Chapter 69 Nursing Management Emergency, Terrorism, and...

Lewis: Medical-Surgical Nursing, 8th Edition Chapter 69: Nursing Management: Emergency, Terrorism, and Disaster Nursing Key Points – Printable CARE OF EMERGENCY PATIENT * Triage refers to the process of rapidly determining the acuity of the patient’s problem. It works on the premise that patients who have a threat to life must be treated before other patients. * The Emergency Severity Index (ESI) is a five-level triage system that incorporates concepts of illness severity and resource utilization to determine who should be treated first. * After the initial assessment to determine the presence of actual or potential threats to life, appropriate interventions are initiated for the patient’s condition. * The†¦show more content†¦* Patients with mild hypothermia (93.2 º F-96.8 º F [34 º C-36 º C]) have shivering, lethargy, confusion, rational to irrational behavior, and minor heart rate changes. * Moderate hypothermia (86 º F-93.2 º F [30 º C-34 º C]) causes rigidity, bradycardia, slowed respiratory rate, blood pressure only by Doppler, metabolic and respiratory acidosis, and hypovo lemia. Shivering diminishes or disappears at temperatures ≠¤86 º F (30 º C). * Severe hypothermia (lt;86 º F [30 º C]) is a severe and potentially life-threatening situation that makes the person appear dead. Profound bradycardia, ventricular fibrillation, or asystole may be present. Every effort is made to warm the patient to at least 86 º F (30 º C) before the person is pronounced dead. The cause of death is usually refractory ventricular fibrillation. Treatment of hypothermia focuses on managing and maintaining ABCs, rewarming the patient, correcting dehydration and acidosis, and treating cardiac dysrhythmias. * * SUBMERSION INJURIES Submersion injury results when a person becomes hypoxic because of submersion in a substance, usually water. Drowning is death from suffocation after submersion in water or other fluid. Near-drowning is defined as survival from potential drowning. Immersion syndrome occurs with immersion in cold water that leads to stimulation of the vagus nerve and potentially fatal dysrhythmias. * Treatment of submersionShow MoreRelatedInternational Management67196 Words   |  269 PagesThis page intentionally left blank International Management Culture, Strategy, and Behavior Eighth Edition Fred Luthans University of Nebraska–Lincoln Jonathan P. Doh Villanova University INTERNATIONAL MANAGEMENT: CULTURE, STRATEGY, AND BEHAVIOR, EIGHTH EDITION Published by McGraw-Hill, a business unit of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY 10020. Copyright  © 2012 by The McGraw-Hill Companies, Inc. All rights reserved. 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