National Home Safety Month – June 2013

By Nurse Diane

"I've fallen and I can't get up!"  I’m sure you all have seen this commercial from Life Support.  I recently saw a new one where the lady is saying, "I just started some new medicine and I feel dizzy.” The lady at the other end of the line asked if she needed an ambulance, then sent one right over.  Many of my friends and family are elderly, and I am always worried that they will fall and injure themselves.  Recently my aunt fell in her garage, hit her head on concrete and eventually passed away from her injuries.

Most of the home accidents occur with the elderly and children.  The home is the site of approximately 20% of all injury death. The top five leading causes of unintentional home injury death are falls, poisoning, fire/burn, choking/suffocation, and drowning; together these causes account for 90% of all unintentional home injury deaths. Yet the majority of unintentional home injuries do not result in death. For every home injury death there are approximately 650 nonfatal injuries. Children under age 5 and adults over age 70 are the highest risk groups for home injury, both fatal and nonfatal according to the Home Safety Council.

Falls continue to be the major reason for injury-related death, injury and hospital admission for older adults.

Follow these tips to prevent slips and falls in your home:

• Keep the floor clear. Reduce clutter and safely tuck telephone and electrical cords out of walkways.
• Keep the floor clean. Clean up grease, water and other liquids immediately. Don't wax floors.
• Use non-skid throw rugs to reduce your chance of slipping on linoleum.
• Install handrails in stairways. Have grab bars in the bathroom (by toilets and in tub/shower.)
• Make sure living areas are well lit. We can all trip and fall in the dark.
• Be aware that climbing and reaching high places will increase your chance of a fall. Use a sturdy step stool with handrails when these tasks are necessary.
• Follow medication dosages closely. Using medication incorrectly may lead to dizziness, weakness and other side effects. These can all lead to a dangerous fall.

Below are some tips that will help make your home more safe but I would suggest that you go to each room in your home, look around to see if there is any possible health hazard that could be lurking in any corner.

Have first-aid kit stocked with emergency items.

• Practice a home fire escape plan twice a year so everyone knows at least two exits out of every room and where to meet outside in case of an emergency
• Test your smoke alarms once a month and replace batteries yearly
• Stay in the kitchen when food is cooking on the stove
• Use nightlights to help light hallways and bathrooms during nighttime hours
• Use a sturdy step stool and not a chair when climbing
• Post the National Poison Control Hotline number (800-222-1222) along with other emergency numbers next to every phone

(Photos from Google) 

Emergency Medical Services (EMS) Awareness Week

By Nurse Diane

This week we are honoring the Emergency Medical Services (EMS).   Who are they? And what do they do? EMS are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency.  The term emergency medical service evolved to reflect a change from a simple system of ambulances providing only transportation, to a system in which actual medical care is given on scene and during transport. In some jurisdictions, EMS units may handle technical rescue operations such as extrication, water rescue, and search and rescue.

History

Documentation of the first EMS is found in the Bible with the story of the Good Samaritan.   Luke 10:34 (NIV) - "He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him."  The first known hospital-based ambulance service operated out of Commercial Hospital, Cincinnati, Ohio (now the Cincinnati General) by 1865.  This was soon followed by other services, notably the New York service provided out of Bellevue Hospital, which started in 1869 with ambulances carrying medical equipment, such as splints, a stomach pump, morphine, and brandy, reflecting contemporary medicine.

Purpose

Emergency medical services exist to fulfill the basic principles of first aid, which are to:

• Preserve Life,
• Prevent Further Injury, and
• Promote Recovery.

