Beruflich Dokumente
Kultur Dokumente
of the
Emergency Department
Introduction
Emergency nurses must possess both general and specific knowledge about health care to
provide quality patient care for people of all ages. Emergency nurses must be ready to
treat a wide variety of illnesses or injury situations, ranging from a sore throat to a heart
attack.
The ER nurse as member of the emergency response team has been responsible
for triaging and caring for patients at the Emergency Department (ED) for care. . This
evaluation. Emergency nurses specialize in rapid assessment and treatment when every
second counts, particularly during the initial phase of acute illness and trauma.
Emergency nurses must tackle diverse tasks with professionalism, efficiency, and above
all-caring.
This scope of service for the Emergency Department aims to offer guide to ER
Emergency Department.
Demographics
Rizal Provincial Hospital (RPH) is under the Rizal Provincial Health Office
governed by the provincial government of Rizal. It is located at Thomas Claudio St. San
Juan Morong Rizal.
RPH is a 100 bed secondary hospital and is expected to provide the following
services: Medical-Surgical, Gyne-Obstetrics, Pediatrics, Operating Room and Emergency
care. The RPH-ED utilizes numerous nursing diagnostic and therapeutic modalities to
facilitate patient care including the following:
• Emergency Nursing Process
o Primary Survey and Secondary Survey
o Initiation of life-saving measures
o Ongoing assessment of nursing care
o Review of nursing efficacy
o Patient advocacy
• IV cannulation and hydration.
• Management of intravenous therapy including blood transfusion
• Assisting with placement of chest tubes.
• Placement of nasogastric tubes
• Placement of urinary catheters.
instruct the patient or relative to retrieve their OPD White Form record at
the information section.
3. Obtain the vital signs of the patient. Patient age 0-13 should be weighted
as well as those that will be treated under Surgery Department.
4. Place the patient in comfortable position, maintain patent airway, provide
adequate ventilation, employ resuscitation measures as necessary and
assess for chest injuries which precedes airway obstruction.
5. Assess whether or not the patient can follow command, evaluate the size
and sensitivity of the pupils and motor response.
6. Assist the doctor while examining the patient and carry out orders
promptly and accurately which includes IVF, O2 therapy and medications.
7. If the patient condition needs admission, call the ward for available room
then obtain informed consent. Complete the admission documents
(Appendix C) and attach the ER pink form to the documents whereas OPD
white form should be returned back to the information section.
8. Document pertinent information regarding patient condition and the
treatment measures given.
9. Carry out all the STAT orders like medications, procedures, laboratories
(Ultrasound, UTZ, Chest X-Ray, ECG), before the patient were brought to
their designated Ward Department.
10. For critically ill patient, the nurse should accompany the patient to the
ward for proper endorsement.
11. Refer to other agencies for further management as the patient’s condition
suggests. Coordinate to the driver and arrange referrals. Ambulance
should be equipped with oxygen set, ambubag and emergency kit prior to
transfer.
• In Patient Care
a. Plan to meet the total nursing needs of the patient.
b. Supervise all nursing attendants related directly and indirectly to patient care.
c. Evaluate of the effectiveness of patient care.
d. Evaluate if the effectiveness of the patient care,
e. Promote the improvement of the patient care.
f. Give direct nursing care to the patient.
g. Responsible for the accurate assessments and documenting treatments and
care rendered whether it may be independent, interdependent or dependent.
h. Responsible for execution of doctor’s order.
• In Unit Management
a. Plan for the environment conducive to the physical, spiritual well being of the
patient.
b. Participate in the formulation, interpreting and implementing objectives and
policies of nursing care.
c. Promote good nurse-patient relationship.
d. Promote the improvement of nursing service in the unit,
e. Teach and guide all new nursing personnel in the unit.
f. Assist in the orientation program of the new nursing personnel in the unit.
g. Demonstrate new procedures and use of the new equipment in the unit.
h. Impart health teaching in personal hygiene to the patient and member of the
family.
I. Endorsement
• Receive endorsement from 10-6 shift.
• Receive the unit, check supplies and instruments available for the ER
Department.
• Receive and check patients in the IE Room, Surgery and Hydration Partition and
Core Room as well as the Incoming patients during shift transition.
• Check the available rooms per department for admission of patient for the shift.
• Check ER Logbook and verify if records from previous shift were returned to the
information section.
