The Roles and Responsibilities in the Resus Room
6Roles and Responsibilities in the Resus Room
ROLES AND RESPONSIBILITIES IN THE RESUS ROOM
The Roles of the Team Leader in the Resuscitation Room
In the discussion, we learnt that the team leader in the resuscitation room is responsible for the coordination of resources and staff. The leader is also responsible for making critical decisions together with the other specialists in the team (Groenestege-Kreb et al. 2014). As a team leader, one should also prioritise treatments and investigations. We also learnt that the team leader should ascertain that the other team members wear personal protective equipment such as tabards and lead. The individual is also responsible for the allocation of roles and making personal and clear introductions. In the event that I am the team leader, the checklist that I should adhere to entails making early notification calls to the required surgeon, interventional radiology and computed tomography (CT) scans.
As the team leader, I should also consider the massive transfusion bleep and the use of 1g tranexamic acid over 10 minutes if HR>110 or SBP<110 (NUH 2015). I would also ensure that the patient moves to the CT as quickly as possible but in a safe manner. I would also make certain that the effective treatment of the imminent life threatening conditions. We also learnt that the team leader should consider the urinary catheters, tetanus, arterial lines and antibiotics as soon as possible. However, the leader should delay considering the mentioned interventions in the case of an emergency surgery. As a frontrunner, I should understand that resuscitation is a continuous process. As a result, it is imperative for the trauma team to accompany the patient to the CT room not forgetting the airway kit and blood products.
The leader also ensures that the trauma team accompanies the patient to the theatre. As the team leader, I should also provide clear directions to the anaesthetist concerning the blood products, key allergies, transfused fluids, drugs given, diagnosis and PMH made. We also learnt that the team leader is responsible for informing the blood bank about the patient location, speaking to relatives, debriefing the team and patient documentation (NRP 2013).
Roles of the Airway Nurse
The discussion also included the roles of the airway nurse before and following the arrival of the patient. The roles that we learnt before the arrival of the patient include: responding to the trauma page, introducing oneself to the team, assembling the required equipment for the management of the airway and the preparation and labelling of the necessary medications such as adrenaline, intubation drugs and normal saline flushes. In the discussion, we also learnt the roles of the airway nurse on the arrival of the patient. The roles include nursing management of breathing and the airway, providing necessary assistance in airway management and intubation and ascertaining in-line immobilisation of the cervical spine (RCHM 2016).
As an airway nurse, I also learnt that I am supposed to inform and administer to the scribe all the given medications including tetanus and antibiotics, and insert the gastric tube. The other roles of the airway nurse that we acquired from the discussion encompass drawing and labelling proper medications and flushes in case of arrests, making inotropic infusions if necessary, ascertaining a complete documentation of the nursing process and accompanying the intubated patient (RCHM 2016).
Roles of the Circulation Nurse
The discussion also involved the roles of the circulation nurse. From the discussion, we learnt that the circulation nurse has the following responsibilities: introducing oneself to the team, assembling the equipment required for circulation management, arranging level 1 fluid pump, preparing fluid warmers and I.V line insertion. The other roles of the circulation nurse before patient arrival include assembling necessary tubes used during laboratory analysis, preparing all monitoring equipment including transport monitor and attaching a non-invasive BP cuff of the appropriate size to the monitor. The roles of the nurse on the arrival of the patient include performing chest compressions in the case of a cardiac arrest, using AVPU to assess the neurological status of the patient, connecting the patient to the transport monitor and providing assistance in strapping I.V cannulae (RCHM 2016).
From the discussion, I also learnt that the circulation nurse should also announce the fluids and medications given, provide assistance in other procedures such; as the insertion of the urinary catheter and the chest tube. I also learnt that the circulation nurse should also obtain and announce vitals four times after every five minutes, followed by similar announcements made after fifteen minutes. The nurse is also responsible for the application of the pressure pad to haemorrhage, as well as the application of appropriate dressings to open wounds after the surgical registrar completes the documentation process. We also learnt that the circulation nurse is also responsible for rewarming procedures such as space blanket and warming lights. The nurse should also monitor and inform the scribe outputs such as vomitus, urine and blood (RCHM 2016). Finally, the circulation nurse should also provide assistance in exposure procedures such as log roll that aim at exposing the back.
The Roles of a Procedure Nurse
We also discussed the roles of the procedure nurse. From the name, it is apparent that the professional is responsible for managing all nursing procedures associated with the patient before the arrival and on the arrival of the patient (Heng et al. 2011). In essence, the procedure nurse should respond to the trauma page, and coordinate departmental staffing to ensure the proper implementation of all nursing procedures by the responsible departmental nurses. The coordination of nursing efforts through the various departments aims at ensuring maximum patient care and seamless flow of nursing procedures in accordance with the checklist. We also learnt that the procedure nurse should also provide a communication link between the resuscitation or trauma room and the other departments of the hospital. The communication is significant in updating other departments and the family members (in the absence of a social worker) about the required equipment and medications and the state of the patient.
Apart from discussing the roles of the team leader, the circulation nurse, the airway nurse and procedure nurse, we also discussed the significance of having good nursing skills and knowledge on the part of the nurse and the nursing practice in general. From the discussion, we learnt that attaining maximum results in patient care is the result of the proper acquisition and implementation of nursing skills. We also learnt about the significance of a team of the trauma management team that comprises of nurses, doctors, social workers and other professionals in data management. We learnt that the proper execution of roles of individual members of the team is detrimental to the success of the nursing and healthcare practice (Barach & Weinger 2007). We gained awareness on the fact that improving the quality of decisions depends on the existence of an effective team that make appropriate observations, prompts and critiques (Howell 2014).
Barach, P & Weinger, M 2007, ‘Trauma team performance’, Trauma: emergency resuscitation and perioperative anesthesia management, Vol. 1, pp.101-13.
Groenestege-Kreb, D T, van Maarseveen, O & Leenen, L 2014, ‘Trauma team’, British Journal of Anaesthesia.
Heng, K W J, Fong, M K, Wee, F C & Anantharaman, V 2011, ‘The role of nurses in the resuscitation of in-hospital cardiac arrests’, Singapore medical journal, Vol. 52, no. 8, pp.611-615.
Howell, S J 2014, ‘Advances in trauma care: a quiet revolution’, British journal of anaesthesia, Vol. 113, no. 2, pp.201-202.
Nottingham University Hospitals (NUH) 2015, ‘Roles and Responsibilities of the Trauma Team’.
The Royal Children’s Hospital Melbourne (RCHM) 2016, ‘Trauma Team Composition Roles’, Available from: http://www.rch.org.au/paed_trauma/guidelines/Trauma_team_composition_roles/#Nursing_Supervisor