This common theme in medicine is demonstrated by the "star of life". The Star of Life, where each of the 'arms' to the star represent one of the 6 points. These 6 points are used to represent the six stages of high quality pre-hospital care, which are:

1. Early detection - Members of the public, or another agency, find the incident and understand the problem
2. Early reporting- The first persons on scene make a call to the emergency medical services and provide details to enable a response to be mounted
3. Early response- The first professional (EMS) rescuers arrive on scene as quickly as possible, enabling care to begin
4. Good on-scene care - The emergency medical service provides appropriate and timely interventions to treat the patient at the scene of the incident
5. Care in transit- the emergency medical service load the patient in to suitable transport and continue to provide appropriate medical care throughout the journey
6. Transfer to definitive care - the patient is handed over to an appropriate care setting, such as the emergency department at a hospital, in to the care of physicians

Members:

• First Responder
• Ambulance Driver
• Ambulance Care Assistant
• Emergency Medical Technician (EMT)
• Emergency Medical Dispatcher
• Paramedic
• Critical Care Paramedic
• Nurse
• Doctor

EMS does more than just provide a taxi service to and from the hospital.  They are usually the first responder to an accident or any emergency situation.  They assess the situation, provide initial care to stabilize the injured or ill person and perform life saving techniques while transporting to a medical facility.  I had several occasions in which I relied on the EMS here to transport my husband to the hospital.  This was not an easy task.  He weighed around 220 pounds, dead weight. It took two EMTs and me to transfer him to a stretcher, and then they had to maneuver their way out of the house, which was also complicated considering the turns they had to make.  Once they got him into the ambulance they would initiate oxygen and start an I.V. for fluids before racing him to the hospital.  Not only did I call them during emergency situations, but also on special occasions when he wanted to get out of the bed for holiday celebrations.  They would help me transfer him to his wheelchair, then return to put him back in the bed.  Not only did they not charge for this service, but also they did it willingly and cheerfully.

Being a part of the EMS team is not an easy job.   They work 12 to 24 hour shifts, all kinds of weather, and any time of the day or night.  The conditions in which they find their victims is not always the best.  And on top of that they are in charge of doing all they can to save lives while also dealing with confused, upset or irrational people.  They all deserve our respect and gratitude for the hard work they do.  So as we honor them this week, reach out to them, give a pat on the back, and let them know how vital they are to your community and how much they are appreciated.

(All images from Google) 

Trauma Awareness

By Nurse Diane

A few days ago near Fort Worth, Texas in a small town called Granbury, an E4 tornado ripped through the community leaving six people dead, seven missing and injuring an undetermined number of people.  Trauma happens when you least expect it.  You could be in a vehicle accident, sporting accident, natural disaster, or even doing things around your home.

During these events, it is comforting to know there is a team of people who are knowledgeable to help you in any situation.  That is why May is National Trauma Awareness Month. Established by President Ronald Reagan in 1988, National Trauma Awareness Month is a time for all of us to appeal to our state and federal lawmakers to support funding for trauma research and provide resources to local trauma centers. It’s also a good time to provide injury prevention messages to the public and to publicize the locations of trauma centers.

National Trauma Institute.org lists several ways that you can help with trauma awareness.  Below are some of the suggestions they have:

• Write to Congressional Appropriations Committee members to ask for their support of federal spending for trauma research.
• Send thank you notes to legislators for their past support of funding for trauma research and ask for their continued support.
• Include recent trauma statistics in patient newsletters and flyers
• Publish safety reminders in local papers
• Publicize Trauma Center locations and facts

For more information and ideas on how to help, visit this site:  http://www.nationaltraumainstitute.org/home/national_trauma_awarness_month.html

Emergency Room Nurse's Week

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By Nurse Diane

While working in the hospital, we were frequently moved to other areas to work when the staffing was short.   One of my favorite areas to work in was the Emergency Department.  This department is constantly moving.  You never know what is going to happen when the next patient comes through the door.  I’m sure you have seen television shows like ER and House.  The action is fast paced, and people are bleeding and having tubes pushed down their throat, and they are getting paddles ready to shock you back to life.  While this kind of activity may happen in the larger cities, here in my small town, we never experience anything that critical.

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The nurses in the Emergency Department have to be knowledgeable in every area, and every medical problem - from heart attacks, to women in labor to cuts and broken bones.  When you go to the hospital for an emergency, you are frightened and anxious.  You rely on the medical staff there to take care of the problem, and fix it and make you all better.

