Nursing Informatics: Bachelor of Science in Nursing

BACHELOR OF SCIENCE IN NURSING:
NURSING INFORMATICS
COURSE MODULE COURSE UNIT WEEK
2 6 7
Trauma and Emergency Care
✓ Read course and unit objectives

✓ Read study guide prior to class attendance
✓ Read required learning resources; refer to unit
terminologies for jargons
✓ Proactively participate in classroom discussions
✓ Participate in weekly discussion board (Canvas)
✓ Answer and submit course unit tasks
At the end of this unit, the students are expected to:
Cognitive:
1. Identify the basic principles and techniques of trauma care within the worst and most critical
hours of a client upon seeking emergency care.
2. Discuss and apply emergency nursing management to clients needing trauma care.
Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and graciously.
Psychomotor:
1. Participate actively during class discussions
2. Confidently express personal opinion and thoughts in front of the class
Schumacher, L., & Chernecky, C. C. (2010). Saunders nursing survival guide: critical care &
emergency nursing. St. Louis, Mo.: Elsevier Saunders.
In order to achieve the best possible outcomes while decreasing the risk of undetected injuries, the
management of trauma patients requires a highly systematic approach. The ABCs of nursing care
is most important.
Rapid sequence intubation (RSI)

A specialized form of placing an endotracheal tube (ETT) in a patient to provide ventilation via a
secure airway. It is an airway management technique that produces inducing immediate
unresponsiveness (induction agent) and muscular relaxation (neuromuscular blocking agent) and is
the fastest and most effective means of controlling the emergency airway (Lafferty and Soo Hoo,
2020)
Indications:
1. Lack of airway protection despite patency (swallow, gag, cough, positioning, and tone) hypoxia
2. hypoventilation
3. need for neuroprotection (e.g. target PaCO2 35-40 mmHg)
4. impending obstruction (e.g. airway burn, penetrating neck injury)
5. prolonged transfer
6. combativeness
7. humane reasons (e.g. major trauma requiring multiple interventions)
8. cervical spine injury (diaphragmatic paralysis)
Process: Remembered as the 7Ps:

1. Preparation (drugs, equipment, people, place)
2. Preoxygenation
3. Pretreatment (optional; e.g. atropine, fentanyl and lignocaine)
4. Paralysis and Induction
5. Protection
6. Placement with proof
7. Postintubation management
Traumatic Brain Injury
A collective term describing a wide range of pathologic conditions and types of trauma involving the
brain.
Types of trauma Brain Injury:
1. Skull fractures
2. Concussion
3. Contusion
4. Diffuse axonal injury
5. Hematomas
A. Concussion – a direct brain injury involving neural tissue (parenchyma); it is generally mild but
may have underlying pathologic consequences such as slow subdural bleed that is not observed
until days after the injury.
B. Contusions – Occur when the head suffers a direct impact with a rigid object.
➢ Categories:
1. Coup injury
2. Coup-contrecoup injury
3. Diffuse axonal injury
C. Hematoma
1. Epidural hematoma – develops under the arterial pressure of the bleed, which tears the
periosteal layer from the cranium as the hematoma expands, resulting in the compression of
brain tissue.
2. Subdural hematoma – an intracranial bleed involving the space between the dura’s meningeal
layer and the arachnoid layer.
3. Secondary brain injury – consists of neurologic tissue damage that occurs after initial injury
and increases the morbidity and mortality of the patient as a result of altered ability of the
brain to maintain a hemeostatic environment
4. Brain Attack (acute ischemic stroke) – a sudden neurologic impairment caused by a decrease
in the blood flow to any vascular territory in the brain; it is considered a medical emergency.
Acute Hemorrhage
A. Related to gunshot wound
➢ Penetrating trauma – one of the leading causes of hemorrhage, and gunshot wounds are the
leading source of high- velocity penetrating trauma.
B. Thrombocytopenia – a decrease in the number of platelets (disk-shaped cells) that are formed
when mature granular megakaryocytes shed their cytoplasm) that circulate through the body.
➢ Two major emergencies associated with thrombocytopenia
1. Hemorrhage
2. Shock
C. Disseminated Intravascular Coagulation – a condition that ranges from an acute situation in
which excessive hemorrhaging and thrombosis occurs to chronic presentation with minor
abnormalities of diffuse bleeding and thrombosis of generalized or local organ infiltration.
➢ Stages of microvascular clotting followed by active hemorrhaging characterize DIC, two
important factors.
1. Consumption of coagulation factors and platelets
2. Fibrinolysis
Other Related Disorders Requiring Emergency Management

A. Cardiac Tamponade
o A life-threatening condition requiring immediate intervention.
o Defined as major compression of all four chambers of the heart cause by an accumulation of
one or more of the following: blood, clots, pus, other fluid, or gas.
B. Spinal Compression – a disorder of sensory and motor dysfunction caused by direct pressure or
compromised vascular supply to the spinal cord or cauda equine.
C. Acute Sepsis
o Septic process – Initiated by the launch of mediators that are part of the inflammatory
reaction.
o Systemic inflammatory response syndrome – refers to a host’s response to a variety of clinical
insults, both infectious and noninfectious, and is part of the acute sepsis process.
Trauma – a serious injury to the body; it usually results to an extremely stressful or life-threatening
situation potentially resulting in secondary complications such as shock, respiratory failure and death
Emergency Nurses Association. (2019). Sheehy’s Manual of Emergency Care, 7th ed. St. Louis:
Elsevier Mosby. pp 504-593
Life in the Fast Lane. (n.d.). Rapid sequence intubation. Retrieved from https://www.litfl.com
Tabulate the different traumatic brain injury types. Compare and contract in terms of cause(s), signs
and symptoms, treatment of choice in emergency situations, and nursing management
(independent, dependent, and interdependent)
Department of Health (Kagawaran ng Kalusugan). (n.d). https://www.doh.gov.ph
Emergency Nurses Association. (2019). Sheehy’s Manual of

Emergency Care, 7th ed. St. Louis: Elsevier Mosby.
Hinkle, J. and Cheever, K. (2017). Brunner & Suddharth’s Textbook

of Medical-Surgical Nursing, 14th ed. USA: Wolters Kluwer
Lafferty, K. and Soo Hoo, G. (2020, April 17). Rapid sequence

intubation. Medscape.com.
Life in the Fast Lane. (n.d.). Rapid sequence intubation. Retrieved from https://www.litfl.com
Schumacher, L., & Chernecky, C. C. (2010). Saunders nursing survival guide: critical care &
emergency nursing. St. Louis, Mo.: Elsevier Saunders.

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BACHELOR OF SCIENCE IN NURSING:

Trauma and Emergency Care

✓ Read course and unit objectives

At the end of this unit, the students are expected to:

Rapid sequence intubation (RSI)

Process: Remembered as the 7Ps:

Other Related Disorders Requiring Emergency Management

Emergency Nurses Association. (2019). Sheehy’s Manual of

Hinkle, J. and Cheever, K. (2017). Brunner & Suddharth’s Textbook

Lafferty, K. and Soo Hoo, G. (2020, April 17). Rapid sequence

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