Trauma Room MEds

Nalon1 RN/EMT-P, BSN, RN · Dec 17, 2016

Only meds are in the crash cart. Everything else you have to go get.

I believe that it is a JCAHO (or state) item that all meds must be secured in a locked area. Somehow crash carts get around that (ours do have the inventory tag on them, but no physical lock).

I know some facilities have a "Stemi" crash cart with basic meds for that (ASA, NTG, Plavix, Heparin, etc).

What type of meds are you needing in a trauma room? So long as they are not narcs, see if you can get some type of "trauma cart" for your facility.

necc2008 · Dec 17, 2016

We have a pyxis in trauma room with pain meds, aspirin, nitro, Zofran and rsi kit. Any kind of drip someone has to go to other pyxis. Most times there is another nurse to run and grab those meds. It would be nice to have pressors and other drips in the trauma room pyxis. It would save a lot of time running back and forth.

elijahvegas, ASN, RN, EMT-P · Dec 18, 2016

Level 1 trauma center here.

If you don't have a dedicated trauma team per shift, that soubds like a real dangerous place to work.

There should always be at least 2-3 nurses, and another 2-3 medics all trauma/tncc certified

If its your patient your only job is to scribe. You stand in the room at all times and record every assessment finding and every med ordered. You dont leave to do anything else. The doc calls out orders and other members of the team follow them, and calls to you when its completed should you beed to ascribe a time to wheb certain actions took place

At least thats how ive seen them run

Nalon1 RN/EMT-P, BSN, RN · Dec 18, 2016

Level 1 trauma center here.
If you don't have a dedicated trauma team per shift, that soubds like a real dangerous place to work.
There should always be at least 2-3 nurses, and another 2-3 medics all trauma/tncc certified
If its your patient your only job is to scribe. You stand in the room at all times and record every assessment finding and every med ordered. You dont leave to do anything else. The doc calls out orders and other members of the team follow them, and calls to you when its completed should you beed to ascribe a time to wheb certain actions took place
At least thats how ive seen them run

Of course that is how it is supposed to be. Level I has the resources to do that. Level III/VI may not. Many times it is you, a tech, physician and hopefully another nurse.

offlabel · Dec 18, 2016

Level 1 trauma center here.
If you don't have a dedicated trauma team per shift, that soubds like a real dangerous place to work.

Dangerous, how?

chare · Dec 18, 2016

[...]
There should always be at least 2-3 nurses, and another 2-3 medics all trauma/tncc certified
[...]

If you are referring to four to six persons at the bedside, that's somewhat excessive for most situations. Three nurses, one per side and the primary nurse recording, is likely sufficient for the majority of trauma patients, with additional staff available and called to the bedside when needed.

NotYourMamasRN · Dec 18, 2016

I worked Level 2 ER and we had the same, but our ER was huge and we had a Pyxis right outside the two trauma bays. However, many times a medication that was needed was in another Pyxis, across the ER.

**canoehead, BSN, RN** · Dec 19, 2016

Is there a JCAHO standard, or ENA standard about the nurse not leaving the bedside, or the meds being within sightline? We need to go about 50 feet and out of sight/hearing of the trauma room to get meds. Often, the orders have changed by the time you get back. If the primary nurse has to do the running, they miss most of the plan of care, and treatments are delayed.

elijahvegas, ASN, RN, EMT-P · Dec 20, 2016

Dangerous, how?

Because that means youre either understaffed, or staffed with people unqualified and untrained . And im sure i don't need to go into detail about how thats bad for everyone involved

elijahvegas, ASN, RN, EMT-P · Dec 20, 2016

If you are referring to four to six persons at the bedside, that's somewhat excessive for most situations. Three nurses, one per side and the primary nurse recording, is likely sufficient for the majority of trauma patients, with additional staff available and called to the bedside when needed.

I suppose youre right. But this trauma center is all i know. We see and receive the worst of the worst. and things tend to flow very well with that many hands on.

I think during the trauma if so many arent needed a few fall back. Im tncc certified but im not part of the trauma team. I still hop in and help where i can, and thats usually about the amount i see. 4+ with a physician

offlabel · Dec 25, 2016

Because that means youre either understaffed, or staffed with people unqualified and untrained . And im sure i don't need to go into detail about how thats bad for everyone involved

How does that follow not having a "dedicated trauma team?" That means people are unqualified and untrained? By what standard? There are ED's where the whole staff is the dedicated trauma team, medical code team and "make the coffee" team. Lot's of them. And they're a helicopter ride from a trauma center.

It would be "dangerous" if they weren't there.

BTW, speaking from personal experience, FWIW, there are folks in those places with more training and ability in their pinky finger than some trauma center folks do in their whole body. It's just that at a TC, there are limitless resources in comparison.