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This anxiousness also calls for alot of patient nursing care.  People often take out their anger on those who are there to help them, only because they are the closest ones available.  The Emergency department is quickly becoming more like a battle ground instead of a hospital.  Drug addicts come in, hoping to steal drugs, fighting family members want to include nurses in their fights, as well as unruly patients.  The security at the Emergency Departments has become tighter than Fort Knox, just to keep the nurses and other staff safe.

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Many people come to the ER with just a cold or virus.  These nurses treat these patients with importance as well.  While the work in the ER is stressful and tedious at times, there is still no place in the hospital these nurses would rather work.  On the site lifeinthefastlane.com, these examples of Emergency room nurses were listed.

You know you’re an Emergency Nurse when:

• You see stress as a normal way of life;
• Your idea of a good time is a code at shift change;
• You occasionally park in the space with the “Doctors Only” sign, and knock it over;
• You have recurrent nightmare of being hit and run over by a portable X-ray machine;
• You silently diagnose people as you walk through the shopping center;
• Your most common assessment question is “what changed tonight to make it an emergency after 6 years?”;
• When checking the level orientation of your patients, you aren't sure of the correct answer yourself;
• You have competitions with patients presenting with urinary retention, who has the largest bladder volume;
• Your sense of humor seems to get more “warped’ each year;
• You think transdermal meal patches would be a good idea;
• Your family members must have a fever over 104° or be missing a limb with active bleeding in order to receive your sympathy;
• You believe the government should introduce a permit to be able to reproduce; and
• You believe “to stupid to die” should be a diagnosis.

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This is Emergency Room Nurse's Week.  If you or a family member have to experience the Emergency Department at your local hospital, please be kind to the nurses there.  They are only there to help you, they can't make tests return any faster, or move along the other patients any quicker.  They will show you the same time, courtesy, professionalism and care as they show to the patient before you, and the ones who come after you.  Even if you aren't feeling your best, they will try their best to make you feel better.   Show your gratitude to an Emergency Department Nurse today.

Be Prepared

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By Terry Orr

Preparedness refers to the state of being prepared for specific or unpredictable events or situations. Preparedness is an important quality in achieving goals and in avoiding and mitigating negative outcomes. It is a major phase of emergency management, and is particularly valued in areas of competition such as sport and military science.

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September 2012 marks the ninth annual National Preparedness Month, sponsored by the Federal Emergency Management Agency in the US Department of Homeland Security. One goal of Homeland Security is to educate the public about how to prepare for emergencies, including natural disasters, mass casualties, biological and chemical threats, radiation emergencies, and terrorist attacks.

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10 Ways YOU Can be Disaster Prepared (from Cal EMA)

1. Identify Your Risk
2. Create a Family Disaster Plan
3. Practice Your Disaster Plan
4. Build a Disaster Supply Kit for Your Home
5. Prepare Your Children
6. Don’t Forget Those with Special Needs
7. Learn CPR and First Aid
8. Eliminate Hazards in Your Home and Work Place
9. Understand Post 9/11 Risks
10. Get Involved, Volunteer

I really like how Cal EMA has layout getting prepared for disasters, especially item one, ‘identify your risk’. What are the hazards where you live or work? Find out what natural or human caused disasters pose a risk for you. Do you live near a flood plain, an earthquake fault, or in a high fire danger area? Are you prepared for an unexpected human-made disaster that can strike any time? Does your neighborhood or community have a disaster plan?

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Be sure to include the following items in your emergency plan:

• How each person will get out of the house, if needed;
• Where to meet if you must leave the house; and
• Contact information for reaching the designated out-of-area contact person.

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Emergency management, emergency preparedness, and disaster services are common throughout the United States—we take care of each other. By whatever name, these activities encompass mitigation, preparedness, response, and recovery related to any kind of disaster, whether natural, technological, or national security. Emergency preparedness means being prepared for all kinds of emergencies, able to respond in time of crisis to save lives and property, and to help a community—or even a nation—return to normal life after a disaster occurs.

