EmergencyRoomYiPingZhaoDepartmentofVascularSurgeryRenJiHospital第一頁，共二十二頁。HowEmergencyRoomsWork

第二頁，共二十二頁。Youwilllearnaboutthenormalflowoftrafficinanemergencyroomthepeopleinvolvedthespecialtechniquesusedtorespondtolife-or-deathsituations第三頁，共二十二頁。EmergencyRoomPatients

CaraccidentsSportsinjuriesBrokenbonesandcutsfromaccidentsandfallsBurnsUncontrolledbleedingHeartattacks,chestpainDifficultybreathing,asthmaattacks,pneumoniaStrokes,lossoffunctionand/ornumbnessinarmsorlegsLossofvision,hearingUnconsciousness第四頁，共二十二頁。EmergencyRoomPatients

Confusion,alteredlevelofconsciousness,faintingSuicidalorhomicidalthoughtsOverdosesSevereabdominalpain,persistentvomitingFoodpoisoningBloodwhenvomiting,coughing,urinating,orinbowelmovementsSevereallergicreactionsfrominsectbites,foodsormedicationsComplicationsfromdiseases,highfevers第五頁，共二十二頁。UnderstandingtheERMaze

Theclassicemergencyroomsceneinvolvesanambulancescreechingtoahalt,agurneyhurtlingthroughthehallwayandsomepeoplefranticallyworkingtosaveaperson'slifewithonlysecondstospare.Thisdoes

happenandisnotuncommon,Themajorityofcasesseeninatypicalemergencydepartmentaren'tquitethisdramatic.第六頁，共二十二頁。Triage

WhenyouarriveattheER,yourfirststopistriage.Thisistheplacewhereeachpatient'sconditionisprioritizedintothreegeneralcategories:ImmediatelylifethreateningUrgent,butnotimmediatelylifethreateningLessurgent第七頁，共二十二頁。Triage

Thetriagenurserecordspatientsvitalsigns(temperature,pulse,respiratoryrateandbloodpressure).Shealsogetsabriefhistoryofpatientscurrentmedicalcomplaints,pastmedicalproblems,medicationsandallergies.第八頁，共二十二頁。Registration

Thisstepisnecessarytodevelopamedicalrecordsothatpatientsmedicalhistory,labtests,X-rays,etc.,willallbelocatedononechartthatcanbereferencedatanytime.Ifthepatient'sconditionislife-threateningorifthepatientarrivesbyambulance,thisstepmaybecompletedlateratthebedside.第九頁，共二十二頁。ExaminationRoom

PatientsareseenbyanERnursewhoobtainsmoredetailedinformationaboutpatients.Oncethenursehasfinishedhertasks,thenextvisitorisanERphysician.Hegetsamoredetailedmedicalhistoryaboutyourpresentillness,pastmedicalproblems,familyhistory,socialhistory,andacompletereviewofallyourbodysystems.Hethenformulatesalistofpossiblecausesofyoursymptoms.第十頁，共二十二頁。DiagnosticTests

Bloodtestsandaurinalysisarerequired.

Acompletebloodcount(CBC)

AserumtestAblood'sclottingtest第十一頁，共二十二頁。DiagnosisandTreatment

Whentheemergencyphysicianhasalltheinformationhecanobtain,hemakesadeterminationofthemostlikelydiagnosisfromhisdifferentialdiagnosis.Alternately,hemaydecidethathedoesnothaveenoughinformationtomakeadecisionandmayrequiremoretests.Atthispoint,appropriateconsultantisneeded.第十二頁，共二十二頁。TheERteam

EmergencyPhysician

EmergencyNurse

PhysicianAssistant

EmergencyDepartmentTechnician

UnitSecretary

PhysiciansinTraining

第十三頁，共二十二頁。ToolsoftheTrade

EmergencyDepartmentsarestockedwithahugearrayofstrangelynamed,oddlyshaped,beepingandblinkingequipment.第十四頁，共二十二頁。Stethoscope

Astethoscopeletsanurseorphysicianlistentoheartandrespiratorysounds.Astethoscopeisusedtotakeyourbloodpressurebylisteningtotheflowofbloodthroughyourarteries.第十五頁，共二十二頁。CardiacMonitor

Acardiacmonitorgivesavisualdisplayoftherhythmofpatientsheart.Somemonitorsalsohaveanautomaticbloodpressurecuffandapulseoximeter.第十六頁，共二十二頁。SutureTray

Thistraycontainsthesterileequipmentneededtoplacestitchesinapatientwithalaceration.needleholderforcepssteriletowelsscissorssmallbowls第十七頁，共二十二頁。OrthopedicEquipment

Mostemergencydepartmentshaveagenerousnumberoforthopedicdevicesformanypurposesplasterand/orfiberglassmaterialspre-madesplintsforspecificjointskneeimmobilizersaluminumfingersplintsVelcrowristsplintsshoulderslingscervicalcollars

castcutters第十八頁，共二十二頁。CrashCart

Acrashcartisacabinetcontainingequipmentthatphysiciansandnursesneedwhenacardiacarrestoccurs.DefibrillatorEndotrachealintubationequipmentCentralveincathetersCardiacdrugs第十九頁，共二十二頁。Defibrilla