1
EMERGENCY ROOM NURSING BASICS MEDICAL SURGICAL 3
WEEK 1 STUDY GUIDE 2026 JUST RELEASED VERSION
Emergency Room Nurses
ER nurses learn to quickly triage patients based on immediate observation
and acute assessment skills, and treat symptoms in order of life-threatening
priority
ER nurses usually have ACLS, BLS, & PALS certification
ACLS: includes BLS, recognition and early management of respiratory and
cardiac arrest and dysrhythmias, airway management, related
pharmacology, management of ACS and stroke
Triage Levels: five-level system ( BEING THE WORST, MAKES YOU FIRST)
Level 1: Resuscitation
- Requires immediate treatment to prevent death
Level 2: Emergent
- Life-threatening conditions and have to be seen in less than
10 minutes
Level 3: Urgent
- Serious health problems but not immediately life-threatening
- Seen within 30 minutes
Level 4: Less Urgent
- Approximately 90 minutes without immediate treatment
Level 5: Non-urgent
- Non-life-threatening condition requiring simple evaluation and care
Mass Casualty Triage
Emergent or Class I
- RED TAG immediate threat to life
Urgent or Class II
- YELLOW TAG major injuries that require immediate treatment
Non-urgent or Class III
- GREEN TAG minor injuries that do not require immediate treatment
Expectant or Class IV
- BLACK TAG one who is unlikely to survive
- ** 3rd degree burns (palliative care and pain relief)
*** Crash cart is checked every shift to ensure it is completely stocked and
equipment is ready for use
Bag-valve masks
Artificial airways
Oxygen delivery devices
Intubation equipment
IV access equipment
Emergency medications
,2
AED (used for V. Fib., pulseless VTACH)
- Delivers shocks of 120-200 joules
,3
- Clear the individual and shock
Suction machine
Checklist of equipment and medication
Emergency Medications
Albuterol
o Asthma
o Bronchodilator
o Don’t use with beta blockers
Amiodarone
o CCB
o Toxic (pulmonary, liver)
o used for Atrial fibrillation
Antiplatelet
o aspirin, toxicity (salicysm)
o can cause tinnitus
Atropine
o anticholinergic, tachycardia, antidote for beta blocker
Beta-blockers
o -lol
o check the HR above 60
o decreases glucose
o don’t use with bronchodilators
Calcium chloride
o Reverse hyperkalemia
Digoxin
o Toxicity 0.8-1.2
o Nausea, loss of appetite (anorexia), halos in the eyes, potassium
drops, educate to eat a lot of potassium
o contractility
Diltiazem
o CCB
o don’t drink grapefruit
o they decrease the HR & BP (monitor for low HR & low BP)
Dopamine
o Parkinson’s
o don’t eat protein with the meds
o catecholamine (vasopressor) it increases the HR
Dobutamine
o tachycardia, hypertension
Epinephrine
o tachycardia, hypertension
o 1:10000
o 1:1000
, 4
Altiplase
o thrombolytic, clot destroyer
o given when they have a MI, stroke
o monitor for bleeding & dysrhythmias
o you do NOT give if they are bleeding
Heparin
o Anticoagulant
o Antidote protamine sulphate
o aPPT: 60-80 ( you want double of the norm)
Furosemide
o hypotension & dehydration
o potassium & sodium
Local anesthetics
o lidocaine (never supposed to enter the blood, unless it is for
an arrhythmia)
Sodium channel blockers
Magnesium sulfate
o blood pressure, & for seizures (muscle relaxer) you can use it for
people who are asthmatic
Nitroglycerin
o chest pain, hypotension, bradycardia, headache, ask if using Viagra
Morphine
o monitor for respiratory depression
Norepinephrine:
Sodium bicarbonate
o buffer to correct metabolic acidosis
Solumedrol
o steroid used for respiratory issues
Diphenhydramine
o Benadryl
o antihistamine can be used for anaphylaxis
Vasopressin
o ADH anti-diuretic hormone
Verapamil
o no grapefruit juice
o hypotension, bradycardia
o CCB for arrhythmias
Primary Survey
Rapid assessment of life-threatening conditions
Standard precautions – gloves, gowns, eye protection, face masks, and show covers.
