Author: 215101 Mudu People's Hospital, Suzhou, Jiangsu Province
Chen Yuling: female, undergraduate, supervisor of nursing
Emergency Department is the window of the hospital, emergency medical service quality directly reflects the hospital
Comprehensive level of emergency treatment level is directly related to the emergency patient's safety, emergency nursing in the process of the role played by no doubt
Emergency care in the process of emergency rescue. The level is directly related to the emergency patient's safety, emergency
Diagnostic nursing in the emergency rescue process plays a role without doubt. In the emergency department
this high-risk location, to make the quality of care excellence is not easy, need
each nursing staff in the work of continuous learning, continuous improvement, and constantly summarize the experience
lessons learned, so as to minimize the potential risk factors. This article discusses three medical
accidents.
Example 1: A 60-year-old patient was admitted to the hospital with dizziness and tinnitus. At the time of admission, BP
136/88 mmHg, P 82 beats/min, R 16 beats/min, was diagnosed as sudden deafness by the department of otorhinolaryngology and was admitted to the internal medicine ward for treatment. The physician on duty in the department of internal medicine returned the patient to the emergency department for observation and treatment on the grounds that it was not a medical condition. The patient is not
full, contact 120 to request transfer to a higher hospital, emergency department nurses and 120 emergency
trolley medical personnel in the emergency hall for the handover of the 120 is responsible for the patient with
stretcher trolley to the emergency vehicle, in the emergency hall through the door of the downhill, due to the accompanying
with the 120 physician did not support the trolley, only a nurse in front of the trolley, a nurse in the front of the trolley, the patient is not a patient, but a patient with the patient is not a patient. Nurses in front of the car, the slope
steep place there is a gap coupled with the stretcher car wheels are small, poor stability, the car folded over, the patient fell
ground, resulting in the patient's zygomatic bone fracture, scalp hematoma, three ribs fracture. The family complained,
hospital compensation for economic losses of tens of thousands of dollars.
Analysis: From the point of view of the incident, 120 emergency medical personnel should be held fully responsible
, the emergency department has made a shift with its, and the patient contacted the 120 emergency
car. However, the panel's final verdict: (1) The 120 physician was primarily responsible because he
did not fulfill his duties. If he had pushed the vehicle with nurse ****, the vehicle would not have overturned
. (2) The 120 nurse was secondarily responsible. (3) The person in charge of the 120 is secondarily responsible. (5)
The Emergency Department was secondarily responsible. Thinking: Although the person directly responsible for causing the accident
is the 120 medical staff, but if the emergency department medical staff a little stronger sense of risk,
stronger sense of responsibility, with the 120 staff to place the patient on the car will not
will not be an accident.
Example 2: The patient, female, 62 years old, was admitted to the hospital at 7:00 a.m. due to excessive grief over the death of a family member, inability to eat, and
lack of energy. At the time of admission, the patient was clear, depressed,
little speech, BP 90/50 mmHg, P 76 beats/min, T 36.2 ℃, family members
did not provide other medical history. The physician diagnosed dysthymia and gave rehydration plus energy synthesis
supportive treatment, no other special medical advice, 7:30 shift to the day shift physician.
The physician who took over
based on the admission diagnosis did not do further examination, until 8: 20 the patient suddenly heart
beats, respiratory arrest, and died after resuscitation. Analysis: this patient is an elderly woman,
usually poor physical condition, the history of the original cardiac history. At that time, the first physician did not
detailed inquiries, but simply based on the feeling that the loss of a loved one caused excessive sadness,
and therefore did not do an electrocardiogram, there is no electrolyte data measurement, and the receiving physician over
believe in the first physician's judgment failed to further examination, resulting in the patient's death
death.
Think: Although this incident had nothing to do with nursing, it had a significant impact on the emergency department.
Physicians, especially those in the lower grades, are often not thorough in their diagnosis of illness.
If the nurse on duty at the time had been a very experienced senior nurse, she might have reminded the physician to do some necessary auxiliary tests, or made some reasonable suggestions,
or done some advance notification, asked about the patient's condition in a timely manner, and observed the changes in his vital signs,
and perhaps avoided this disaster that should not have happened.
Example 3: The patient, a woman, was transferred to the emergency department of our hospital at 4:30 a.m. from a rural health center for two episodes of abdominal pain and diarrhea.
The patient was in pain. At that time, the patient was in pain, and the nurse on duty checked her health center medical
record and found that the diagnosis was diarrhea, but she did not find that her blood pressure was 80/50 mm-
Hg as indicated in the lower right corner of the medical record, and she did not have her vital signs monitored in time. In accordance with the regulations on the prevention and treatment of intestinal diseases issued by the Medical Department, all intestinal diseases are treated in the Infectious Diseases Department, so the nurse was sent to the Infectious Diseases Department by trolley. The infectious disease physician asked about the medical history and diagnosed
ectopic pregnancy. Because the physician did not notify the Department of Obstetrics and Gynecology in a timely manner, and did not send someone to escort the patient to the Department of Obstetrics and Gynecology, and asked the patient to go there on her own, while the patient was uneducated, did not understand the severity of the disease, and could not find the location of the Department of Obstetrics and Gynecology, wandering back and forth within the hospital.