Protocols In Emergency Medical Services

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

Have you ever thought about what you would do if a family member suddenly stopped breathing? Imagine that you grow up in a small town, the population is 700 people, and one morning you wake up and everyone in the town is dead. On any given day 670 people die of sudden cardiac arrest. Could it be a loved one, someone you care deeply for, or just a complete stranger? The chances are that someone in your family is going to die of sudden cardiac arrest in your lifetime. On average it takes an ambulance no less than seven minutes to reach someone in need, therefore, every adult should know how to administer CPR.

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

DNACPR orders are of considerable concern to ambulance staff, the patient and their families in tackling requests at the end of life (NHS End Of Life Care Programme 2007). A study by Stone et al. (2009) showed nearly all participants had questioned whether interventions performed were correct for the patient when using cardiac life support on patients they thought were terminal. When a patient requires resuscitation and a DNACPR is in place immediate sharing of information is critical. At certain points in the patient care pathway incompatible systems may mean DNACPR requests are not being followed and inappropriate resuscitation being attempted.

Prior to attending the CSL class, I completed the lab preparations which included basic CPR questions and watched the video clip provided. I understood the procedures for CPR outside and within a hospital environment. When given an event of a cardiac arrest in hospital, the emergency alarm is pressed and pillows are removed from behind the patient to allow the head to be tilted backwards to open the airways. Within this time the ratio of 30 compressions to 2 breaths are given while a call is made

After the men came back they said they called an ambulance to take me to the hospital. Ten minutes later, the paramedics came in and got be and we left. On the way to the hospital one of paramedics asked what I did to my foot.

Event Maps and this document will be placed throughout the event area at various locations.

The lack or delay in appropriate treatment for individuals who experience a sudden cardiac arrest has created a major public health disparity. Research into pre-hospital treatment and subsequent implementation has historically seen neglect by the medical and scientific community creating vast differences in survivability of cardiac arrests between demographic groups. In 2010, the American Heart Association and Emergency Cardiovascular Care program developed the 2020 impact goal to reduce death from cardiovascular disease and stroke by 20% and double out-of-hospital cardiac arrest (OHCA) survival rates (http://circ.ahajournals.org/content/121/4/586#sec-1). This has prompted a massive influx of research into the disparities that exist and an

The role of the emergency department is to diagnose and treat acute and urgent illnesses and injuries. Patients are seen in order of medical urgency. The emergency department bases the patients urgency for treatment based on levels. Level 1 is critical and life-threatening. This is usually related to ABC’s (Airway, Breathing, and Circulation). These patients are top priority and require a lifesaving intervention. Level 2 is also considered high priority and can also be life-threatening. Psychiatric patients are considered level 2, and patients arriving to the ED with chest pain. Level 3 patients require resources such as sutures, x-rays, CAT scans, MRI, etc. Level 3 patients are provided treatment services only after Level 1 and 2 have been addressed. The emergency department at CEMC also has a trauma room and a SANE room. The trauma room is equipped with life-saving medications (such as antidotes for drug overdose) and medical equipment. The SANE (Sexual Assault Nurse Examiner) room consists of equipment used to assess a patient who has been sexually assaulted. The equipment takes pictures of the patient for the SANE nurse to later provide to law enforcement. A SANE nurse is a specialty nurse and CEMC has one on call 24/7.

WEEK 5 PICO(T) QUESTION 1Good Afternoon Class and Dr. Stephenson,In and out of the hospital high quality cardiopulmonary resuscitation (CPR) is crucial to survival of victims of cardiac arrest. This research topic will focus on implementation of in hospital chest compressions in CPR. It will be based on a comparison of the efficacy of manual compressions and automated chest compressions in relation to survival outcomes. The potential attributes and short comings related to manual and automated chest compression will be reviewed. Intensive care unit (ICU) nurses have to be prepared to implement CPR during a cardiac arrest code. In consideration that patients in the ICU are often only marginally stable it is important that ICU nurses are familiar with their patient’s recent and past medical histories.

| Lesson Outline: Allocated teacher-NExplaining legal requirements : Duty of care: A duty of care is implied when the person who is requiring your assistance is in your workplace. E.g. patient, co-worker or visitor. Consent of an unresponsive patient is assumed in an emergency situation. (Crouchman, 2009; Milne & Mellman-Jones, 2010).Cultural awareness/sensitivity: We need to mindful of varying cultures when assisting patients, as different cultures prefer to be unexposed which is necessary when defibrillation is required. Eg, Muslims (Hattersley & Keogh, 2009). Confidentiality: Following an emergency situation it is vital to refrain from speaking to others outside the workplace about the patient to ensure the patient’s privacy and dignity. Think about how you would feel if you where in the patient’s situation. (Maeder, Martin-Sanchez, Croll, & Ambrosoli, 2012)?Limitations: Remember that once you start you can’t stop until you’re physically unable to or help arrivesDebriefing: Participating in the debriefing process is vital due to the enormity of the situation, enabling the nurse to express

A Do not resuscitate (DNR) order is a legal document written by a licensed physician, which is developed in consultation with the patient, surrogate decision maker, and attending physician. This document indicates whether the patient will receive resuscitative care, cardiopulmonary resuscitation (CPR), or advanced medical directives, in the setting of cardiac and/or respiratory arrest. A DNR can also be referred as a no code when identifying a patient’s resuscitation status. If a patient has an existing DNR it allows the resuscitation team, taking care of the patient, to either withhold or stop any resuscitation measures, and therefore respect the patient’s wishes. Historically, DNR orders did not become active in the care of patients until 1974, when it was identified that patients who received CPR, and survived, had significant morbidities (Braddock & Derbenwick-Clark, 2014). Braddock and Derbenwick-Clark further noted, the American Heart Association (AHA) recommended that physicians, in consultation with the patient, family, and or surrogate, place on the patients chart when CPR was not indicated. This documentation is now what we refer to as the DNR order and has become the standard to allow autonomous respect for patients, and their families, to make informed medical decisions. Therefore, the purpose of this paper is to discuss the legal aspects, ethical issues, and the application surrounding the DNR order.

Safe, effective, patient-centered care delivered in a timely and efficient manner is the goal of quality healthcare. Unfortunately, the delivery of such quality faces serious concerns. The Institute of Medicine (2001) describes the quality gap in healthcare as having three types of problems, “overuse, underuse, and misuse” (p. 23). In recent years, emphasis on improving the quality of care has increased (IOM, 2001). Quality improvement methods, such as plan-do-study-act (PDSA), have successfully enabled health care providers to address the quality gap. The purpose of this paper is to identify a quality healthcare problem, discuss the quality improvement plan, and describe the strategy for implementing effective change using the PDSA method.

The first lesson that I have learned in the beginning of the EMT course is safety. If there is a situation where someone needs your help is unconscious,it is your duty to