Emergency Situation Identification for Certified Perioperative Nurse (CNOR)
Included In This Lesson
Outline
Emergency Situation Identification
Guidelines:
- Code (obvious)
- Facility specific policies
- “NOW”
- Trauma
- Cold leg
- hemorrhage
- “Within 24”
- Incarcerated hernia
- Perf
- Complicated fracture
- “Within 48”
- D/c
- Acute Chole
- “Routine”
- Life, Limb, Sight, Fertility
Considerations:
- Emergencies:
- Bump other cases
- Utilize reserve resources – all needed
- Skip count(X-ray instead)
- Order sets best
- Facility specific, planned
- Strategically located if possible
- Sterility “second”
- Pre-made carts are best
- Patient care > cost
- Infinite budget on test
- Infinite ability to delay other cases
Nurse’s role:
- Train, advocate for policy before emergencies arise
- Clear interpretation of emergency policies
- Anticipate needs of emergencies to keep as much “normal” as possible
- Count sheets premade, carts, etc
- Drills
- “Who’s on first”
Pitfalls:
- Delaying for routine practices
- Patient in room, table not open
- No training, anticipation
- Unsafe practices
- Bovie
- Alcohol prep
- Radiology
- Failure to recognize developing situation intraop
Examples:
- Laparoscopic chole punctures aorta on entry (emergent open, activate response, Xray after, anticipate needed gear/help, ICU after, etc)
Linchpins (Key Points):
- Emergency situations should follow an expected pathway that preserves as much safety as possible without compromising care of the patient
Transcript
References
- Association of periOperative Registered Nurses. (2022). Guidelines for Perioperative Practice (2022 ed.).