ED nurses attend decon skills camp
You need 'across-the-room' recognition
Almost the entire ED staff at St. Joseph's Hospital in St. Paul, MN, just went through a contamination recognition "skills camp" given by Joan Somes, PhD, MSN, RN, CEN, FAEN, ED educator. Somes covered signs and symptoms of possible contamination, how to decontaminate patients, and how to route them through the hospital.
During the recent Republican convention, the ED was provided with a decontamination unit staffed with Marines in the parking lot, should massive decontamination be necessary. Normally, however, patients would be routed through the shower system in the hospital's ambulance garage and would not be allowed to get any further than the ED waiting room door.
"They would be redirected back out to the ambulance garage area," says Somes. "The triage nurse would also probably go through the decon process as well."
As an ED nurse, Somes says you need to have "across-the-room" recognition when a patient needs decontamination.
Somes says when she heard about a recent St. Louis incident of chemical exposure, she hoped that the ED nurses knew how to protect themselves. "White powder on someone is a good reason to stay back, call security, and let the charge nurse know you have a decon situation. Instruct the patient to keep back and that help is being arranged," she says.
Also, have the patient undress, as 90%-95% of the contamination is on their clothing. "We would then direct them to the decon area and have them do their own showering," Somes says.
Keep in mind the acronyms SLUDGE (salivation, lacrimation, urination, defecation, gastrointestinal upset, and emesis), and DUMBELS (diarrhea/ diaphoresis, urination, miosis, bronchospasm/bradycardia, excited muscles/tremors/seizures, lacrimation, and salivation) as reminders of what to check.
Decontaminate the patient without contaminating yourself as well. "Way too often, if a patient presents with respiratory distress or other problem, we jump in," says Somes. "If the patient has an odd odor, powder, or presentation, use caution."
Almost the entire ED staff at St. Joseph's Hospital in St. Paul, MN, just went through a contamination recognition "skills camp" given by Joan Somes, PhD, MSN, RN, CEN, FAEN, ED educator. Somes covered signs and symptoms of possible contamination, how to decontaminate patients, and how to route them through the hospital.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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