NLE Emergency & Critical Care Nursing — Principles of Emergency & Critical Care NursingConcept Map

Concept

Triage: Prioritization by Acuity

Sub Concepts

• Three-Tier System (Emergent, Urgent, Non-Urgent)
• Five-Level ESI Scale
• Continuous Re-triage
• Mass-Casualty START Triage (Red, Yellow, Green, Black)
• Color-Coding in Disaster Settings

Relationship To Central

First-line nursing responsibility; determines order of patient care based on severity

Concept

Primary Survey: ABCDE Framework

Sub Concepts

• A - Airway with C-spine Protection
• B - Breathing Assessment & Support
• C - Circulation & Hemorrhage Control
• D - Disability & Neurologic Status
• E - Exposure & Environmental Management

Relationship To Central

Systematic rapid assessment for life-threatening conditions; never advance until current threat is managed

Concept

Secondary Survey

Sub Concepts

• SAMPLE History Framework
• Head-to-Toe Physical Examination
• Complete Vital Signs
• Diagnostic Testing
• Pain Assessment

Relationship To Central

Follows primary survey completion; detailed head-to-toe assessment and focused history

Concept

Critical Care Environment & ICU Management

Sub Concepts

• Continuous Hemodynamic Monitoring
• Prevention of Iatrogenic Harm
• Ventilator-Associated Pneumonia Prevention
• Central-Line Infection Prevention
• Venous Thromboembolism Prophylaxis
• Pressure Injury Prevention
• Family Communication & Support

Relationship To Central

Specialized setting for highest-acuity patients requiring continuous monitoring and advanced support

Concept

Hemodynamic Monitoring Parameters

Sub Concepts

• Arterial Line Monitoring
• Central Venous Pressure (CVP)
• Pulmonary Artery Catheter
• Mean Arterial Pressure (MAP)
• Perfusion Assessment
• Transducer Leveling & Zeroing

Relationship To Central

Guides fluid and drug therapy; allows early recognition of deterioration before clinical collapse

Concept

Nursing Priority Interventions

Sub Concepts

• Stabilize Before Diagnosing
• Establish Vascular Access Early
• Continuous Monitoring
• Post-Intervention Reassessment
• Structured Documentation & Handover (SBAR)

Relationship To Central

Core interventions that prevent patient deterioration and death; applied systematically across all emergency scenarios

Concept

Complications & Prevention

Sub Concepts

• Hypoxic Brain Injury from Airway Loss
• Tension Pneumothorax
• Hemorrhagic Shock
• Device-Related Infections
• Ventilator-Induced Lung Injury
• Pressure Injuries

Relationship To Central

Life-threatening or iatrogenic complications arising from missed/delayed assessment or care lapses

Concept

Patient & Family Education

Sub Concepts

• Acute-Phase Orientation
• Equipment & Alarm Explanation
• Realistic Expectation-Setting
• Advance Directive Discussion
• Return Precautions at Discharge

Relationship To Central

Nursing responsibility per RA 9173; supports informed decision-making and safe transitions of care

To

Primary Survey

From

Triage

Strength

strong

Relationship

Triage determines priority for Primary Survey; emergent patients go straight to ABCDE assessment

To

Secondary Survey

From

Primary Survey ABCDE

Strength

strong

Relationship

Primary Survey must be completed and life threats addressed before Secondary Survey begins; they are sequential, not simultaneous

To

Nursing Priority Interventions

From

Primary Survey ABCDE

Strength

strong

Relationship

Each ABCDE component requires specific priority interventions; nursing actions are driven by the survey findings

To

Hemodynamic Monitoring

From

Circulation Assessment

Strength

strong

Relationship

Circulation assessment (C in ABCDE) leads to hemodynamic monitoring establishment in critical care; parameters guide fluid and drug therapy

To

Hemodynamic Monitoring

From

Critical Care Environment

Strength

strong

Relationship

ICU setting requires continuous hemodynamic monitoring; transducer leveling, CVP interpretation, and MAP goals are core ICU nursing skills

To

Complications & Prevention

From

Critical Care Environment

Strength

strong

Relationship

ICU patients are at high risk for iatrogenic complications; prevention strategies are central to critical care nursing

To

Disability Assessment D

From

Airway Assessment A

Strength

strong

Relationship

Airway management directly affects oxygenation, which affects brain perfusion and neurologic status; airway dysfunction causes disability

To

Circulation Assessment C

From

Breathing Assessment B

Strength

strong

Relationship

Respiratory failure leads to hypoxia, which triggers anaerobic metabolism and shock; breathing must be restored before circulation stabilizes

To

Patient Family Teaching

From

Secondary Survey

Strength

moderate

Relationship

Information gathered during secondary survey informs what patients/families need to understand about diagnosis, treatment plan, and discharge precautions

To

Primary Survey

From

Mass-Casualty START Triage

Strength

strong

Relationship

START triage is an accelerated, streamlined version of primary survey designed for rapid sorting in disaster; uses same ABCDE logic but with rapid decision rules

To

Nursing Priority Interventions

From

Hemodynamic Monitoring Parameters

Strength

strong

Relationship

Hemodynamic values (CVP, MAP, urine output) guide the priority interventions nurses implement (fluid administration, vasopressor use, reassessment frequency)

To

Critical Care Environment

From

Complications & Prevention

Strength

strong

Relationship

Prevention of complications (VAP, CLABSI, VTE, pressure injuries) is the defining focus of ICU nursing; protocols are embedded in daily ICU routines

To

Blood Glucose Check

From

Disability Assessment D

Strength

strong

Relationship

Hypoglycemia is a rapidly reversible cause of altered mental status; must be ruled out immediately in any patient with decreased consciousness

To

Complications & Prevention

From

Exposure Assessment E

Strength

moderate

Relationship

Exposure phase prevents hypothermia and identifies hidden injuries; hypothermia is part of the trauma lethal triad (hypothermia, acidosis, coagulopathy)

To

Nursing Priority Interventions

From

Patient Family Teaching

Strength

moderate

Relationship

Patient/family education supports adherence to interventions, reduces anxiety, and facilitates informed decision-making; part of holistic nursing care per RA 9173