Emergency Care in Nursing
Emergency nursing involves caring for patients with acute and urgent health needs. Emergency nurses work in emergency departments, urgent care centres, and as part of hospital response teams. Quick assessment, prioritisation, and intervention are essential.
The ABCDE Approach
The ABCDE approach is a systematic method for assessing and managing acutely unwell patients:
- A — Airway — Is the airway patent? Look for signs of obstruction
- B — Breathing — Assess respiratory rate, oxygen saturation, breath sounds
- C — Circulation — Assess pulse, blood pressure, capillary refill, skin colour
- D — Disability — Assess consciousness level (AVPU: Alert, Voice, Pain, Unresponsive)
- E — Exposure — Examine the patient fully, maintaining dignity and temperature
Treat life-threatening problems as they are identified before moving to the next step.
Triage
Triage is the process of prioritising patients based on the urgency of their condition. The Manchester Triage System (MTS) uses clinical indicators to assign priority levels:
- Red (Immediate) — Life-threatening, seen immediately
- Orange (Very urgent) — Seen within 10 minutes
- Yellow (Urgent) — Seen within 60 minutes
- Green (Standard) — Seen within 120 minutes
- Blue (Non-urgent) — Seen within 240 minutes
Cardiac Arrest
The Resuscitation Council UK guidelines follow the Chain of Survival: early recognition and call for help, early CPR, early defibrillation, and post-resuscitation care. Nurses should be trained in Basic Life Support (BLS) and ideally Advanced Life Support (ALS).
Sepsis
Sepsis is a life-threatening condition caused by the body's response to infection. The Sepsis Six pathway includes:
- Give oxygen
- Take blood cultures
- Give intravenous antibiotics
- Give intravenous fluids
- Monitor lactate
- Monitor urine output
Early recognition and treatment of sepsis saves lives. Use NEWS2 to identify patients at risk.
Anaphylaxis
Anaphylaxis is a severe, life-threatening allergic reaction. Signs include airway swelling, breathing difficulty, and circulatory collapse. Treatment is intramuscular adrenaline (epinephrine) 1:1000, 0.5ml (adult dose), repeated after 5 minutes if no improvement.