Question

Emergency Chart
Create a chart of medical emergencies and the level of required care. Column one, medical emergencies that can be treated in a medical office setting and column two medical emergencies that require a higher level of care; such as, ambulance transportation to a hospital. Create a medical office protocol to determine if the emergency requires higher level and the steps for office personal to follow.

Mod 5 Assign 1

Answer 1

Medical office setting

Higher level of care

Head: migraine, vertigo, Eye: conjunctivitis, foreign body, corneal abrasion, subconjunctival haemorrhage Ear: otitis media, otitis externa Nose: foreign body, epitasis Throat: upper respiratory tract infection, tonsillitis Lungs: bronchitis, asthma Heart: non-specific chest pain Abdomen: urinary tract infection, gastritis, cystitis, vomiting, diarrhoea Minor trauma, lacerations Insect bite, allergic reaction Fever, abdomen cramps Uncomplicated overdose Radiating pain Psychological impairment, anxiety, depression

Head injury with glasgow coma scale – below 12 Seizure disorder, status epileptics Angina – mi, unstable Cardiac arrest Rapid heart rate requiring intravenous treatment Chronic heart failure Pulmonary embolism Status asthmaticus Pneumothorax Chronic obstructive pulmonary disease Active gastrointestinal bleed Abdomen pain: ectopic pregnancy, acute appendicitis Gun shot or stab wounds to major areas Severe bleeding Shock- anaphylactic, septic, hemorrhagic, hypovolemic Severe trauma Complicated overdose Unstable vital signs requiring aggressive treatment Need for procedures: cpr, thrombosis, defibrillation, intubation, thoracostomy, cricothyroidotomy. Suicidal ideation

The steps for office personal to follow if the emergency requires higher level:

Usually the emergency medical services (ems) team is activated to respond quickly and handle the emergency situation. While waiting for the team the basic life support (bls) should be provided to the patients. Following are the preliminary steps taken by the medical office before setting up an emergency unit.

1. Evaluation: a plan should first be developed. An evaluation of the setting, the environment and the nearby hospital facilities should be done.
2. Office preparation: list of appropriate equipment should be made. After the evaluation, the office personal will come to know the availability of the equipments and supply and the drawbacks. If there is less resources it should be made available as quick as possible.
3. Equipment: all the emergency equipment and resources should be in an easily accessible area. Basic emergency supplies include ambu-bags and masks, oxygen tank, flow meter and tubing, a pulse oximeter, blood pressure cuffs of all sizes, latex gloves, alcohol swabs, protective eye gear, blood glucose monitors, portable suction/catheters or bulb syringe, nebulizers, intravenous catheters and tubing. An automatic external defibrillator (aed) is should also be available.
4. Medications: emergency medications may be kept with the equipment in cart, box or in specific room. The equipment should be checked for its working condition and supplies should be stocked. Medications should be checked for expiry. Keep a list of the required supplies and medications and the staff member should sign and date the maintenance form verifying the supplies and medications have to be checked.
5. Automatic external defibrillator (aed) maintenance: inform your local emergency medical services provider that the office has an aed available, check for its working condition daily and learn how to use it and provide training for the staff members.
6. Staff training: members of your staff know how to use them. Evaluate the size and structure of your staff and the knowledge and skills that are appropriate. Ensure your physicians, physician assistants or nurse practitioners receive basic life support training. Training for them may include: basic life support training; understanding signs or symptoms which indicate a potential emergency; assessing potential telephone emergencies; developing techniques for calming down an individual who calls about a potential medical emergency and what information to gather to assist the medical staff in assessing the situation; role for contacting emergency numbers including 911 or poison control; and identifying how to communicate with the office medical personnel that a patient in the waiting area, or on the phone, requires immediate attention. The nurse notes should include patient status, specific actions taken, timeframe from onset of emergency to resolution or transfer to emergency personnel. Documentation should also indicate the medical information communicated to the emergency service personnel.
7. Response plan: drills should be conducted to practice the office's response to a medical emergency. Steps in the response plan are:

• How to identify a patient in need of emergency care
• Roles of each based on their training
• Designated room for emergency treatment
• Location of emergency supplies
• Treatment sequence
• Distribute a copy of the plan to all employees
• Post it in a location where staffs will see it
• Drill should be conducted often