Emergency department technician edt
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Emergency Department Technician (EDT). Your Role with Our TEAM. Developed by Lori Baker, RN, BSN. Communication. Verbal Words used Speech patterns Tone of voice Non-Verbal Posture Eye-contact Facial expressions Physical space. Barriers to receiving a message…. Stress

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Emergency Department Technician (EDT)

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Emergency department technician edt

Emergency Department Technician (EDT)

Your Role with Our TEAM

Developed by

Lori Baker, RN, BSN


Communication

Communication

  • Verbal

    • Words used

    • Speech patterns

    • Tone of voice

  • Non-Verbal

    • Posture

    • Eye-contact

    • Facial expressions

    • Physical space


Barriers to receiving a message

Barriers to receiving a message…

  • Stress

  • Psychiatric or emotional conditions

  • Age and developmental level

  • Cultural differences

  • Past experiences

  • Privacy and confidentiality issues

  • Distractions in the environment


Handling conflict

Handling Conflict

  • A stressful environment does NOT excuse rudeness or inappropriate behavior


Communication review

COMMUNICATION REVIEW…

  • Two types of communication

    • Verbal and Non-verbal

  • Rolling eyes and huffing falls into which category

    • Non-verbal

  • Name 3 barriers to receiving a message appropriately…

    • Stress, psychiatric or emotional conditions, age, developmental delays, cultural differences, past medical experiences, privacy and confidentiality issues, distractions in the environment


Documentation

Documentation

  • MUST ALWAYS BE ACCURATE –

  • NO EXCEPTIONS


Documentation1

Documentation

  • DO’S

    • Record time using the 24-hour method (often called military time)

    • Record time precisely – if it is 0953, don’t document 0950 – there are many times when EXACT time is needed when reviewing certain situations

    • Use correct spelling and grammar – if the case goes to court you will be considered “not credible” if your spelling and grammar is atrocious


Documentation2

Documentation

  • DO’S (cont’d)

    • Use only institution-approved abbreviations

    • Charting must be to the point, in sequence, and entered when there is a change in a patient’s condition or when care is given

    • If using paper documentation write legibly, date and time all entries, sign each page with complete name and credentials


Documentation3

Documentation

  • DON’TS

    • Document BEFORE care is given

    • Use documentation to argue a point, place blame, criticize, or include personal opinions in the patient’s chart

    • Document with and incident report has been filled out on a patient

    • When paper-charting DON’T

      • White-out or erase

      • Destroy records

      • Scribble over – just draw one line and place your initials over it

      • Leave blanks


Documentation4

Documentation…

  • Per legal standards, the following must be part of every patient’s documentation…

    • Accurate dates and times

    • Patients physical condition, including results of a primary and secondary survey

    • Patient’s medical history

    • Any treatment administered in the ED

    • Any reaction or lack of reaction from these treatments

    • Any changes in vital signs or physical condition

    • Any unusual circumstances or causes for delay in tests or treatments, such as the failure to obtain consent


Documentation5

Documentation…

  • Must have’s (cont’d)

    • Mental status of the patient, with any changes, should be recorded on a regular basis, especially if the patient has sustained a head injury

    • All airway maintenance procedures, as well as use of any supplemental oxygen devices

    • If the patient sustains any spinal or possible spinal cord injury, the movement and sensation of all the extremities must be recorded as well as any changes in condition

    • Any violent or unusual behaviors should be listed


Documentation6

Documentation…

  • Again, it is NOT the responsibility of the EDT to do ANY INITIAL assessment, however, the EDT must follow-up on all assessments and properly document as well as inform the RN


Documentation review

DOCUMENTATION REVIEW…

  • White-out is appropriate on consents ONLY but not notes

    • False

  • If paper charting and a mistake is made, use a sharpie marker so the charting cannot be seen

    • False

  • Make sure you use correct spelling whether paper charting or computerized charting

    • True

  • You can use any abbreviations as long as you tell people what they mean

    • False


Legal issues

Legal Issues…

  • Delegation and Responsibilities

    • While it is the RNs responsibility to know what can and cannot be delegated to the EDT it is also YOUR RESPONSIBILITY to know when to say NO (with respect)

  • Rule of thumb – if you have not been checked off on a task you are NOT to do it

    • Also, if you know it is NOT within your scope of practice, DO NOT do it.


