Show:
Falling Down on the Job
Sedation Aggravation
Mind-boggling Menagerie
Pediatric Ponderings
IO-nly have eyes for you
100
What should all fall-risk patients in the ED be wearing on their feet?
Yellow non-slip socks.
100
When should two consents be filled out?
When the EM team is performing the sedation, but a consulting service is performing the procedure.
100
In the Emergency Department, when is an appropriate time to use the PCA pump?
NEVER!
100
A 16-year-old male wearing swim trunks walks into the ED. He tells you that he dove into a pool and his face struck the bottom. You notice an abrasion over his forehead and nose as he tells you that both of his hands “feel tingly". He is alert, anxious, pale, breathing 28/min, HR 50 BPM. What is your first action?
C-spine immobilization.
100
Name two contraindications for I/O placement.
1. OI 2. Fracture 3. Recent IO placement within the last 24 hours 4. Infection or Tumor of the extremity NINE THOUSAND POINTS OFF IF YOU SAY TRAUMATIC AMPUTATION TO THAT LEG.
200
A 13-month-old patient walking down the hallway falls onto her hands and knees. What forms need to be filled out?
None! With a developmental fall, we do not need a post-fall debriefing or PSN completed.
200
What is the final section of the Sedation Navigator that must be completed?
"Meets Discharge Criteria".
200
What is the infusion rate with the Alaris syringe pump channel that requires the special micro-bore tubing?
A rate of < 1ml/hr.
200
“The smoke was so bad; she’s been having trouble breathing ever since,” reports the father of a 6-year-old who ran through her burning house to rescue her cat. You note that she is hoarse, has a frequent cough, an audible wheeze, and is breathing 50 times a minute with retractions. SpO2 is 82% RA. H/o asthma with PRN albuterol. What is her ESI level?
ESI Level 2.
200
What products can be infused into an I/O by gravity?
None. You must always use a pressure-delivery system or an IV pump.
300
Where can you find the two pieces of the bed alarms in the Emergency Department?
Alarm units- wooden cupboard by the Acute Pyxis. Sensor pads- Obs Pyxis.
300
True or False? On sedation consent forms, MDs may use abbreviations such R for right or L for left as long as it is completely explained to the family before they sign.
False. No abbreviations of any kind may be used on a consent form.
300
What are the two mandates of EMTALA?
1. Medical screening exam by a qualified provider. 2. Stabilization.
300
A three-year-old boy presents to triage with a 3cm jagged cut to the palm of his hand from knocking over a glass vase from the table. There is no active bleeding. The patient is screaming, crying, and hitting at you as you try to examine his hand. What is his ESI level?
ESI Level 3.
300
After removal of an IO, when can a patient resume normal activities?
Immediately.
400
What is the hospital signage to show that a patient is at risk for falls?
A maple leaf sign on the door.
400
Should LOC documentation occur BEFORE, DURING, or AFTER sedation?
BEFORE, DURING and AFTER.
400
What does EMTALA stand for?
Emergency Medical Treatment and Active Labor Act.
400
A 6-month-old is brought in by his parents for increased fussiness. The patient has hydrocephalus and a VP shunt. His fontanel is noted to be bulging, and he seems fussy. HR 130. RR 28. No fever. What is his ESI level?
ESI Level 2.
400
What is the only fluid that can never be given through an IO?
Hypertonic saline.
500
Who is responsible for jumping off their stool and helping a patient who appears unsteady on their feet or is walking alone with yellow socks on?
EVERYONE!!!!!
500
TRUE or FALSE: The Post Sedation section “Meets Discharge Criteria” means the patient is ready to go home and is walking out the door.
False. Discharge Criteria: - Vital signs are stable - Airway is patent as demonstrated by intact gag, cough & deep breathing - The patient is easy arousable - No untoward side effects exist (such as vomiting, agitation, etc.) - The patient is in the care of an adult; or has returned to baseline - Pain level <= 3 or tolerable to patient
500
What are the FIVE independent areas of our nursing scope of practice? 500 points for each correct answer.
1. Restorative Measures 2. Hygiene 3. Comfort 4. Safety 5. Health Promotion
500
A patient's mother walks into triage and reports "our pediatrician sent me and my son here for his belly pain". Per the patient's mother, he has had three days of worsening abdominal pain, and started vomiting this morning. No fevers. The child is pale and clutching an emesis basin. Temp 37.9C, HR 110, RR 20 BP 103/62. What is his ESI level?
ESI Level 3.
500
What are the three areas that OHSU RNs are allowed to place IOs? 500 points for each correct answer.
1. Proximal tibia 2. Distal tibia 3. Proximal humerus