ABCDE Principle
Airway/Cervical Spine
EMERGENCY ROOM NURSING BASICS MEDICAL SURGICAL 3
WEEK 1 STUDY GUIDE 2026 JUST RELEASED VERSION
Emergency Room Nurses
ER nurses learn to quickly triage patients based on immediate observation
and acute assessment skills, and treat symptoms in order of life-threatening
priority
ER nurses usually have ACLS, BLS, & PALS certification
ACLS: includes BLS, recognition and early management of respiratory and
cardiac arrest and dysrhythmias, airway management, related
pharmacology, management of ACS and stroke
Triage Levels: five-level system ( BEING THE WORST, MAKES YOU FIRST)
Level 1: Resuscitation
- Requires immediate treatment to prevent death
Level 2: Emergent
- Life-threatening conditions and have to be seen in less than
10 minutes
Level 3: Urgent
- Serious health problems but not immediately life-threatening
- Seen within 30 minutes
Level 4: Less Urgent
- Approximately 90 minutes without immediate treatment
Level 5: Non-urgent
- Non-life-threatening condition requiring simple evaluation and care
Mass Casualty Triage
Emergent or Class I
- RED TAG immediate threat to life
Urgent or Class II
- YELLOW TAG major injuries that require immediate treatment
Non-urgent or Class III
- GREEN TAG minor injuries that do not require immediate treatment
Expectant or Class IV
- BLACK TAG one who is unlikely to survive
- ** 3rd degree burns (palliative care and pain relief)
*** Crash cart is checked every shift to ensure it is completely stocked and
equipment is ready for use
Bag-valve masks
Artificial airways
Oxygen delivery devices
Intubation equipment
IV access equipment
Emergency medications
,2
AED (used for V. Fib., pulseless VTACH)
- Delivers shocks of 120-200 joules
,3
- Clear the individual and shock
Suction machine
Checklist of equipment and medication
Emergency Medications
Albuterol
o Asthma
o Bronchodilator
o Don’t use with beta blockers
Amiodarone
o CCB
o Toxic (pulmonary, liver)
o used for Atrial fibrillation
Antiplatelet
o aspirin, toxicity (salicysm)
o can cause tinnitus
Atropine
o anticholinergic, tachycardia, antidote for beta blocker
Beta-blockers
o -lol
o check the HR above 60
o decreases glucose
o don’t use with bronchodilators
Calcium chloride
o Reverse hyperkalemia
Digoxin
o Toxicity 0.8-1.2
o Nausea, loss of appetite (anorexia), halos in the eyes, potassium
drops, educate to eat a lot of potassium
o contractility
Diltiazem
o CCB
o don’t drink grapefruit
o they decrease the HR & BP (monitor for low HR & low BP)
Dopamine
o Parkinson’s
o don’t eat protein with the meds
o catecholamine (vasopressor) it increases the HR
Dobutamine
o tachycardia, hypertension
Epinephrine
o tachycardia, hypertension
o 1:10000
o 1:1000
, 4
Altiplase
o thrombolytic, clot destroyer
o given when they have a MI, stroke
o monitor for bleeding & dysrhythmias
o you do NOT give if they are bleeding
Heparin
o Anticoagulant
o Antidote protamine sulphate
o aPPT: 60-80 ( you want double of the norm)
Furosemide
o hypotension & dehydration
o potassium & sodium
Local anesthetics
o lidocaine (never supposed to enter the blood, unless it is for
an arrhythmia)
Sodium channel blockers
Magnesium sulfate
o blood pressure, & for seizures (muscle relaxer) you can use it for
people who are asthmatic
Nitroglycerin
o chest pain, hypotension, bradycardia, headache, ask if using Viagra
Morphine
o monitor for respiratory depression
Norepinephrine:
Sodium bicarbonate
o buffer to correct metabolic acidosis
Solumedrol
o steroid used for respiratory issues
Diphenhydramine
o Benadryl
o antihistamine can be used for anaphylaxis
Vasopressin
o ADH anti-diuretic hormone
Verapamil
o no grapefruit juice
o hypotension, bradycardia
o CCB for arrhythmias
Primary Survey
Rapid assessment of life-threatening conditions
Standard precautions – gloves, gowns, eye protection, face masks, and show covers.
ABCDE Principle
Airway/Cervical Spine
