We are often given warning of the impending arrival of high acuity patients by pre-hospital teams.
So how do you approach this vital and often short period of time ?
You need to get prepared and remember the 7 P’s of preparation:
Proper Planning and Preparation Prevents Piss Poor Performance
The following gives you a structured approach to preparing not only for the arrival of a patient but also other EM encounters e.g. preparation for transport or for a procedure.
- AREA – Where does the patient need to be ?
- Resus bay
- Rest of ED workload
- Non-ED areas e.g theatre, cardiac lab
- ? Need to liaise with other hospital
- STAFF – Who do you need ?
- ED Staff
- PCA’s / Porter
- Allied Health
- CT tech
- Laboratory / Blood bank
- Other area staff e.g theatre, cardiac lab
- In-Patient Teams
- Trauma / General Surgeons
- Orthopaedic Surgeons
- Anaesthetics / Critical Care
- Others e.g. obstetrics, paediatrics
- ED Staff
- EQUIPMENT – What do you need ?
- Airway Equipment – Adjuncts to Advanced
- Circulatory Support – iv access, iv fluids, IO access, rapid infuser
- Procedural Equipment e.g chest drains, bedside ultrasound, c-spine collar, pelvic binder
- PPE – Personnal Protective Equipment – e.g Gloves, Googles, Apron
- DRUGS – What & how much do you need ?
- Paediatric dose calculations – estimate weight & calculate, ? Broselow tape
- Resuscitation drugs e.g adrenaline, atropine
- Sedation +/- Induction Agents
- ADDITION INFORMATION – Where else can you found stuff out ?
- From paramedic crew / Other emergency services
- Old Notes
- Command Tier in Disasters