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Like a good scout – Be Prepared

References and links:

http://www.ready.gov

http://www.cdc.gov/features/beready/

http://www.bt.cdc.gov/preparedness/

http://www.citizencorps.gov/

http://www.calema.ca.gov/NewsandMedia/Pages/Preparedness-Month.aspx

http://www.emergencypreparednessdepot.net/

https://www.disability.gov/emergency_preparedness#map

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Celebrating EMS Week

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By Akindman

EMS Week is 20-26 May 2012!  It is a time to reflect on their accomplishments, services to their communities and sacrifices.

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During my Navy career, all hands were required to attend and participate in First Aid, Fire Fighting, and Damage Control training and refresher training.  Aboard ship, the EMS was known as the Medical Response Team.  First responders were those personnel in the immediate area (this could be you) – so understanding what to do was critical and could be a lifesaving activity.

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Emergency medical services (EMS) are a type of emergency service dedicated to providing out-of-hospital acute medical care, transport to definitive care, and other medical transport to patients with illnesses and injuries which prevent the patient from transporting themselves.

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Emergency medical services may also be locally known as a first aid squad, emergency squad, rescue squad, ambulance, squad ambulance service, ambulance corps, or life squad.

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The goal of most emergency medical services is to either provide treatment to those in need of urgent medical care, with the goal of satisfactorily treating the presenting conditions, or arranging for timely removal of the patient to the next point of definitive care. This is most likely an emergency department at a hospital. The term emergency medical service evolved to reflect a change from a simple system of ambulances providing only transportation, to a system in which actual medical care is given on scene and during transport. In some developing regions, the term is not used, or may be used inaccurately, since the service in question does not provide treatment to the patients, but only the provision of transport to the point of care. (http://en.wikipedia.org/wiki/Emergency_medical_services)

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Thank you to all of the First Responders for your dedication and professionalism!!

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Links:

http://www.jems.com/

http://www.emsworld.com/

http://www.ems.gov/

http://www.acep.org/emsweek/

http://www.facebook.com/National.EMS.Week

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10/10-16 National ER Nurses Week

By Diane Forrest, RN

You might work in an ER if...

• You've ever had to contend with someone who thinks constipation for 4 hours is a medical emergency...
• You've ever entered a patient's chief complaint as "I'm drunk"...
• You refer to motorcyclists as "organ donors"...
• You've ever had a patient with a nose-ring tell you "I'm afraid of shots"...
• You stare at someone in utter disbelief when he or she actually covers his or her mouth when coughing...
• You've ever thought "as long as he's got a pulse, I won't worry about that rhythm."...
• You've ever referred to a body bag as a "To Go" bag...

• You think of chocolate, coffee, Coca-Cola® and the cafeteria's frozen yogurt when anyone mentions the 4 food groups...
• You think that the announcement of an impending arrival in 5 minutes of two adults in a serious MVA on backboards with sirens on and anxiety a level 10 would be a great opportunity to eat lunch...
• You have ever heard triage nurse first ask, "Is it urgent?" when interrupted from the first break in hours...
• You have four categories of patients...urgent, emergent, non-emergent, and S.I.O. (sleeping it off)...
• You automatically multiply by 3 the number of drinks they claim to have daily...
• You feel that you can diagnose passersby at the mall based on physical presentation...
• You don't have to ask "frequent flyers" any medical history questions because you can fill it out from memory...
• You can keep a straight face as the patient responds "Just two beers"...
• You give the local drunks tips on where to sleep so they (and you) won't be disturbed by a return visit

The other day I was telling you about Pediatric Nurses Week, and the important work these nurses do.  Well it is also Emergency Nurse's Week.  These nurses are amazing.  They never know what to expect from one minute to the next.  They see people who come in with colds, to patient having heart attacks, to accidents, gunshot wounds, or victims of other crimes.

There have been many security changes for the ER as well, patients come in wanting drugs pose a serious security risk.  Psychiatric patients can be harmful as well.  Each emergency room I have ever visited has their own security staff for these reasons.

