This is the process of receiving a critically ill child requiring urgent assessment, treatment and rehabilitation in the hospital/ward. The nurse’s responsibility is to ensure that emergency medications and functional equipment are readily accessible for the child’s care. The nurse is also expected to demonstrate capacity in a timely, safe, ethical and responsive care to restore the child’s health.
Aims
· Perform emergency resuscitative procedures
· Conduct diagnostic assessment
· Undergo emergency medical treatments
· Undergo emergency surgery
· Stabilize and monitor existing condition
Requirements
a. Emergency tray containing the following:
· Padded spatula
· Nasal prongs/oxygen mask
· Ambu bag/self inflating mask
· IV cannula and giving set (age appropriate)
· IV fluid (Normal saline, Ringer’s lactate, 1/5NS in 4.3% dextrose, 10% dextrose)
· Syringes and needles (various sizes)
· NG tube (various sizes)
· Urethral catheter (various sizes)
· Water soluble lubricant
· Emergency medications
· Glucometer and strips
· Pulse oximeter
· Sterile and disposable gloves
· Specimen containers
· Sterile swabs
· Sutures
· Needle holding forceps
· Inflatus tube
b. Suction apparatus with catheters
c. Oxygen cylinder/source
d. Nebulizer
e. Vital signs tray
f. Drip stand
g. Other appropriate PPEs
h. Sterile dressing packs
i. Antimicrobial dressing solution/ointment
j. Infusion pumps/infusion flow meter
k. Bed cradle if needed
l. CPR monitor
m. Receiver for used swabs
Steps
1. Welcome child and caregiver
2. Establish rapport (Refer to steps)
3. Confirm patient name and diagnosis from admission records (Manual or electronic)
4. Take emergency history
5. Assess for head injury and immobilize child if present
6. Perform the necessary resuscitation:
· Assess airway and suction prn
· Assess for blood stain and bubble sputum, if present immobilize chest and call for surgical intervention
· Remove tight clothing d. Nebulize prn
· Administer oxygen for labored breathing (SPO2 < 90%)
· Secure an IV access
· Treat shock if present
· Arrest bleeding if present
· Keep child warm
· Assess level of consciousness
· Abort seizures if present
· Correct dehydration if present
7. Administer immediate treatment:
· Administer prescribed medication
· Pass an NG tube in abdominal distention or silent abdomen
· Pass urethral catheter for continuous drainage in urine retention
· Assess for perineal tears and arrange for repair
· Assess for fracture and immobilize
8. Put child into cot/bed with side rails
9. Keep caregiver with the child if preferred
10. Check vital signs, weight and record
11. Check random blood sugar and intervene appropriately
12. Collect needed specimen
13. Take a brief history of child’s condition from the caregivers
14. Allow caregiver to see where child is lying and orientate caregiver to the ward
15. Explain policies, visiting time, National Health Insurance scheme, meal times etc. to child/caregiver
16. Guide caregiver to sign consent form for treatment etc. if necessary
17. Encourage caregiver to bring child’s play and learning materials
18. Hand over child’s valuables to caregiver
19. Assist the caregiver to change the child into pajamas or hospital clothing
20. Update the ward record with patient’s information (manual or electronic)
21. Document all procedures and observations (manual or electronic)
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