ESI Triage Level
A 22 year old female presents to the Emergency Department reporting depression and a history of suicidal thoughts. What should her triage level be?
Level 2
What do we need to have before we start our heparin drip?
An accurate weight.
How often do we need to put in a note on our behavioral health patients?
Every 2 hours.
When do we need to get Q15 minute vitals on our septic patient?
If they are hypotensive OR their lactic is greater than 4.
Who can administer the sedatives and paralytics during an RSI?
We can.
How long do we scrub the skin with chlorhexidine and how long do we let it dry when drawing blood cultures?
Scrub for at least 30 and let it completely dry.
A 77 year old male presents via EMS on Bipap for respiratory distress. What is the patient's triage level?
ESI Level 1
When do we first check our PTT and titrate our drip?
6 hours after it is started.
How often do we need to complete a behavioral health reassessment on our behavioral health patients?
Every 4 hours.
If the lactic is greater than 2, when do you need to obtain a second lactic?
Within 3 hours.
How often do we need to obtain lab work on our DKA/Endotool patients?
Q4 Hours
How many ml's need to be in each blood culture bottle and what is our order of draw?
10 ml's
Blue then Gold.
A 20 year old male presents to your ED screaming at you that he wants to leave. The patient was found by EMS after an overdose. His initial respiratory rate was 4. EMS gave Narcan to the patient. What is the patient's triage level?
ESI Level 1.
Who puts in the orders for the PTT lab draws?
We do!
What are the restraint time limits for the different age groups?
>18 years, 9-17 years, <9 years
>18 years = 4 hours
9-17 years = 2 hours
<9 years = 1 hour
How long do you have to get the fluid bolus completed for the patient?
Should be completed within 1 hour. You need to document a stop time for the fluids and obtain a full set of vital signs when fluids are complete.
When do we start transition fluids on our Endotool patient? Bonus: What are transition fluids?
When the blood sugar is less than 250.
Transition fluids are dextrose containing fluids.
How often do vital signs need to be completed on our TPA patients?
Q 15 minutes for 2 hours.
A 32 year old female presents with complaints of abdominal pain, nausea, and vomiting for one day. Her vitals are within normal limits. What is the patient's triage level?
ESI Level 3
Besides the EMAR, where else do we need to document our heparin drip?
IV Drip Titration Screen.
How often do you need to complete a restraint documentation assessment?
What is our goal time for antibiotic administration?
They MUST be started within 30 minutes of the order.
What is our door to EKG goal time?
3 minutes
What screen needs to be completed on EVERY neuro patient?
Dysphagia Screen
A code neuro presents to ED. Last known well was 3 hours ago. The patient's vital signs are within normal limits. What is the patient's triage level?
ESI Level 2
Where do we find our heparin protocols?
Intranet -> Forms Section -> Search for Heparin
If you are sitting for a behavioral health patient, how often do you have to document that the patient's safety, rights, and dignity are maintained?
Q15 minutes
Do we need to fill out the sepsis checklist?
Yes!
Bonus: Where do we put the sepsis checklist when our patient leaves us?
Who can administer the medications during a conscious sedation?
ONLY THE DOCTOR!
What is our goal for pain med administration for a possible long bone fracture?
30 minutes