II. Patient Care
• Give oral medication and injection as ordered.
• Prepare and administer intravenous therapy as ordered.
• Assist in treatment and special procedure to be done for the patient.
• Prepare the patient with medicine secured from supplies if indigent.
• Explain the diagnostic procedures like X-ray, ECG, UTZ that the patient will be
subject to.
III. Ward Policies
• Answer telephone calls.
• Make sure that only one companion comes with the patient in the ER.
• Make sure that the patient or the significant other is informed about any
procedure prior to execution.
IV. Proper Documentation
• Check the admission documents, referral request and prescription before patient
were discharged or transferred.
• Document all medical treatment and nursing intervention given to the patient.
• Document or report any untoward incident during the shift in a clean piece of
paper. Indicate the date and time of incident, people involved, actual scenario,
with the signature over printed name of the Nurse on Duty and address it to the
Supervisor or Head Nurse.
V. Housekeeping and Maintenance
• Supervise and guide the nursing attendant within the shift.
• Report out of order equipments and instruments to the Head Nurse.
• Receive and check patients in the IE Room, Surgery and Hydration Partition and
Core Room as well as the Incoming patients during shift transition.
• Check the available rooms per department for admission of patient for the shift.
• Check ER Logbook and verify if records from previous shift were returned to the
information section.
• Receive and check patients in the IE Room, Surgery and Hydration Partition and
Core Room as well as the Incoming patients during shift transition.
• Check the available rooms per department for admission of patient for the shift.
• Check ER Logbook and verify if records from previous shift were returned to the
information section.
Patients with condition requiring tertiary care need to be transferred to tertiary hospital
for further management. Inter-referral form is given to the patient addressed to the agency they
are being endorsed to or to their hospital of choice (Appendix F). Communicable Disease Cases
and Psychiatric Cases are transferred to specialty hospitals that cater such conditions. A referral
book is kept for records for reference and inquiry of significant others of patients.
Procurement of Medicine
Prescription should be given as soon as possible to the patient or their significant others
when medications are not available at the hospitals pharmacy. Relatives are instructed to buy
outside the hospital pharmacy whenever supplies are not available. Emergency Room (ER)
supplies used in critical cases should be replaced as soon as possible. In case that patient cannot
afford to replace the ER supplies used, a charge slip must be given to the hospital pharmacy for
Patient Presentation
Patient Age Range
The Emergency Department provides health care for emergency presentations for all
triage categories of patients ranging from newborn to the aged.
Presenting Conditions
A. Surgical Case
Cases which require usual and operative procedures are catered. These include burns,
cuts, fall fractures and vehicular accident which happened few minutes prior to
consultation. Hernia that requires emergency operation is accommodated, however
elective cases are referred OPD.
B. Pediatric Case
Febrile patients are asked to consult at OPD except when there is possible convulsion.
Patient having LBM and vomiting that would require hydration are treated within the
Hydration Partition of Emergency Room.
C. Medical Cases
Febrile patients are asked to consult at OPD except for patients with convulsion and
chills. Patient having LBM and vomiting that would require hydration are treated within
the Hydration Partition of Emergency Room.
E. Medico-Legal Case
This include vehicular accident, mauling, stub wounds, gunshot wound, suicidal attempt
or injection of poison that happen few minutes or hours prior to consultation.
F. Gross Death
Patient expires less than 24 hours are advice to secure death certificate to their respective
Municipality.
MINOR PROCEDURES AT ER
Thoracostomy
A surgical incision is done in the mid-axillary line at the level of the nipple line or higher
with the insertion of one or more chest tube connected to a drainage bottle.
• To remove air and fluid from the thoracic cavity.
8. After insertion of chest tube, attach the drainage tube from the pleural cavity to the
tubing that leads to along tube that ends under a sterile saline in the drainage.
9. The end of the chest catheter from the patient is submerged about 2.5cm (1inch) below
the surface of sterile normal saline. This water acts as a one-way valve or seal to allow air
or fluid from the patient’s chest to flow down the tubing.
10. Secure the connecting points of the tubing with tape to make sure that the tubing
remains airtight.
11. Mark the original fluid level wit tape on the long glass tube. This marking will show
the amount of fluid and how fast it collects in the drainage.
12. Make sure there is fluctuation of fluid level in the long glass tube. The fluctuation of
fluid level shows an effective communication between the pleural cavity and the drainage
bottle.
