Emergency Nurse

• Emergency nursing deals with human responses to any trauma or sudden illness
that requires immediate intervention to prevent imminent severe damage or death

• Care is provided in any setting to persons of all ages with actual or perceived
alterations in physical or emotional health.
• Initially, patients may not have a medical diagnosis.
• Care is episodic when patients return frequently, primary when it is the initial
option for health or preventive care, or acute when patients need immediate and
additional interventions.
• Emergency nursing is a specialty area of the nursing profession like no other.
• Emergency nurses must be ready to treat a wide variety of illnesses or injury
situations, ranging from a sore throat to a heart attack.
• HISTORICAL DEVELOPMENT OF EMERGENCY NURSING
• Florence Nightingale was the first emergency nurse, providing care to the wounded in the Crimean
War in 1854.
• The Emergency Department Nurses Association (EDNA) was organized in 1970
• A competency-based examination, first administered in 1980, provides Certification in Emergency
Nursing; certification is valid for 4 years
• EDNA developed Standards of Emergency Nursing Practice, published in 1983, to be used as a
guideline for excellence and outcome criteria against which performance is measured and evaluated.
• In 1985, the Association name was changed to Emergency Nurses Association (ENA), recognizing the
practice of emergency nursing as role-specific rather than site- specific.
• Originally, ENA aimed at teaching and networking, the organization has evolved into an authority,
advocate, lobbyist, and voice for emergency nursing. It has 30,000+ members and continues to grow,
with members representing over 32 countries around the world.
• ONCEPT OF EMERGENCY NURSING
• The term emergency is used for those patients who require immediate
action to prevent further deteriorations or stabilizing the condition until
the availability of the services close to the patients.
• “Emergency has been defined as a condition determined clinically or
considered by the patient or his/her relatives as requiring urgent medical
services, failing which, it could result in loss of life or limb”.-WHO
• Medical emergency is a situation when patient requires urgent & high
quality medical care to prevent loss of life or limb and/or to initiate
action for the restoration of normal healthy life.
• Emergency care can be defined as the episodic and crisis-oriented care
provided to patients with conditions ranging from minor to serious or life-
threatening injuries or illnesses.
• Emergency management traditionally refers to urgent and critical care
needs; however, the ED has increasingly been used for non-urgent problems,
and emergency management has broadened to include the concept that an
emergency is whatever the patient or family considers it to be
• Emergency nursing is a specialty within the field of professional nursing
focusing on the care of patients with medical emergencies, that is, those
who require prompt medical attention to avoid long-term disability or
death.
• PRINCIPLES OF EMERGENCY NURSING
• Principles of Emergency Nursing includes –
• 1. Guiding principles for emergency care
• Quick assessment of the casualty and situation to institute life saving measures.
• Keep casualty in dorsal position and cover his/her body with whatever cloth is available to
prevent heat loss.
• Avoid unnecessary handling except to remove the victim from additional danger.
• Give first aid to the injured part.
• Observed and keep a medical record of the casualty’s initial condition till he reaches the
hospital.
• Reassurance should be given to the victim and relatives that he/she is in safe
hands.
• Prevent people crowding near the victim; allow fresh air to circulate around
the victim.
• Do not give water to drink to the victims with abdominal injuries may
requiring immediate surgery.
• Make arrangements for safe transportation to hospital after first aid.
• In few emergencies like unconsciousness, uncontrollable bleeding, respiratory
difficulties etc., require coordinated efforts for speedy transportation for
medical facilities with simultaneous lifesaving appropriate care is important.
• Principles of emergency management
• Maintain patent airway & provide adequate ventilation employing resuscitation measures when
necessary
• Control hemorrhage & its consequences
• Evaluate and restore cardiac output
• Prevent and treat shock, maintain or restore effective circulation
• Carry out a rapid initial and ongoing physical examination
• Assess the patient consciousness, whether the patient can follow commands or not, evaluate the
size & reactivity of pupils.
• Start ECG monitoring if appropriate
• Apply Splint of suspected fractures sites including cervical spines in patients with head injuries
• Protect wounds with sterile dressings
• Start a flow sheet of patient’s vital sign, neurological state, to guide in
decision-making.
• SCOPE AND PRACTICE OF EMERGENCY NURSING
• The emergency nurse has had special training, education, experience, and expertise in
assessing and identifying health care problems in emergency & crisis situations.
• The emergency nurse establishes priorities, monitors and continuously assesses acutely ill
and injured patients, supports and attends to families, supervises allied health personnel,
and teach the patients and families within a time-limited, high-pressured care
environment.
• Nursing interventions are accomplished interdependently in consultation with or under
the direction of a licensed physician.
• Appropriate nursing and medical interventions are anticipated based on assessment data.
• The emergency health care staff members work as a team in performing the highly
technical, hands-on skills required to care for patients in an emergency situation.
• EMERGENCY NURSES
• Emergency nurses also deal with non-emergent populations that
present with non-life threatening issues as well. Patients that present
to the Emergency Department may range from birth to geriatric.
• Qualities of Emergency Nurse
• The Nurses working in Emergency or trauma units must have specialized skills
in handling emergencies. Some of these skills are:
• Observation and assessment skills
• Quick decision making skills
• Patient care skills in emergency situations.
• Emotional stability
• Self-confidence with ability to lead and control the patients as well as
attendants.
• Recording and reporting skills.
• Roles of the Emergency Nurse
• Care provider: provides comprehensive direct care to the patient and
family.
• Educator: provides patient and family with education based on their
learning needs and the severity of the situation and allows the patient
to assume more responsibility for meeting health care needs
• Manager: coordinates activities of others in the multidisciplinary team
to achieve the specific goal of providing emergency care
• Advocate: ensures protection of the patient’s rights
• Functions of the Emergency Nurse
• Uses triage to determine priorities based on assessment and
anticipation of the patient’s needs
• Provides direct measures to resuscitate, if necessary
• Provides preliminary care before the patient is transferred to the
primary care area
• Provides health education to the patient and family
• Supervises patient care and ancillary personnel
• Provides support and protection for the patient and family
• Qualifications of an Emergency Nurse
• An emergency nurse is a registered nurse with specialized education and experience in
caring for emergency patients.
• Emergency nurses continually update their education to stay informed of the latest
trends, issues, and procedures in medicine today.
• Many take a special examination that proves their level of knowledge. After successful
completion of this exam, they are certified in emergency nursing.
• Some emergency nurses also acquire additional certifications in the areas of trauma
nursing, pediatric nursing, nurse practitioner, and various areas of injury prevention
• Many emergency nurses acquire additional certifications in the areas of trauma nursing,
pediatric nursing, nurse practitioner, and various areas of injury prevention

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• Emergency nursing deals with human responses to any trauma or sudden illness

that requires immediate intervention to prevent imminent severe damage or death

• 1. Guiding principles for emergency care

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