Library of Resources & Solutions

The following are documents, FAQs, and exemplars of solutions prepared by others and made available by them in the public interest. Anyone using these as the basis in preparing a similar document, or clinical recommendation, or proposes implementation of any contents elsewhere assumes full responsibility for doing so and insuring the accuracy and legality of it in their own setting.
The DISCLAIMER posted by Emergency Nursing World ! fully and completely applies to all such documents.

Download Utilities
    

    ACLS Drips & Drugs:

ACLS Drugs & Drips-Final  by Willi Kirenko, RN(EC) BScN DipAdEd ENC(C) PHCNP who writes: "A few revisions were made to the ACLS "Drugs and Drips" charts that I developed.

1. Amiodarone is now available in multi-dose vials (3mL, 6mL and 18mL) and we've made the switch so that we are less likely to be injured while snapping open the 3mL glass ampoules. The chart and "recipe cards" for the kits were adjusted to reflect that change.

2. The procainamide (Pronestyl) section on the chart was difficult to work with. The previous chart suggested using a syringe to inject 4mL per minute until the end points were met, requiring someone to manually inject the drug over time. The new chart describes a "kit" with a 20mg/min drip that is stopped with the end points are met. Not as much fuss.

3. All of our staff and physicians were really pleased with the original charts, but asked for the addition of a few drugs. Another page including verapamil, vasopressin, norepinephrine, labetolol and dobutamine was added as requested.

Again, the dose rates and calculations have been carefully checked by our pharmacy team, and it's all a go ... as of June 27, 2002. Laminated copies of the charts and "kit bags" containing the amiodarone and procainamide contents and instructions have been placed on every arrest cart throughout our hospital Alliance."

    Analgesia:

Guidelines for the use of Sucrose Solution in management of Neonatal Pain by Willi Kirenko, RN, ENC(C)
Procedure: Application Of LET Solution For Wound Anaesthetic (Lidocaine, Epinephrine and Tetracaine Solution)
by Willi Kirenko, RN, ENC(C)

Ethics.doc submitted by Carol Minnis, RN CEN

Medical Directive Set.zip by Willi Kirenko, RN, ENC(C)
   Protocols for Advanced Triage and initiation of immediate treatment

Medical Directive Final Set 2.doc by Willi Kirenko, RN, ENC(C)
               Three more Medical Directives for addition to the previous set

Nutritional Screening as practiced at Frederick Memorial Hospital in Maryland. Submitted by Cynthia Russell, RN

Your Visit to the Emergency Department submitted by Donna Toohey, RN CEN SANE CNC
    Brief brochure explaining ED process and expectations for family members. (MS Word format) (Download as .pdf file)

CKHA ED Your Guide.doc An Informational Brochure For Local Clientele submitted by Willi Kirenko, RN, ENC(C)

CKHA ED InfoTriage.doc "You feel you have an emergency and then you are asked to wait …" Waiting Room explanation of ED Process and rules. submitted by Willi Kirenko, RN, ENC(C)

Interim Admission Orders
Here is a sample of our Interim Admission Orders-- We use this form to prevent delays in patients being admitted to the floors from the ED due to
waiting for orders from the inpatient physician. They are not used for ICU or pediatric patients.

Nursing Interventions.doc submitted by Shawn Keenen
    A "points" system for assigning levels to equal one of the four levels of billing for reimbursement according
to federal APC coding standards. (MS Word format) Final Draft

Quantify the Level of Nursing Care.doc submitted by Brian Cesar, RN
    A final-draft "points" system for assigning levels to equal one of the four levels of billing for reimbursement according
to federal APC coding standards. (MS Word format) Final Draft

ED charge sheet 981.xls   ED interventions and def1.xls  submitted by Alicia Gardella, RN CEN
These are Microsoft Excell spreadsheets. To download, Right-Click your mouse on the filename, and choose "Save Link as" or "Save Target as" You may then download to your hard drive.
    Alicia Gardella, RN CEN writes: "We are still working on it regarding the number of points and what equals an appropriate level so it is not a final draft. What I have sent you is the charge sheet itself and then the list of definitions and interventions that define each of the items noted on the charge sheet.
Work-In-Progress

Andorra:

Andorran Triage Model (MAT)

Australian:

Submitted by Toni McCallum Pardey of Emergency Nurses Association of NSW, Inc. are four documents concerning Australian Triage Scales:

Australian Triage Scales Guidelines	Australian Triage Scales Policy	Australian Triage Scales References	Australian Triage Scales Comments
Australasian College of Emergency Medicine's website posting of "Guidelines for Implementation of the Australasian Triage Scale in Emergency Departments"

Canada:

The Canadian Triage & Acuity Scale (CTAS) for Emergency Departments

Canadian Acuity Triage Scale Implementation Guidelines

CTAS Wall Poster

Irish Republic:

Triage Levels At St.James's Hospital, Dublin, Ireland

United Kingdom:

Emergency-Nurse.com's Triage Bibliography

United States of America:

Agency for Healthcare Research and Quality (AHRQ) "Implementation Handbook and DVDs Emergency Severity Index, Version 4"

ACEP Information Paper "A Uniform Triage Scale In Emergency Medicine"

Rebecca S. McNair's Five Tier Acuity Lecture - ENA Reno - 2001 from www.triagefirst.com   ENW!'s Archived Copy

National Five-Level Triage System Resolution Adopted by the Emergency Nurses Association

TriageForm.doc
CKHA CLINICAL RECORD ORIGINAL.doc
submitted by Willi Kirenko, RN, ENC(C)
This is a 2-sided page, with one side containing the triage documentation, and the other, the initial assessment information for all patients - no matter the acuity.
Our staff have found it all most helpful, as there is space for quality nursing documentation, and it's a separate sheet, so there's no need to chase the chart down. Our physicians appreciate it, as well, and . . .  note it with their initials.

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