13. Watch for leaks of air in the drainage system as indicated by constant bubbling in the
water seal bottle.
14. Observe and report immediately of rapid, shallow breathing, cyanosis, pressure in the
chest and symptoms of hemorrhage.
15. Record amount of fluid, nature, color and viscosity. If ordered prepare sample for
labory evaluation.
16. If the patient is to be transported, place drainage bottle below the chest level.
17. Chest tube may be clamped during transportation, as a safety measure with some
units. Check with surgeon as to whether or not clamping is contraindicated. Two clamps
(hemostats) should be kept at bedside at all in case water-seal bottle is accidentally
broken.
Thoracentesis
Nursing Intervention for Patient’s undergoing Thoracentesis:
1. Inform client about the procedure and indicate how he can be helpful.
3. Obtain informed consent.
4. Prepare the equipments needed in the procedure:
• Aspirating needle
Excision
Removal of tissure, organ or tumor from the body.
Nursing Intervention for patient undergoing Excision.
1. Informed patient about the procedure.
Suturing
Nursing Intervention for patients undergoing suturing:
1. Inform patient about the procedure.
Removal of foreign body like needle, fish hook, bone, wood or glass which penetrates the
skin and underlying tissue.
Nursing Intervention for patient undergoing removal of foreign body.
1. Position patient with site exposed.
2. Instruct the patient not to remove foreign body since unskilled manipulation produces
swelling or infection which makes removal difficult.
3. The physician places marker ear the foreign body before any attempt of surgical
removal is made.
4. Request for x-ray is made as ordered to confirm the success of the surgery.
5. Ensure x-ray examination is done before the procedure.
6. During the procedure, instruct patient to prevent trauma and decrease movement that
may affect the affected surgical area.
7. Dressing is applied after removal of the foreign body.
8. Instruction in cleaning and home management is given to the patient.
SURGICAL CASES AT ER
Vehicular Accident
Nursing Considerations:
*Note if the patient is positive in Alcoholic Breath (+). For any medico-legal pattern a
form should be attached to the OPD record.
Wounds
1. Ask the patient when, where and how did the patient acquired the wound.
R! More than 3hours delay in management increases risk of infection.
2. Inspect the wound using aseptic techniques.
2.a Shave around wound if necessary.
3. Clean the wound area as well as the surrounding tissue in aseptic technique.
3.a If the wound is open, clean the wound in and around with cotton soaked in
betadine.
3.b Lacerated wound exposing internal organs can be flushed with PNSS.
3.c Remove devitalized tissue and foreign matter.
3.d Clamp and tie bleeding vessels and/or pack the wound with sterile gauze and
bandage for pressure.
4. Assist physician in suturing the wound.
5. Apply non-adhesive dressing.
6. Administer antimicrobial agents as prescribed.
7. Elevate site to limit accumulation of fluid in he affected area.
8. Administer tetanus prophylaxis as prescribed.
6. If the patient may go home, advice the patient and relative for home management.
7. If the patient condition requires hospitalization. Inform the patient and relative and
secure consent.
8. Advise the patient and relative to report any signs of complication like fever, bleeding,
rapid swelling, foul odor, profuse serosangenious drainage.
Multiple Traumas
1. Place the patient on stretcher.
Burns
• Superficial Partial Thickness (1st Degree Burn)
Emergency Treatment:
1. First Aid
Burns less than 10%, immense in cold or tap water for 15 minutes.
For chemical burns, do copious water lavage.
2. Airway
Endotracheal intubation is preferred than traecheotomy if necessary to establish
airway
3. Intravenous therapy
Intravenous therapy is required for burns larger that 20% in adults.
Large bore needle, venipunture or cut should be used for IV therapy.
Sample for CBC, blood typing, blood sugar, BUN, UA, Na+, and K+
Weight the patient if not possible, ask the patient’s weight or have an estimate.
Fluid replacement:
1. Plain LR only in 1st 24 hours
2. Adult: 2ml x body weight (kg) x % of burn
8. Transport
a. Contact the receiving hospital.
b. Maintain correct IV infusion.
c. Ensure drainage
d. Administer oxygen.
MEDICAL CASES AT ER
Nursing Interventions:
1. Asses the patient’s level or responsiveness, arousal and awareness
Measure the neurological assessment of the patient using Glasgowcoma scale (GCS).
