Common Injuries/illnesses That Mostly Bring People to the Emergency Room (ER)
Burns at home are caused by open fires, hot liquids, or steamy air. When the skin is burned, the skin cells die and this results in scarring or discoloration of the place. The burn may occur in different stages, a simple burn is known as a first-degree burn, a mild burn is regarded as a second-degree burn and a severe burn is a third-degree burn.
Poisoning occurs when someone consciously or unconsciously ingests stale or contaminated foods. Poisoning can also arise from the ingestion of chemical products such as cosmetic lotions or detergents. Inhalation of toxic gas such as Carbon monoxide (CO) also causes poisoning with severe medical effects. Lastly, a venomous insect sting can also cause poisoning, which occurs when an individual is bitten or stung by a venomous animal.
Heart attack is a lifestyle disease that arises from unhealthy eating habits such as eating fatty foods such as fries, chicken skin, and fatty fish. Physical inactivity encourages the retention of excess fats in the body which increases the chances of arterial blockage. Also, high levels of stress increase blood pressure which interferes with the blood flow. However, there are various preventative measures that can help avoid these health issues (DeWit et al., 2016). Some of the preventative measures are discussed in the next slide.
One precaution for the burn is keeping all flames contained because the fire spread very fast. Another control measure is creating awareness of fire safety mechanisms such as extinguishing strategies and the best escape plan in case of an emergency to enhance chances of escape. To prevent poisoning, detergents should not be transferred into juice or water bottles to limit the chances of ingestion. Mixing chemicals can also produce toxic gases which can influence poisoning. For instance, bleach and vinegar produce chlorine gas which is poisonous when inhaled.
Heart attack can be avoided by adopting a healthy diet plan that is low in cholesterol. For instance, avoid eating deep-fried foods such as fries. Also, maintaining physical activity such as jogging, walking, or running every day is a necessary routine to avoid fat buildup (DeWit et al., 2016). Management of stress is necessary because stress increases blood pressure which is a key factor in cardiac arrest. Refraining from self-medication is a necessary precaution to avoid cardiac arrest. Some over-the-counter medications such as acetaminophen increase the blood pressure which may trigger a heart attack.
First Aid Steps
In case of a burn run cold water on the burnt area for 10 minutes. This is to cool the burn, avoid spread, and reduce pain, and scar tissue formation. This should only be done to a mild burn. For severe burns seek medical attention. Remove any clothing or jewelry around the burned area since it bruises the skin more which increases trauma and scarification. Cover the wound loosely to avoid infection and hypothermia. Afterward, taking pain relievers is advised. In air poisoning, evacuate the person from the intoxicated to get some fresh air. In case of contact poisoning, rinsing the area of contact with water is necessary since dermal exposure results in absorption which may cause skin rashes and brain damage.
In case of a cardiac arrest, call for help. Meanwhile, put the patient in an upright position to aid circulation. Administer aspirin to reduce the size of the clot and slow the clotting process. An unconscious patient with a heart attack should be administered CPR to enable the heart to pump blood into the body. CPR is only administered to unconscious patients because the chest compresses are meant to steer spontaneous breathing. If a child/infant is experiencing a heart attack and is unconscious, perform a 2-minutes CPR. Note: Seek medical attention always because the severity of a health issue can only be ascertained through therapeutic testing (DeWit et al., 2016).
Prioritization of Client Care in Triage
The chronological order of prioritization will be determined by the ABCDE’s signals. A patient with most of the symptoms mentioned will be seen first. Airway obstruction is determined by an assessment of the voice. If the patient has an obstruction, they will have a coarse sound that limits communication. Deviating or wrong answers to questions indicate an obstruction. Also, the rate of breathing or respiratory distress and pulse oximetry is checked to evaluate the severity of the problem. Circulation is determined by the palpate pulse rate and blood pressure. If below 60 or above 100 beats per minute, then the case is treated as an emergency (DeWit et al., 2016). If the blood pressure is low or high the case is treated as an emergency. Neurologic disability is determined by the level of consciousness of the patient. This is in terms of how responsive they are to their surrounding. Lastly, the severity of a medical issue is determined by the exposure which gauges how risky the ailment is in terms of being infected.
By using the prioritization concept the chronological order of care, in this case, will be as follows;
- Heart attack – This patient will receive the first priority since the body’s supply of oxygen is limited. The obstruction limits the circulation of oxygen and through this, the heart muscles become damaged which is irreversible. Each time that passes is critical (DeWit et al., 2016).
- Poisoning – severe poisoning presents serious symptoms such as difficulty in breathing for both ingested and inhaled poisons. Also, seizures and loss of consciousness may occur due to the effect of the non-controlled poison. The chances of survival depend on the instant response.
- Burn – A patient with severe burns will be given the third priority. The reason is that the patient may be in severe pain limiting their neurological ability. Also, a delay in treatment for weeks may cause sepsis which is an infection that causes the immune system to attack the body resulting in septic shock.
Prioritization of Acute Treatment Provided in the Emergency Room
The prioritization of acute treatment is based on the risks that a patient is exposed to without treatment. To determine whose condition requires ER treatment, the mechanism of injury and the index of suspicion applies. Mechanism of injury is used to predict the damages and the future complications (DeWit et al., 2016). A heart attack case cannot wait since deterioration takes place with each second that passes. CPR is administered to aid breathing. If this does not work, electric shock is applied to restore the normal rhythm. These steps are crucial and can only be performed in the ER. For a patient with burn injuries, intravenous fluids are given through an IV process to replace the liquids and salts lost. Later, skin grafting may be necessary for quick healing and minimizing scarring.
The last treatment category is poisoning which is done in the ER. Patients who are brought after ingesting poisons are given activated charcoal. This is to help reduce absorption as other measures are taken. Even though this can be done outside the ER, the other steps cannot be done there (DeWit et al., 2016). For instance, evacuation of stomach content in case of ingestion of poison is done in the ER. The insertion of a nasogastric tube during the process is a delicate process that requires consistent monitoring.
DeWit, S. C., Stromberg, H., & Dallred, C. (2016). Medical-surgical nursing: concepts & practice. Elsevier Health Sciences.