Clinical Attachment On NORMAH MEDICAL SPECIALIST CLINIC CENTER 2017
A & E ( Accident and Emergency) Room
Date Group Times Activity
12/04/201 D 08.30 Orientation : room, facilities, medical 7 16.30 equipments, procedure and nursing documentation. Verbed is done by doctor itself. Nurse is absolutely partner of doctor. Triage room is not divided to be red, yellow, green or black. But it is only for one doctor/nurse and one patient. Observe the condition of patient is start from the patient is called, in triage room patient only need answer the question. Then the patient is decided to go to emergency room or poly. A & E service is quick and friendly. Averagely, the patient is only one hour in emergency room then they will be transferred to the poly or go home. Not all patient get infusion therapy or antibiotic, it will be depended on the case. For example the patient with low back pain is only given pain killer and check radiology. Then the result decides the next step, go to poly or go home. Ambulance service is also quick, when they are called, they will go to the location directly to do pre-hospital procedure and evacuate to the hospital. For example, one of building project accident where one of the employees is fall down. Victim is helped by ambulance team, sent to the hospital with condition already paired neckcollar and long spinal board. So, when the patient come to emergency room, he will be assessed and then go to radiology for CT-Scan and X-Ray. When there is no trauma in neck and head, patient will only be done wound care and adviced to go home. The nurse asks us about primary survey, and how to evaluate Airway, Breathing, Circulation, Disability, or Exposure. He says that the simplest evaluate airway is communicate with the patient. If they have good respon, there is no problem and otherwise. Catheter set, wound care or other procedure which need sterile principles is absolutely have different equipment. In one wound set, there are 3 PINSET, plastic, KASA, cotton, all equipments are dispossible. Catheterization, nurse does not touch with hand but they will use PINSET to put in. Sometime patients knowledge is critic to procedure, so nurse or doctor must be brilliant to answer every question. When the patient gets nebulizer therapy, the mask will be given back to the patient to be used next time on therapy schedule. If offered, nurse will pair the infusion set for homecare. When the patient is crowd, nurse will be busy. Student has to have inititatif to join or see at the procedure. Nurse will be quiet if the student does not want to ask something. But if the student does, nurse will answer and explain about procedure which has done. 13/04/201 E 08.30 Orientation 7 16.30 First we are introduce our team and staff of A & E (accident & emergency) rooms Room, at that time there are two nurses doing shift, they are Mr. James and Mrs. Siti Mariam. Then Mr. James explain room of A & E (accident & emergency) room. It rooms has 5 rooms, there are Doctors room, triage room, procedure room, linen room, registration room. In there we are explained by them all about E & E (accident & emergency) room, such as: First assesmement, triage, A&E equipment, drugs and the procedure if the patient come in, and plan disaster. We just observed to patients when nurses doing take blood sample (ADV), nebulizer, infuse set installasion, and accompany patient going to X- Ray room, we are doing verbed too. 21/4/2017 C 08.30-13.00 Orientation; Nurses and doctor , rooms, equipments, procedures, and nursing documentation Fiirst, we learn about TRIAGE, , there are 5 scale of TRIAGE that used. Scale 1 and 2 going to red scale, 3 and 4 are yellow scale, 5 is green scale. Than, we learn about defibrilator, emergency troly, drugs, and electrocardiogram. Next, we also joined to observed the doctor and nurse did wound dressing. It was kind of decubitus that used absorben dressing. Last, we learn about ambulance system at A & E.