2. Place patient in a comfortable position, if unconscious, patient in lateral or semi prone.
3. Check the patient’s baseline neurovital signs.
4. Assess the patient’s airway. Remove dentures or anything that obstruct the airway.
5. Administer oxygen as needed.
6. Refer to the medical resident duty.
7. Carry out physician’s order such as:
• Insertion of intravenous fluid and medications.
• Preparing for possible insertion of nasogastric tube and IFC
• Request for blood chemistries, Electrocardiogram (ECG), Chest X-ray (CXR)
• Instruct the patient and/ or relatives for the prescribed diet of the patient.
8. Accompany patient to ward nurse
Bronchial Asthma
Created 2006 Revised May 2010 Page 28 of 51
Rizal Provincial Hospital Scope of Service
of the
Emergency Department
Nursing Responsibilities
1. Assess the rate, depth and character of respiration.
2. Place the patient in high Fowler’s position, sitting position, or whichever position the
patient feels comfortable.
3. Administer oxygen installation at 2-3L/min as needed.
4. Teach the patient how to do deep breathing properly. Promote its use and benefits
towards his condition.
5. Take vital signs.
6. Call the physician.
7. Provide nebulization therapy as ordered.
8. Administered medications as ordered.
9. Assess effectiveness of the therapy.
10. Refer to doctor for further order.
Hypertension
A disease of vascular regulation in which the mechanisms that control arterial pressure
within the normal range are altered.
Nursing Interventions:
1. Identify signs and symptoms such as headache, weakness muscle cramps, tingling
palpitations and sweating visual disturbances.
2. Take the patient’s vital signs and record.
If the blood pressure is 140/90 mmhg and above, let the patient lie on bed.
3. Refer the resident on duty.
4. Administer medication as ordered (usually nifedipine 5mg SL)
5. Recheck the blood pressure after 15-30 minutes of drug administration. And document
and refer the response of the patient to the Medical Resident on Duty (MROD) for further
management.
7. Request for ECG and other blood chemistries as ordered.
8. Instruct patient on diet restrictions and the importance of follow up and health care
visits.
Dynamic process by which one or more regions of the heart muscle experience as severe
or prolonged del rense in oxygen supply because of insufficient coronary blood flow ;
subsequently , necrosis or tissue death occurs.
Nursing Interventions:
1. Gather information regarding the patient’s chest pain.
Nature and Intensity
Onset and Duration
Location and Radiation
Precipitating and Aggravating Factors
2. Place the patient n Fowler’s position to reduce workload of the heart.
3. Obtain Vital Signs.
4. Refer to the MROD.
5. Administer O2 therapy as ordered and encourage deep breathing exercise.
6. Request for ECG and their laboratory examination as ordered.
7. Administer medication nitroglycerine (NTG) and narcotics as ordered.
8. Obtain baseline vital signs prior to giving agents and 10-15 minutes after each dose.
9. If his condition requires hospitalization, inform patient and relatives and secure
consent.
10. Provide a quiet atmosphere.
11. Accompany the patient to the ward for proper endorsement.
Excavation of the mucosal lining of the esophagus, stomach, pylorus and duodenum.
Nursing Interventions:
1. Determine the location, character, radiation,
2. Determie if there is gastrointestinsl bleeding and refer to resident physician.
3. Take vital signs.
4. If there is profuse bleeding:
• Administer prescribed IV fluids.
• Request for stat determination of hemoglobin, hematocrit and typing.
• Prepare patient for NGT insertion and do gastric lavage as orders by the
physician.
• Administer prescribed medications.
5. If hospitalization is needed, inform the patient ad relatives. Secure consent for
admission.
6. Endorse to ward nurse.
Seizure
Nursing Interventions:
A.During the attack:
1. If aura proceeded, insert padded tongue depressor to patient’s mouth.
2. When jaws are already clenched because of spasms, do not try to insert the mouth
depressor.
3. Place the patient on the side to prevent aspiration. Loosen the patients clothing.
4. Safety precautions should be implemented.
5. Administer Oxygen therapy.
B. After the Attack:
1. Turn the patient’s head to his side.
2. Take and record vital signs.
3. Note for the following and record:
• Description of the circumstances before the attack
• The first thing the patient did during the attack
• Duration and frequency of the attack.
4. Refer to the physician.
5. Administer IV fluids ad anticonvulsant drugs as ordered.
6. Suction secretions as ordered.
7. Observe patient closely.
8. If his condition requires hospitalization, inform the patient and relatives and secure
consent.
