First aid is the emergency care of a sick or injured person until medical aid is available or until the person recovers. The nurse may encounter an emergency situation in a health care facility, in the home environment or in a public place. Knowing what to do in an emergency situation may mean the difference between a person living and dying. An emergency situation within a health care facility may involve a patient, a visitor or a staff member. Under these circumstances lifesaving equipment and expert help are usually at hand, but prompt emergency care given by the person who is first on the scene may still save lives. Documentation of the incident will be required, and health care facilities provide incident and accident forms for this purpose. Information to be documented includes: details of the onset of the incident; the date, time and location; the emergency care provided; and the name of any person who witnessed the incident. The nurse attending the emergency must remain with the individual and summon assistance. If the incident occurs within a ward area, the nurse in charge must be notified immediately.

This chapter addresses some emergencies and the basic care that needs to be provided. For more detailed information, the nurse is advised to consult a current first aid text.


An emergency is a situation requiring immediate action. Recognising an emergency is the first step in responding. You may become aware of an emergency because of certain things you observe (Australian Red Cross 1998), such as unusual noises, sights, smells, signs or behaviours.


In an emergency situation your involvement as a nurse may be critical, as staffing levels are frequently at a minimum and all personnel are called on to give assistance. In a health care environment, strict emergency protocol is laid out and should be firmly adhered to. When working as a nurse it is part of your responsibility to ensure that you are familiar with each facility’s protocol. All the relevant information will be located in the facility’s policy and procedure manuals, commonly located at the nurse’s station, or electronically on the facility’s intranet site.


In a first aid situation you may be the only person available to assist the casualty. There are many ways to help, but to do this you must first make the decision to respond. Sometimes people do not respond to an emergency because they are unaware that a situation is occurring, and at other times they are reluctant to offer help for various reasons. These include:

See Clinical Interest Box 48.1. However, the worst thing to do is nothing!

CLINICAL INTEREST BOX 48.1 Barriers to responding to an emergency


The following four emergency action principles (Australian Red Cross 1998) should guide the nurse’s actions in an emergency:

Implementing these principles (Figure 48.1) provides safety for you and for others and ensures that critical care is given to those who need it.


Resuscitation is the preservation of life by establishment and/or maintenance of airway, breathing and circulation. The objective of resuscitation techniques is to ensure adequate supply of oxygen to the brain, not only to preserve life but also to prevent the damage to brain cells that results from lack of oxygen (Australian Red Cross 1998). Clinical Interest Box 48.3 presents more detail on resuscitation.

CLINICAL INTEREST BOX 48.3 Resuscitation

The central focus of resuscitation is the protection of the brain and heart from ischaemia, and the steps involved in resuscitation are systematic and implemented in order of priority. The principles of basic life support (BLS) include: (i) establishing and maintaining an airway; (ii) breathing; and (iii) circulation — the objective being to provide the brain and heart with an oxygenated blood supply. If a defibrillator is available, defibrillation is performed by attaching an AED (Automated External Defibrillator), and following the prompts (Australian Resuscitation Council [ARC] 2006).

Effective BLS techniques rely on rapid assessment of the situation and initiating procedures that facilitate and maintain an adequate supply of oxygenated blood to the brain before irreversible damage occurs.

Advanced life support (ALS) techniques include a range of therapeutic and technological interventions carried out by trained health personnel. These are not discussed here.


Every emergency situation must be assessed, and appropriate measures taken in the sequence most logical for that particular situation. A variety of factors influences the actions taken and the order in which they are taken; for example, the presence of life-threatening circumstances, the availability of assistance, the location where the emergency occurs and the availability of transport. Clinical Interest Box 48.4 outlines the emergency response steps. The general principles of emergency care are:

Feb 12, 2017 | Posted by in NURSING | Comments Off on EMERGENCY CARE

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