EMERGENCY DEPARTMENT NURSE INTERVIEW QUESTIONS:-2

WISH YOU GOOD LUCK DK ACADEMY FOR NURSES

Trauma assessment:

      Assess for consciousness by calling his name

      ABCD assessment

      Administer oxygen if necessary

      Stabilize neck –neck collar

1. C-spine

-manual immobilization, colloar, bags, tape

2. airway clear

3.Oxygen

4.Adjuncts-oronasopharyngeal tube , bag and mask

5.Definitive-ET tube, surgical airway

6. Help-anesthetist

      Check neck, chest for ijury

      Check back for injury

HOW TO HANDLE AGGRESSIVE PATIENT:

      Your safety is important-Make your self safe-security and co-worker, police officer with legal cases

      Check for sharp objects and remove sharp objects

      Look for signs of aggressiveness-yelling

      Never turn your back to your patient

      Keep a pillow with you to obstruct

      Safe distance

      Restraints as per doctors order-check hospital policy for restraints

      Listen to patient-show empathy, express concern for patient feeling

      Remain safe distance from patient

      Ask for help –if patient shouts

      Team work

GLASGOW COMA SCALE ASSESSMENT :

Check-observe-stimulate and rate

-hearing impairement

Eye opening:

1.      Spontaneous-E4

2.      To sound(shout name)-E3

3.      To pressure(10 second)-E2

4.      None-E1

Verbal :

1.      Oriented-V5

2.      Confuse-V4

3.      Words-V3

4.      Sounds-V2

5.      None –V1

Note: If tracheostomy/ET tube present-verbal response not testable

Motor

1.      Obeys commands-M6

2.      Localize (trapezius pinch-shoulder-for 10 second), supra orbital notch –ey brow-pressure 10 second-M5

3.      Normal flexion-M4

4.      Abnormal flexion-M3

5.      Extension-M2

6.      None –M1

Note: if paralysed with drugs-note -not testable

If different responses are exhibited between limbs , on right and left sides , record better isde response as best index of over all responsiveness. The response of the worst side may reflect focal brain damage or local injury.

 LOWEST GLASGOW COMA SCALE-3

 hospital emergency codes

answer:

Š RED for fire

 Š BLUE for adult medical emergency

Š WHITE for pediatric medical emergency

 Š PINK for infant abduction

Š PURPLE for child abduction

Š YELLOW for bomb threat

Š GRAY for a combative person

Š SILVER for a person with a weapon and/or hostage situation

Š ORANGE for a hazardous material spill/release

Š TRIAGE INTERNAL for internal disaster

 Š TRIAGE EXTERNAL for external disaster

. warning signs/caution for any illness?-vital signs

MANAGEEMENT OF PATIENT WITH SEIZURE:

Classification:

    Generalized:

1.    Tonic –clonic

2.    absence

    Partial :

1.    Simple partial

2.    Complex partial

Management:

    Check for  area safety-electrical wire, sharps etc

    Check LOC & response

-Alert

-Verbal

-Painful

_Unconscious

    Head to toe exam

    Talk to witness

    Check for medical alert bracelet

Generalized tonic clonic seizure management:

    Sidelying position

    Check airway for any obstruction

    Assess respiratory status-provide high flow oxygen.

    Assess pulse rate

    Assess blood sugar

    Medication –if more than 5 minute and repeating -benzodiazepines-diazepam, lorazepam, midazolam diastat acu dial

: causes resp depression –check for respiratory status

    Check for blood sugar –if low administer dextrose

Complication-status epilepticus

    Avoid physical contact

    Approach slowly from rear or side

    Speak calmly ,advise of actions

    Stay with patient until he regains consciousness at the conclusion

    Post ictal state-10-60minute or longer:

Causes of seizure:

SAMPLE

S-SIGNS AND SYMPTOMS

A-ALLERGIES

M-MEDICATIONS

P-PAST MEDICAL HISTORY

L-LAST ORAL INTAKE

E-EVENTS

HYPOGLYCEMIA MANAGEMENT:

      Life threatening

      RBS-70mg/dl -40-30mg/dl

Triggers:

      Too much insulin

      Not enough food

      Inconsistent exercise pattern

Clinical manifestation:

      Weakness, dizziness, hunger

      Lightheadness, sleepiness, confusion

      Slurred speech, rapid heart beat

      Clammy hands, headache, shaking

      Sweating, listlessness, discomfort

Severe:

      Unconsciousness, coma

      Seizure

      Death

Management:

      15gm sugar if can eat

      Medical care

      Check RBS

      Medication as per order-glucagon, dextrose 50%, Octreotide

And Diazoxide (antidote for hypoglycemia due to hyperinsulinemia)

      Food or drinks if conscious

      Monitor continuously RBS