4) Less urgent- Conditions with mild to

TRIAGE moderate discomfort

Time for Nurse assessment <1h
 Triage involves the sorting of patients in Time for physician assessment < 1h
emergency care settings according to  Head injury, alert, no vomiting Chest
their level of acuity; it aims to ensure that pain, no distress, no cardiac susp.
all patients receive access to care in an  Depression with no suicidal attempt
organized, equitable and timely manner
based on the urgency of their clinical
need/s. 5) Non urgent- Conditions can be delayed, no
 Triage nursing is an important role in a distress
hospital. Triage nurses make the first 6) Time for nurse and Physician assessment
assessment of any incoming patients to more than 2h
the ER.  Minor trauma
 Sore throat with temp. < 39

E-CART

1. Epinephrine
- Alpha- and Beta-adrenergic agonists
(sympathomimetic agents).
- It works by relaxing the muscles in the
airways and tightening the blood
vessels.
- Used to treat severe allergic reactions
(anaphylaxis) to insect stings or bites,
TRIAGE LEVELS foods, drugs, and other allergens.
- Used to treat low blood pressure that is
1) Resuscitation- threat to life/limb caused by septic shock.
Time to nurse assessment IMMEDIATE 2. Nicardipine
Time to physician assessment IMMEDIATE - Calcium Channel Blocker
- It lowers blood pressure by relaxing the
 Cardiac and respiratory arrest blood vessels so the heart does not
 Major trauma have to pump as hard.
 Active seizure 3. Dextrose 50%
 Shock - Glucose-Elevating Agents, Metabolic &
 Status Asthmaticus Endocrine, Other
- Indicated in the treatment of insulin
hypoglycemia (hyperinsulinemia or
2) Emergent- Potential threat to life, limb or insulin shock) to restore blood glucose
function Nurse Immediate, Physician <15 levels.
minutes 4. Magnesium Sulfate
 Decreased level of consciousness - Laxatives, Minerals and electrolytes,
Miscellaneous anticonvulsants
 Severe respiratory distress
- Indicated for the prevention and control
 Chest pain with cardiac suspicion of seizures in preeclampsia and
 Overdose (CONSCIOUS!) eclampsia, respectively.
 Severe abdominal pain 5. Lidocaine
 G.I. Bleed with abnormal vital signs - Group I antiarrhythmics, Local injectable
•Chemical exposure to eye anesthetics
- Local anesthetic used in a wide variety
of superficial and invasive procedures.
3) Urgent- Condition with significant distress 6. Potassium Chloride
Time: Nurse < 20 min, physician < 30 min - Minerals and electrolytes
•Head injury without decrease of LOC but - Used to prevent or to treat low blood
with vomiting levels of potassium (hypokalemia).
 Mild to moderate respiratory distress 7. Sodium Bicarbonate
- Antacid
 G.I. Bleed not actively bleed - Reduces stomach acid
 Acute psychosis - Treat heartburn, indigestion, and upset
stomach
8. Norepinephrine - Adenosine is used to help restore
- Alpha/Beta Adrenergic Agonists normal heartbeats in people with certain
- Indicated for blood pressure control in heart rhythm disorders.
certain acute hypotensive states (e.g., - Adenosine is also used during a stress
pheochromocytomectomy, test of the heart.
sympathectomy, poliomyelitis, spinal
anesthesia, myocardial infarction,
septicemia, blood transfusion, and drug
reactions)
9. Dopamine DRUGS COMPUTATION
- Catecholamines, Inotropic agents,
Vasopressors
- Used to treat certain conditions that
occur when you are in shock, which may
be caused by heart attack, trauma,
surgery, heart failure, kidney failure, and
other serious medical conditions.
10. Dobutamine
- Inotropic Agents
- Stimulates heart muscle and improves
blood flow by helping the heart pump
better.
- Used short-term to treat cardiac
decompensation due to weakened heart
muscle.
11. Atropine Sulfate
- ANTICHOLIRGENIC DRUG (blocks the
effects of acetylcholine at muscarinic
receptors)
- Used for treatment of bradycardia
- Should be used in care in patients with
Ischaemic Heart Disease
12. Solucortef
- Corticosteroids
- This medication is used to treat various
conditions such as arthritis, severe
allergies, blood diseases, breathing
problems, certain cancers, eye
diseases, intestinal disorders, and skin
diseases
13. Albuterol
- Bronchodilators
- Relaxes muscles in the airways and
increases air flow to the lungs
14. Calcium Gluconate
- Antidotes, Other; Calcium Salts
- Used to treat conditions arising from
calcium deficiencies such as
hypocalcemic tetany, hypocalcemia
related to hypoparathyrodism, and
hypocalcemia due to rapid growth or
pregnancy. Calcium gluconate is
available in generic form.
15. Amiodarone
- Class III anti-arrhythmic drug
- It is used to help keep the heart beating
normally in people with life-threatening
heart rhythm disorders of the ventricles
(the lower chambers of the heart that
allow blood to flow out of the heart).
16. Adenosine
- Cardiac stressing agents, Group V
antiarrhythmics
- Adenosine is a naturally occurring
substance that relaxes and dilates blood
vessels. Adenosine also affects the
electrical activity of the heart.
 IEC- INTERNATIONAL ELECTROTECHNICAL
COMMISION

