Critical Care and Emergency Nursing
Core concepts
Critical care and emergency nursing emphasizes rapid assessment, prioritization, and resuscitation. Know the ABCDE approach, triage principles, shock types and early signs, cardiac rhythms and defibrillation, airway management, and the monitoring of hemodynamics and oxygenation. Understand sepsis recognition and bundle timing, increased intracranial pressure precautions, and post-resuscitation care.
Traps candidates fall for
- Delaying action for "complete assessment"; in emergencies, treat life threats as you find them.
- Missing early shock signs (tachycardia, cool extremities, narrowing pulse pressure) before hypotension appears.
- Confusing defibrillation (VF/pulseless VT) with synchronized cardioversion (unstable but perfusing rhythms).
- Forgetting that CPR compressions are the priority and should minimize interruptions.
- Overlooking sepsis: fever or hypothermia, tachycardia, tachypnea, and altered mental status demand prompt cultures and antibiotics.
- Ignoring that a patient with increased ICP should avoid neck flexion and straining.
Rule of thumb
In any emergency, airway, breathing, circulation, disability, exposure - and fix the first problem that will kill the patient fastest. Time-critical interventions (defibrillation, antibiotics in sepsis) should not wait.
Worked example
A patient in the emergency department becomes unresponsive with no pulse and a monitor showing ventricular fibrillation. The nurse should start CPR immediately and defibrillate as soon as the defibrillator is available, minimizing compression interruptions. Synchronized cardioversion is not appropriate for a pulseless rhythm.