1. 1 2016 Annual Clinical Competency

2. 2 PURPOSE of Emergency Care Guidelines To provide a standardized response in the event of emergency care situations at the Kansas Spine & Specialty Hospital, (KSSH). These mandatory guidelines address emergencies that occur to patients, staff, visitors and others at KSSH, and to individuals who come to the KSSH seeking or needing emergency care.

3. 3 PROTOCOL Any individual at KSSH who develops an emergency condition, or any individual who presents to KSSH requesting emergency medical treatment will be appraised, provided initial treatment and provided referral when appropriate. KSSH will not utilize 9-1-1 services as a substitute for appraisal and initial treatment. Appraisal, initial treatment and referral as appropriate, will not be denied to anyone because of race, age, gender, citizenship, legal status or ability to pay.

4. 4 NURSING PROCEDURE Nursing personnel will: APPRAISE the patients medical condition and begin initial emergency medical treatment to stabilize the patient. Initial treatment may include, but is not limited to: A irway management B reathing C irculation Application of cardiac monitor and early D efibrillation

5. 5 NURSING PROCEDURE Nursing personnel will: STABILIZE AND TREAT: Provide the patient with appropriate care ranging from basic first aid to all available life saving measures, including Advanced Cardiac Life Support (ACLS). These measures may include, but are not limited to: Initiation of CPR and ACLS Control of bleeding Administration of oxygen Obtaining vital signs Application of cardiac monitor Initiation of intravenous line if one is not present Immobilization of fractures and basic first aid

6. 6 NURSING PROCEDURE Nursing personnel will CONTACT: For inpatients: Contact the physician on call and then patient’s attending physician or designee. For staff, visitors and others present at KSSH, and for individuals who arrive at KSSH seeking or needing emergency care: Contact the physician on call.

7. 7 The physician responding to the emergency will provide the medical direction for the appraisal and treatment process until the emergency resolves, or the patient is transferred appropriately. The physician may alternately provide the appraisal and initial treatment him/herself. The physician will make all transfer decisions based on medical judgment and in the best interest of the patient.

8. 8 NURSING PROCEDURE Nursing personnel will DOCUMENT: For Inpatients: All appraisals, interventions and outcomes in the patients medical records. For staff, visitors and others present at KSSH, and for individuals who arrive at KSSH seeking or needing emergency care: Appraisals, interventions and outcomes on Downtime Documentation Form and attach to a completed Incident Report.

9. 9 NURSING PROCEDURE Nursing personnel will CONTACT THE CNO for all emergencies and prior to any transfers. Nursing personnel will make arrangements with the emergency medical service providing transport. Services may include an ambulance service of the receiving facility.

10. 10 NURSING PROCEDURE Nursing personnel will COMMUNICATE: Ensure the necessary medical information is sent to the receiving facility and that report has been called by the attending RN. Complete the Transfer Memorandum in its entirety.

11. 11 In emergency situations, remember the following nursing components of emergency care: APPRAISE STABILIZE TREAT ADMIT OR TRANSFER – based on the physicians medical judgment in the best interest of the patient.

12. 12 Clinical Annual Competency 2016 1.) Any individual at KSSH who develops an emergency condition, or who presents to KSSH requesting emergency medical treatment will be appraised, provided initial treatment and provided referral when appropriate. True or False 2.) KSSH will utilize 9-1-1 for appraisal and treatment. True or False 3.) Nursing will contact the physician on call and then the patient’s attending physician or designee for inpatients requiring emergency care. True or False 4.) The CNO should be contacted prior to any transfers. True or False 5.) The components of care for emergency patients are appraise, stabilize, _______________, and admit or transfer.