Legal issues1

Legal Issues…

  • Examples of tasks for the EDT…

    • Clean and stock exam rooms

    • Assemble crutches

    • Assemble equipment

    • Collect and transport specimens

    • Assist with admission and discharge of patients

    • Perform clerical tasks

    • Obtain vital signs

    • Document in patient records

    • Clean and bandage simple wounds

    • Splinting of extremities

    • Perform 12-lead EKG

    • Remove sutures

    • Perform CPR

NOT an all-inclusive list


Legal issues2

Legal Issues…

  • Professional Negligence entails 4 elements

    • Duty

    • Breach of Duty

    • Causation

    • Damages


Legal issues3

Legal Issues…

  • Intentional Torts

    • Abandonment

    • Assault

    • Battery

    • False imprisonment

    • Invasion of privacy

    • Libel

    • Slander


Legal issues4

Legal Issues…

  • Consents

    • (It is NOT the responsibility of the tech to get consent for any patient, however, you need to be aware of them)

    • Informed consent

    • Implied consent

    • Expressed consent

    • Consents for minors

    • Involuntary consent


Infection control

Infection Control…

  • Microorganisms

    • Bacteria

    • Viruses

    • Fungi

    • Protozoa

  • Modes of transmission

    • Droplet or airborne

    • Direct contact

    • Ingestion

    • Animals or Insects


Infection control1

Infection Control…

  • Standard Precautions/Universal Precautions

    • Guidelines used by the CDC for reducing the risk of transmission of blood-borne pathogens in hospitals

    • Used for ALL patients regardless of any known disease or condition

    • Always use if there is ANY remote possibility you may come in contact with any bodily fluids


Infection control2

Infection Control…

  • Bodily fluids include

    • Blood

    • Urine

    • Stool

    • Sputum

    • Vaginal or penile secretions

    • Cerebrospinal fluid

    • Synovial fluid

    • Pleural fluid

    • Peritoneal fluid

    • Amniotic fluid


Infection control3

Infection Control…

  • Personal Protective Equipment (PPE)

    • Situational

    • Equipment

      • Disposable gloves

      • Disposable gowns

      • Disposable masks

      • Eye protection

      • Disposable containers


Role of the edt in triage

Role of the EDT in Triage…

  • Functions of PCT at Triage

    • Vital signs on patients

    • Assist patients to and from registration, to the assigned room, x-ray, or other treatment area

    • Assist with re-assessing patients in the lobby

    • Patient advocate to the family/visitors


Triage

Triage…

  • Does the person who performs triage have to be a nurse?

    • Yes, it is the policy

    • Non-nursing personnel do not have the authority to make advanced protocol and triage decisions

    • THE RN IS ULTIMATELY RESPONSIBLE FOR ALL TRIAGE DECISIONS.

      • Please do not take it upon yourself to do any task beyond your scope of practice. Consult the RN first.


Triage1

Triage…

  • Decisions

    • The TRIAGE NURSE makes the decision who goes to which room first

    • The time of patient arrival is not the purpose of triage

      • acuity

      • symptoms

      • VS stability

      • Pain Scale >7


Triage2

Triage…

  • Triage Staff

    • Can “set the tone” for the ED staff, patients, and families as well

    • Remember to “SMILE”

    • Introduce yourself

    • Explain what you are doing

    • Validate findings

    • Explain prioritization’s


Triage3

Triage…

  • Triage Staff, cont.

