Clinical Attachment On NORMAH MEDICAL SPECIALIST CLINIC CENTER 2017

A & E ( Accident and Emergency) Room

Date Group Times Activity

12/04/201 D 08.30 Orientation : room, facilities, medical
7 16.30 equipments, procedure and nursing
documentation.
Verbed is done by doctor itself.
Nurse is absolutely partner of doctor.
Triage room is not divided to be red, yellow,
green or black. But it is only for one
doctor/nurse and one patient. Observe the
condition of patient is start from the patient is
called, in triage room patient only need answer
the question. Then the patient is decided to go
to emergency room or poly.
A & E service is quick and friendly. Averagely,
the patient is only one hour in emergency room
then they will be transferred to the poly or go
home. Not all patient get infusion therapy or
antibiotic, it will be depended on the case. For
example the patient with low back pain is only
given pain killer and check radiology. Then the
result decides the next step, go to poly or go
home.
Ambulance service is also quick, when they are
called, they will go to the location directly to
do pre-hospital procedure and evacuate to the
hospital. For example, one of building project
accident where one of the employees is fall
down. Victim is helped by ambulance team,
sent to the hospital with condition already
paired neckcollar and long spinal board. So,
when the patient come to emergency room, he
will be assessed and then go to radiology for
CT-Scan and X-Ray. When there is no trauma
in neck and head, patient will only be done
wound care and adviced to go home.
The nurse asks us about primary survey, and how
to evaluate Airway, Breathing, Circulation,
Disability, or Exposure. He says that the
 simplest evaluate airway is communicate with
the patient. If they have good respon, there is
no problem and otherwise.
Catheter set, wound care or other procedure
which need sterile principles is absolutely have
different equipment. In one wound set, there
are 3 PINSET, plastic, KASA, cotton, all
equipments are dispossible. Catheterization,
nurse does not touch with hand but they will
use PINSET to put in.
Sometime patients knowledge is critic to
procedure, so nurse or doctor must be brilliant
to answer every question.
When the patient gets nebulizer therapy, the mask
will be given back to the patient to be used
next time on therapy schedule.
If offered, nurse will pair the infusion set for
homecare.
When the patient is crowd, nurse will be busy.
Student has to have inititatif to join or see at
the procedure. Nurse will be quiet if the
student does not want to ask something. But if
the student does, nurse will answer and explain
about procedure which has done.
13/04/201 E 08.30 Orientation
7 16.30 First we are introduce our team and staff of A &
E (accident & emergency) rooms Room, at that
time there are two nurses doing shift, they are
Mr. James and Mrs. Siti Mariam. Then Mr. James
explain room of A & E (accident & emergency)
room. It rooms has 5 rooms, there are Doctors
room, triage room, procedure room, linen room,
registration room.
In there we are explained by them all about E &
E (accident & emergency) room, such as: First
assesmement, triage, A&E equipment, drugs and
the procedure if the patient come in, and plan
disaster.
We just observed to patients when nurses doing
take blood sample (ADV), nebulizer, infuse set
installasion, and accompany patient going to X-
Ray room, we are doing verbed too.
21/4/2017 C 08.30-13.00 Orientation; Nurses and doctor , rooms,
equipments, procedures, and nursing
documentation
Fiirst, we learn about TRIAGE, , there are 5 scale
of TRIAGE that used. Scale 1 and 2 going to red
scale, 3 and 4 are yellow scale, 5 is green scale.
Than, we learn about defibrilator, emergency
troly, drugs, and electrocardiogram.
Next, we also joined to observed the doctor and
nurse did wound dressing. It was kind of
decubitus that used absorben dressing.
Last, we learn about ambulance system at A & E.