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EmergencyRoomYiPingZhaoDepartmentofVascularSurgeryRenJiHospital第一页,共二十二页。HowEmergencyRoomsWork

第二页,共二十二页。Youwilllearnaboutthenormalflowoftrafficinanemergencyroomthepeopleinvolvedthespecialtechniquesusedtorespondtolife-or-deathsituations第三页,共二十二页。EmergencyRoomPatients

CaraccidentsSportsinjuriesBrokenbonesandcutsfromaccidentsandfallsBurnsUncontrolledbleedingHeartattacks,chestpainDifficultybreathing,asthmaattacks,pneumoniaStrokes,lossoffunctionand/ornumbnessinarmsorlegsLossofvision,hearingUnconsciousness第四页,共二十二页。EmergencyRoomPatients

Confusion,alteredlevelofconsciousness,faintingSuicidalorhomicidalthoughtsOverdosesSevereabdominalpain,persistentvomitingFoodpoisoningBloodwhenvomiting,coughing,urinating,orinbowelmovementsSevereallergicreactionsfrominsectbites,foodsormedicationsComplicationsfromdiseases,highfevers第五页,共二十二页。UnderstandingtheERMaze

Theclassicemergencyroomsceneinvolvesanambulancescreechingtoahalt,agurneyhurtlingthroughthehallwayandsomepeoplefranticallyworkingtosaveaperson'slifewithonlysecondstospare.Thisdoes

happenandisnotuncommon,Themajorityofcasesseeninatypicalemergencydepartmentaren'tquitethisdramatic.第六页,共二十二页。Triage

WhenyouarriveattheER,yourfirststopistriage.Thisistheplacewhereeachpatient'sconditionisprioritizedintothreegeneralcategories:ImmediatelylifethreateningUrgent,butnotimmediatelylifethreateningLessurgent第七页,共二十二页。Triage

Thetriagenurserecordspatientsvitalsigns(temperature,pulse,respiratoryrateandbloodpressure).Shealsogetsabriefhistoryofpatientscurrentmedicalcomplaints,pastmedicalproblems,medicationsandallergies.第八页,共二十二页。Registration

Thisstepisnecessarytodevelopamedicalrecordsothatpatientsmedicalhistory,labtests,X-rays,etc.,willallbelocatedononechartthatcanbereferencedatanytime.Ifthepatient'sconditionislife-threateningorifthepatientarrivesbyambulance,thisstepmaybecompletedlateratthebedside.第九页,共二十二页。ExaminationRoom

PatientsareseenbyanERnursewhoobtainsmoredetailedinformationaboutpatients.Oncethenursehasfinishedhertasks,thenextvisitorisanERphysician.Hegetsamoredetailedmedicalhistoryaboutyourpresentillness,pastmedicalproblems,familyhistory,socialhistory,andacompletereviewofallyourbodysystems.Hethenformulatesalistofpossiblecausesofyoursymptoms.第十页,共二十二页。DiagnosticTests

Bloodtestsandaurinalysisarerequired.

Acompletebloodcount(CBC)

AserumtestAblood'sclottingtest第十一页,共二十二页。DiagnosisandTreatment

Whentheemergencyphysicianhasalltheinformationhecanobtain,hemakesadeterminationofthemostlikelydiagnosisfromhisdifferentialdiagnosis.Alternately,hemaydecidethathedoesnothaveenoughinformationtomakeadecisionandmayrequiremoretests.Atthispoint,appropriateconsultantisneeded.第十二页,共二十二页。TheERteam

EmergencyPhysician

EmergencyNurse

PhysicianAssistant

EmergencyDepartmentTechnician

UnitSecretary

PhysiciansinTraining

第十三页,共二十二页。ToolsoftheTrade

EmergencyDepartmentsarestockedwithahugearrayofstrangelynamed,oddlyshaped,beepingandblinkingequipment.第十四页,共二十二页。Stethoscope

Astethoscopeletsanurseorphysicianlistentoheartandrespiratorysounds.Astethoscopeisusedtotakeyourbloodpressurebylisteningtotheflowofbloodthroughyourarteries.第十五页,共二十二页。CardiacMonitor

Acardiacmonitorgivesavisualdisplayoftherhythmofpatientsheart.Somemonitorsalsohaveanautomaticbloodpressurecuffandapulseoximeter.第十六页,共二十二页。SutureTray

Thistraycontainsthesterileequipmentneededtoplacestitchesinapatientwithalaceration.needleholderforcepssteriletowelsscissorssmallbowls第十七页,共二十二页。OrthopedicEquipment

Mostemergencydepartmentshaveagenerousnumberoforthopedicdevicesformanypurposesplasterand/orfiberglassmaterialspre-madesplintsforspecificjointskneeimmobilizersaluminumfingersplintsVelcrowristsplintsshoulderslingscervicalcollars

castcutters第十八页,共二十二页。CrashCart

Acrashcartisacabinetcontainingequipmentthatphysiciansandnursesneedwhenacardiacarrestoccurs.DefibrillatorEndotrachealintubationequipmentCentralveincathetersCardiacdrugs第十九页,共二十二页。Defibrilla

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