    • Explain wait times

    • Explain rechecking them

    • Direct to next process

    • Direct to return to triage if condition changes

    • Offer comfort measures, i.e. wheelchair, stretcher, blanket, ice bag, splint, sling, etc.


Triage4

Triage…

  • Triage Staff, cont.

    • Remember to convey that calm, caring approach during the process to allay the patient and family anxiety and lead to a more comprehensive and successful visit for the patient and family.


Triage5

Triage…

  • KEEPING EVERYONE INFORMED

    • Communication is the KEY

    • Informing patients of delay is of the utmost importance

    • Can’t predict length of stay or how long it will take

    • Offer comfort measures

    • Discuss other reasons for information:


Triage6

Triage…

  • Legal Considerations

    • An emergency evaluation must be performed on any individual with an emergency medical condition or a woman in active labor

    • If the individual’s condition is unstable, then an attempt to stabilize the individual must be done

    • Level of transportation to treatment area/s must be appropriate


Triage7

Triage…

  • JCAHO Standards

    • Domestic abuse victims are identified by criteria developed by the hospital

    • Each patient needs to be reassessed at intervals designated by the institution

    • Each patient’s physical, psychological, and social status is assessed

    • Need for discharge planning assessment is determined


Triage8

Triage…

  • JCAHO

    • Staff members integrate the information from various assessments of the patient to identify and assign priorities to his/her care needs

    • A Registered Nurse assesses the patient’s need for nursing care in all settings where nursing care is provided


Triage9

Triage…

  • Special Considerations

    • Violence in the Emergency Department

      • Disruptive Clients

      • Disruptive Family members/visitors

      • Potential of Psychiatric patients to become agitated and violent

      • Beware of the emotionally distraught clients or family members especially when advised to loss of a loved one

      • Any other situations?


Triage10

Triage…

  • Communicable Diseases

    • Chickenpox or Shingles

    • Remove from waiting area to an isolated area, such as a room, out of the way place in the hallway, etc.

    • Identify some other communicable diseases?


Triage11

Triage…

  • Immuno-suppressed Patients

    • Chemo-therapy patients, AIDS, transplant patients, high dose of steroids

    • Mask them and remove to an area away from the public and other flu’s, colds, viruses, etc.

    • Reverse type isolation treatment for these patients


Triage12

Triage…

  • Pediatric Patients

    • Remember safety issues with these little ones

    • Remember the parent may be suffering more than the child

    • Beware of the child’s activity and bed heights, side rails, playing in the trash cans, etc.

    • List other concerns with pediatric patients?


Triage13

Triage…

  • Triage from a Motor Vehicle

    • Use the buddy system

    • Use C-spine precautions if indicated

    • Use good body mechanics

    • List other ideas for getting a patient out of the vehicles?


Triage14

Triage…

  • Hazardous Waste

    • Remember to use safety precautions

    • Beware of the fact that bio-hazards or contamination to materials is a major concern

    • Look for MSDS sheets or call the 1-800 number for copies of the MSDS sheets, etc.

    • Discuss other concerns:


Triage15

Triage…

  • Psychiatric Patients

    • Beware of their behavior

    • Speak softly and slowly in short sentences or phrases

    • Never turn your back to them

    • Stay near an exit when interacting with a psychiatric patient

    • Other Pearls from experiences?


Triage16

Triage…

  • Obstetric Patients

    • Place in wheelchair to go to L&D

    • If presenting part is visible or lots of rectal pressure keep patient in ED for quick evaluation to determine if eminent delivery is about to occur

    • Never send a patient to L&D alone, an employee must accompanying a woman in labor to the unit

  • If presenting with obstetric complaints and under 18 weeks gestation, we see them in the ED.


Further information for the edt

Further Information for the EDT

  • Specimen collection

  • Cardiac monitoring

  • Administrative P&P

  • Advanced Triage Protocols (ATPs)

  • Disaster Management

  • These are on separate power points.


Questions

QUESTIONS???????


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