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Nurs 6361 PMC ENP
ABC's of Patient Mgt
| Question | Answer |
|---|---|
| ESI Level 1 | Requires immediate life saving interventions |
| ESI Level 2 | High Risk situation; confused lethargic or disoriented. Or severe pain/distress |
| ESI Level 3 | Many resources needed but no danger zone vital signs |
| ESI Level 4 | One resource needed |
| ESI Level 5 | No resources are needed |
| ESI Resources | Labs, Xrays, Radiology, Meds via IV's IM's or nebs, Specialty consult, simple or complex procedures |
| EMTALA | All ED's provide screening, stabilization and appropriate transfer to all patients with any medical condition |
| ESI for Peds days 1 to 28 days of age: | Assign at least ESI 2 if temp >38.0 C (100.4F) |
| ESI Level for Peds 1-3 months of age: | Consider assigning ESI 2 if temp >38.0 C (1 00.4F) |
| ESI Level for Peds 3 months to 3 yrs of age: | Consider assigning ESI 3 if: temp >39.0 C (102.2 F), or incomplete immunizations, or no obvious source of fever |
| Glasgow Eye Opening - 4 | Spontaneous |
| Glasgow Eye Opening - 3 | To Sound |
| Glasgow Eye Opening - 2 | To pressure |
| Glasgow Eye Opening - 1 | None |
| Glasgow Verbal Response - 5 | Oriented |
| Glasgow Verbal Response - 4 | Confused |
| Glasgow Verbal Response - 3 | Words |
| Glasgow Verbal Response - 2 | Sounds |
| Glasgow Verbal Response - 1 | None |
| Glasgow Motor Response - 6 | Obeys commands |
| Glasgow Motor Response - 5 | Purposeful movement to painful stimulus |
| Glasgow Motor Response - 4 | Withdraws in response to pain |
| Glasgow Motor Response - 3 | Flexion in response to pain (decorticate) |
| Glasgow Motor Response - 2 | Extension in response to pain (decerebrate) |
| Glasgow Motor Response - 1 | None |
| When is it appropriate to decide if a patient needs to be transferred? | After D assessment in the primary survey |
| A normal CT in patients with cervical tenderness requires further evaluation. What is the further evaluation | Ask the patient to flex and extend neck. If normal, then cleared, if abnormal consult neurosurg |
| What components make up the primary survey? | Airway with cspine immobilization, Breathing, Circulation and Disability |
| What components make up the secondary survey? | Expose /environment Full set of vitals Get a history Head to toe exam and history Inspect posterior surfaces |
| What is SPIRAL? | A model for ED providers thinking process: Sick? Pain? Investigate? Resuscitate? Assess again? Leaves department? |
| When is labs and imaging appropriate to obtain? | During secondary survey |
Created by:
DianaB
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