AHA- AMERICAN HEART ASSOCIATION

MAIN CORONARY ARTERY

1) Aorta
2) R Coronary artery (RCA)
3) L Coronary artery (LCA)
4) Circumflex artery
5) L anterior descending artery

GCS

The Glasgow Coma Scale is a tool that healthcare

providers use to measure decreases in
consciousness. The scores from each section of
the scale are useful for describing disruptions in
nervous system function and also help providers
track changes. It’s the most widely used tool for
measuring comas and decreases in consciousness.

ECG

ECG PLACEMENTS:

V1 4th ICS, (R) Red

/C1 sternum soft
tissue

V2 4th ICS, (L) Yellow

sternum

V3 Midway Green
between V2
& V4

V4 5th ICS, Brown

Midclavicular
line

V5 5th ICS, Black

Anterior
axillary

V6 5th ICS, Purple

midaxillary

EXTREMITIES:

RIGHT ARM RED

LEFT ARM YELLOW

LEFT LEG GREEN

RIGHT LEG BLACK

 DENGUE MCH 27-33 pg

If symptoms occur, they usually begin 4–10 days MCHC 33-36 gldl
after infection and last for 2–7 days. Symptoms
White cell count 4-10.5 10^3/ ul
may include:
 high fever (40°C/104°F) Neutrophils 43-65%
 severe headache
 pain behind the eyes Lymphocytes 20-45%
 muscle and joint pains
 nausea Monocytes 5-12%
 vomiting
Basophils 0-1%
 swollen glands
 rash Eosinophils 1-7%
Individuals who are infected for the second time are Platelet count 150-400 10^3/ ul
at greater risk of severe dengue.

Severe dengue symptoms often come after the

fever has gone away: E-CART
 severe abdominal pain
 persistent vomiting 1) Epinephrine - alpha and beta-adrenergic
 rapid breathing agonist
 bleeding gums or nose
2) Nicardipine - calcium antagonist
 fatigue
3) Dextrose 50% - hyperglycemic
 restlessness
 blood in vomit or stool 4) Magnesium Sulfate - anti-convulsants
 being very thirsty 5) Lidocaine - class 1 anti-antiarrhythmic;
 pale and cold skin local anesthetic
 feeling weak 6) Potassium Chloride – electrolytes
7) Dopamine - cardiac drugs
People with these severe symptoms should get 8) Dobutamine - Cardiac drugs
care right away. 9) Atropine Sulfate - anticholinergics
10) Solucortef - corticosteroids hormones;
After recovery, people who have had dengue may
feel tired for several weeks. glucocorticoids
11) Albuterol - bronchodilator beta 2
andrenergic agonist; bronchodilator
12) Calcium Gluconate - calcium salt/ antidote
13) Amiodarone - class III anti-arrhythmic
LAB RESULTS
14) Adenosine - antiarrhythmic drugs

URINALYSIS SI CONVENTIONAL

Blood Urea 2.1-7.1 5.83-19.72mg/dl

Nitrogen mmol/L

Creatinine 53-97 umol/L 0.6-1.1 mg/dl

Sodium 135.00-145.00 135.00-145.00

mmol/L mEq/L

Potassium 3.50- 3.50-5.30 mEq/L

5.30mmol/L 15) Sodium bicarbonate- electrolytes
16) Norepinephrine- vasoconstrictors

HEMATOLOGY

Hemoglobin 12-16 g/dl

Hematocrit 37-43%

Red cell count 4.2-5.4 10^6/ ul

MCV 80-96 fl