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Emergencies

What to do. Read now, not during.

These are worth reading before you need themNothing here is signed for and nothing is recorded when you open it. Every step is visible at once — no Next button, nothing collapsed — because a paginated anaphylaxis procedure is a procedure that gets abandoned halfway.

Anaphylaxis

Adrenaline first. Everything else second.

  1. 1

    Call for the provider and the emergency kit, out loud, now.

    Do not leave the patient to go and find someone quietly.

  2. 2

    Give intramuscular adrenaline into the outer thigh.

    Adult 0.3–0.5 mg of 1 mg/mL. Paediatric dosing is by weight.

  3. 3

    Call 911.

    Every anaphylaxis goes to hospital, including the ones that improve.

  4. 4

    Repeat adrenaline after 5 to 15 minutes if there is no improvement.

    On the provider's call. Same dose, same route, other thigh.

Unresponsive patient — code blue

Compressions, cart, AED, 911.

  1. 1

    Shout for help and send someone specific for the crash cart and AED.

    Name a person. “Somebody get the cart” is how nobody goes.

  2. 2

    Check for a response and for normal breathing. No more than 10 seconds.

    Gasping is not breathing.

  3. 3

    Start compressions and call 911.

    The moment help is called for, not after the first cycle.

  4. 4

    Put the AED on as soon as it arrives and follow its prompts.

Splash to the eyes or face

Fifteen minutes of irrigation before anything else.

  1. 1

    Get to the eyewash station and start irrigating immediately.

    Seconds matter more than anything else on this list.

  2. 2

    Hold the eyelids open.

    The reflex is to squeeze them shut, which is the one thing that stops it working.

  3. 3

    Irrigate for a full 15 minutes by the clock.

    It will feel far longer than it is. Have someone time it.

Needlestick or sharps injury

Wash, report now. Prophylaxis is time-limited.

  1. 1

    Wash the site with soap and running water.

    Do not squeeze the wound and do not put bleach or disinfectant into it.

  2. 2

    Report it to the provider or manager immediately.

    Before the end of the shift, however minor it looks.

  3. 3

    Understand the clock.

    HIV post-exposure prophylaxis works best started within hours.