Emergency room nurses have to be knowledgeable about every possible illness or injury be able to comfort and calm the patient and family member.  In the past year my husband was transported the ER on 4 occasions.   Luckily I knew and or worked with several of these nurses, so the process was fairly easy.  I was able to provide all the necessary information as well as take care of him while he was having tests run, freeing up the nurse to take care of other patients.  However most of the patients that enter the ER are not as prepared.

Emergency room nurses deserve this week of celebration and honor.  They could be the one to save your life

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Rules for the Emergency Room

• Here are some tips to those who may end up in an ER, be it yourself or a family member.
• If it requires the ambulance team and entire truck crew of firefighters to transport you and safely place you on a hospital stretcher, it is time to go on a diet.
• When you present to the triage nurse, do not tell him/her that your doctor called ahead. If you survey our waiting area, probably 50% of the people waiting said the same thing, and the other 50% use the ER as their regular doctor.
• Never start out by saying, "I was searching the Internet . . . "
• When asked how much you weigh, please do not give the "Deer-In-The-Headlights Look", and tell us you "really don't know". It's a simple question with a simple answer.
• Just because you have a phone and know how to call 911, we are not impressed by your arrival on an ambulance stretcher. You had better be sick.
• If you came escorted via EMS for multiple complaints that started more than one week ago and your entire family followed the ambulance to the hospital, you will be labeled a ninnie and treated like one, enjoy the waiting area with your family.
• One complaint/ailment per visit, please.
• Just because you came in on a ambulance, doesn't mean you're going home on one. You better start making arrangements, now. I am not driving you home, or figuring out how to get you home. Cab vouchers are not an option.
• If you have one of these four, go to your own doctor in the morning: A Migraine; the Flu; a stomach virus; or a stuffy nose.
• Do not ask us how long it will be. We don't know. I don't know what is coming through my door 30 seconds from now,so I sure as hell don't know when you're getting a room.
• We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That is why she goes first.
• If your mother is a patient and we ask her a question, let her answer it.
• If your child has a fever, you had damn well better give him Tylenol® before coming in. DO NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure? Do you?
• If you are well enough to complain about the wait, you are well enough to go home.
• Do not utter the words "it is in my chart", I don't have your chart, and I don't have the time to call and get it. Just tell me. It is faster.
• We know how many times you've been to an ER. We can usually tell if you are faking it during the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will have to assume you are lying about everything. You don't want that.
• If you have diabetes and do not control it, you are committing slow suicide.
•  If you are a female between 16 and 42 and your last period was between 28-35 days ago, please don't waste our time if you are here for Abdominal Pain & Vaginal bleeding. Guess what!!?? You got your period, again.
• Do not bring your entire posse with you. One person at the bedside is all you need. It is really difficult to move around seven people who are in the way if you are really sick.

• Every time I ask you a question, I learn more about what is wrong with you. I don't care if I asked you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless whether you have answered them before.
• If you want something, be nice. I will go out of my way to piss off rude people.
• Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or have been shot. We don't consider a kidney stone, sick. Painful, yes. Sick, no.
• At any given time, one nurse has four patients. One doctor has up to 15.
• There is a law (similar to Murphy's) in the ER. If you have four patients: one of them will be sick (see above for definition); one of them will be whining constantly; one of them will be homeless; and one of them will a delightful patient. (don't be the whiner). Please.
• If you see someone pushing a big cart down the hall at full speed and you hear bells going off, do not ask for a cup of coffee. Someone is dying, you inconsiderate a*****e. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.
• If you can bi**h about the blood pressure cuff being too tight, or the IV hurting, you are not in that much pain.
• Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonald's®, and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, and the lights dimmed, go to the Ramada®.
• If you have any sort of stomach pain and you ask for something to eat, you are not sick.
• Do not talk s**t about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more that I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.
• If you are homeless, don't ask for a bus token or cab voucher to get home. It just confuses the staff.
• Please don't tell us how to do our job. Do we go to your place of business and tell you how to do your job?
• Please don't bring in a "show and tell". If you have to fish it out of the toilet, it's really not necessary to bring it in; we will take your word. If you did fish something out of the toilet, you may not use my pen.