9. Endorse the patient to ward nurse.
Increase in frequency and consistency of bowel movement ranging from formed turned to
watery.
Nursing Interventions:
1. Determine the characteristics, amount frequency of stool and vomittus.
2. Assess for signs of dehydration.
3. Take vital signs.
4. Refer to MROD
5. If the patient’s condition doses not require hospitalization, instruct on oresol intake and
observance of proper hygiene.
6. If hospitalization is required, inform the patient and/or significant others then secure
consent.
7. Administer IV fluids as ordered.
8. Endorse to ward or accompany the patient and significant other to Hydration Section.
Alcohol Intoxication
Nursing Interventions:
1. Assess the patient’s level of consciousness.
2. Place patient in a comfortable position.
3. Check the vital signs and papillary size and reaction to light.
4. Refer to MROD.
5. Request for random blood sugar as ordered.
6. Administer IV fluid with high concentration of glucose and vitamin B complex as
prescribed.
7. If the patient is severely agitated or violent, restraints can be applied for the safety of
the patient and the nurse.
8. If the condition needs hospitalization, inform relatives.
9. Carry out all stat orders.
10. Accompany the patient to the ward for proper endorsement.
Dyspnea
1. Assess for level of consciousness and ascertain circumstances that cause dyspnea.
2. Place the patient on high back rest while assessing the patient for accompanying signs
and symptoms such as cough, cyanosis and others.
3. Encourage doing deep breathing exercise.
4. Take vital signs.
5. Refer to the MROD.
6. Administer Oxygen therapy as prescribed.
Hemoptysis
Nursing Interventions:
1. Ascertain whether blood is coming out from nose or throat, gastrointestinal tract or
lungs.
2. Document for the quantity, color and character of the coughed out blood.
3. Place the patient on bed rest.
4. Take vital signs.
5. Save all coughed out blood.
6. Refer to the MROD and carry out orders.
7. Maintain a calm reassuring approach.
8. If the patient is admitted, inform the patient and secure consent.
9. Carry out all stat orders before patient is brought to ward.
10. Accompany the patient to ward for proper endorsement.
Poisoning
i. General non-corrosive
Nursing Interventions:
1. Assess the level of consciousness and ability to swallow.
2. Place the patient in sde lying position.
3. Administer Oxygen therapy as ordered.
4. Take vital signs.
5. Remove poison from the patients’s stomach immediately by inducing vomiting. Carry
out gastric lavage procedure to remove any unabsorbed poison.
6. Refer to the MROD and carry out orders.
7. Remain at the side of the paitent and provide emotional support.
8. Instruct the family to bring the unuse poison to the hospital for identification of
components.
Food Poisoning
1. Determine the source and type of poison ingested.
2. Take vital signs.
3. Administer oxygen therapy as ordered.
4. Refer to the MROD.
5. Insert and IVF as prescribed.
6. Collect food, gastric contents, vomitus, serum and feces for diagnostics.
OB-GYNE CASES AT ER
Placenta Previa
Nursing Interventions:
1. Obtain baseline data. BP, PR, RR, WT, appearance, and LOC.
2. Evaluate the amount of blood loss and duration of bleeding.
3. Refer to the attending physician and carry out oders.
4. Request for stat hemoglobin, hematocrit, blood typing as ordered.
5. Administer IVF using large bore needle.
6. Position patient in left lateral decubitus to promote placental prefusion.
7. Administer oxygen therapy as ordered.
8. Secure consent as ordered.
9. Endorse the patient to the ward.
Abruptio Placenta
Nursing Interventions:
1. Obtain Vital Signs
2. Evaluate the amount of blood loss.
3. Refer to ROD and carry out orders.
4. Position the patient in left lateral with head elevated.
5. Administer oxygen therapy as ordered.
6. Insert an IVF using large bore needle.
7. Secure consent for admission.
Eclampsia
Convulsions occur in the absence of underlying neurological condition in the presence of
hypertension, edema and proteinuria.
Nursing Interventions:
1. Obtain baseline data.
2. Note for the intensity, duration and frequency of pain and the amount of blood loss.
3. Refer to the ROD and carry out orders.
4. Secure consent for admission.
5. Administer IVF using large bore needle. And if necessary a second line maybe inserted
as ordered.
