![]()
CHAPTER 1
Emergency care and
management
Tina Moore
Overview
Emergency care and management entail early recognition of clinical deterioration through the use of the ABCDE assessment model and effective management of a patient suffering from the most common life-threatening clinical conditions (e.g. shock, burns, anaphylaxis). It also includes life support through airway management, basic life support and advanced life support.
Link to Future Nurse Proficiencies (Nursing and Midwifery Council [NMC] 2018a)
Platform 4 Providing and evaluating care: specifically 4.13 This demonstrates the knowledge, skills and confidence to provide first aid procedures and basic life support.
Skills annexe B, 10.5: use evidence-based, best practice approaches for meeting needs for care and support at the end of life, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions.
Expected knowledge
• Anatomy and physiology of the respiratory, circulatory, renal and neurological systems
• Methods of assessment
• Fundamentals of basic and advanced life support
• Key general ethical and legal principles
Introduction
In the UK, similar to other countries, there has been increasing emphasis on safety issues. The internet has become a welcome source of accessing immediate information. There is a wealth of evidence-based material (some formulated as clinical guidelines) available. Useful information can be found from sources such as:
• National Institute for Health and Care Excellence (NICE)
• National Patient Safety Agency (NSPA)
• Department of Health (DH)
• Resuscitation guidelines
• British Thoracic Society Publications
• Scottish Intercollegiate Guidelines Network (SIGN)
The healthcare needs of patients within the hospital setting and the community are becoming increasingly complex. This is for a variety of reasons: people are living longer so more have experienced the effects of the ageing process; modern technology; and medications prolonging life. This requires healthcare professionals, including nurses, to have the appropriate knowledge and skill to preserve life, relieve suffering, limit disability and promote recovery.
Content
| ABCDE assessment | Recognition of the deteriorating patient | Airway management |
| Basic life support | Early defibrination | Emergency first aid |
| Advanced life support (ALS) and professional issues (adult) | ALS and professional issues (paediatric) | Post-resuscitation care |
Learning outcomes
• Demonstrate knowledge and understanding of the use of a systematic approach (ABCDE) in the assessment of an acutely or critically ill patient, or a patient who is clinically deteriorating
• Recognise the signs that indicate a patient is deteriorating
• Discuss the procedure for basic and a...
