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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

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.
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