "trauma-esque" is worthless outside of the ER. I needed my stuff!

Up Vote Up Vote ×

As far as action or first aid even for the critical stuff, an RN or even an off duty Paramedic will not be able to do much more than any other lay person first responder at the scene of an MVC. Your technique for opening and clearing an airway might be better but the cell phone is your best partner in these situations for quick activation of EMS and other responders.

However, where an RN's expertise should shine is recognition of other medical problems that may need to be addressed as well as the trauma. Sometimes the trauma masks medical conditions that exacerbated either before, during or after the MVC. These can be pointed out to an EMS responder who may not be familiar with all the different medical conditions and medications that patients are taking which give a clue to these disease processes that also need a closer look as well as the traumatic injuries.

Also, don't ever put yourself or your family in harm's way to stop at a scene. Several well intentioned off duty EMS and health care workers have been injured or killed trying to do what they felt was the right thing to do. Stop at MVAs only if you know there is not an ambulance anywhere in the area and you can do so safely with what you are wearing and will not cause another MVC involving you or your vehicle.

Up Vote Up Vote ×
Specializes in ER, ICU.

I've been a medic and nurse for a long time. The best thing you can do is a scene size up which catalogs the number and severity of injuries, and any special needs such as extrication. This can make a big difference in getting the right resources to the scene. Then either call it in, or approach the first EMS responder with an organized report. The only other care that might really make a difference is clearing or maintaining an airway, or controlling bleeding. I always have a basic kit in my car along with the bunker gear I use at one of my jobs.

Up Vote Up Vote ×

Once. I was driving down the interstate and watched a woman be ejected from an SUV that had lost control and was flipping. By that time I had slammed on my brakes and jerked my car over to the side of the road. She landed maybe 10 feet from my car. I got out and ran over, she was not breathing, felt no pulse. Obvious head trauma and bilateral open femur fractures. Started CPR with the assistance of an off duty cop that had pulled over also, tried for around 7 minutes before EMS got there (actually got a faint pulse back) and took over. She ended up dying at the hospital from her head trauma

Up Vote Up Vote ×
Specializes in Cardiac Telemetry, ED.

Thank you all for your replies! I thought of this to be a very fun article. It's great to hear everyone's point of views and own personal experiences!

By the way, does anyone know what nurse2033 meant by his "Bunker Gear"? What all does that consist of?!

Thanks!!!

Up Vote Up Vote ×
Specializes in ER, IICU, PCU, PACU, EMS.
Thank you all for your replies! I thought of this to be a very fun article. It's great to hear everyone's point of views and own personal experiences!

By the way, does anyone know what nurse2033 meant by his "Bunker Gear"? What all does that consist of?!

Thanks!!!

Bunker gear or turnout gear is the protective clothing that firefighters wear in a fire or in any situation where they need protection from the scene.

Up Vote Up Vote ×
+ Join the Discussion