6. Request for stat hemoglobin, hematocrit and typing.
7. Secure consent for admission.
8. Endorse to ward.
Incomplete Abortion
Nursing Interventions:
1. Obtain baseline vital signs.
2. Position patient on left lateral side.
3. Inform ROD and carry our orders.
4. Give all medications as ordered.
5. Secure consent for admission.
6. Administer oxygen as needed.
7. Prepare a tongue blade for eclamptic patient.
8. Explain the effects of all medications.
9. Protect eclamptic patient from injury during seizure.
10. Insert IFC and note for the color and amount of urine output
11. Accompany patient to ward with proper endorsement.
Ectopic Pregnancy
1. Obtain baseline data. Take the vital sign of the patient.
2. Note for the intensity, duration and frequency of pain and the amount of blood loss.
3. Refer to ROD and carry out orders.
4. Secure consent for admission.
5. Administer IVF using a large bore needle. And if necessary a second line maybe
inserted as ordered.
6. Request for stat hemoglobin, hematocrit ad typing.
7. Bring patient to ward and endorse properly.
Septic Abortion
PEDIATRIC CASES AT ER
Dyspnea
Nursing Responsibility:
1. Asses the child-breathing pattern.
Respiratory Physical Assessment
1.a Note the pattern of respirations:
Rate
Regularity:
Apnea Episodes (cessation of breathing for 20seconds)
Periodic Respirations (period of rapid respiration, separated by
periods of slow breathing or short periods of no respiration which is N in
young infants)
Respiratory Efforts:
Nasal Flaring
Open Mouth Breathing
Facts in Respiratory Assessment
• Infants are obligatory nose breathers and diaphragmatic breathers.
• Number and size of alveoli continue to increase until age 8 years.
• Until age 5, structures of the respiratory tract have a narrow lumen and children
are more susceptible to obstruction and distress from inflammation.
• Normal respiratory rate in children is faster than in adults.
NORMAL RESPIRATION IN PEDIA
Infants 40-60
1 year 20-40
2-4 years 20-30
5-10 years 20-25
10-15 years 17-22
15 and older 15-20
1.b Observe skin color and temperature particularly mucus membranes and peripheral
extremities.
Fever
Nursing Intervention:
1. Assess physical condition and appearance of the patient. Note if the patient has a
history of convulsion.
2. Take vital signs and weight.
3. If highly febrile perform Tepid Sponge Bath (TSB) till fever subsides.
4. Administer antipyretic as ordered.
6. Continue TSB.
7. Educate patient with home medication and management.
8. Inform the patient and/or relative if admission is needed then secure consent.
9. Start IV therapy, regulate and document the start of infusion then carry out all orders.
9. If the patient needs to be transferred, inform the relative and make necessary
arrangements for transfer ambulance, on call ROD and NOD.
Food Poisoning
Ingestion of food/drink with chemical or natural substance contaminated with bacterial
toxins or organisms.
Nursing Interventions:
1. Assess the patient. Note for the source and type of poisoning substance ingested.
2. Take vital signs and weight.
3. Administer oxygen therapy per inhalation.
4. Inform ROD and carry out order/s.
5. Administer IVF therapy and emergency medications.
6. Prepare NGT and saline and assist the ROD in the procedure.
7. Perform gastric lavage until clear out put is obtained.
8. Inform the relative and/or patient the need of admission and secure consent.
9. Endorse to ward.
APPENDICES
Physcial Examination:
Vital Signs: BP: HR: RR: TEMP: WT:
Physical Examination:
Clinical Impression: _______________________________________________________
________________________________________________________________________
Management: ____________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________ _______________________________
RESIDENT ON DUTY NURSE ON DUTY
Date:_________________
Name:_________________________________________________________
-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --
--
ACKNOWLEDGEMENT SLIP
Ibalik po sa EMERGENCY ROOM NURSE ang bahaging ito para sa maayos
na pagtatala ng iyong pagpapakonsulta.
APPENDIX C
SEQUENCE OF ADMISSION DOCUMENTS
1. ADMISSION PREFACE
2. INTRAVENOUS FLUID SHEET
3. CLINICAL CASE RECORD
4. T, P, R GRAPHING SHEET
5. CONSENT
6. DOCTOR’S ORDER
7. NURSES REPORT
APPENDIX F
INTER-HOSPITAL REFERRAL SLIP
Thank you!
_______________________________