Garden City Hospital Emergency Services Orientation

1. Garden City Hospital Emergency Services Orientation Developed by Kelly Banasky, RN, , BSN,TNCC, ENPC Emergency Services Educator

2. Elmwood Entrance Ambulance Entrance Entrances

3. Parking During the Day shift, parking is limited. It is hospital policy that all staff park in designated areas which are located: • Behind the hospital in the hospital parking areas • At the Harrison Parking Lot • Afternoon shift has a designated parking lot located off of Inkster road • Do NOT park on the side streets surrounding the hospital or on the neighborhood streets. We strive to maintain respect with our neighbors. • If security or staff requests for you to move your vehicle to the correct parking area, please comply

4. Harrison Lot • The Harrison Lot is located on Hartel Street, between Maplewood and Cambridge. • Shuttle Service is provided from 5:30am to 8pm • There is no shuttle service on legal holidays • Drop-off is at the chapel door entrance at the hospital. • The chapel door faces Inkster Road. • When dropped off at the chapel door, enter through the main hospital entrance and see information, they will direct you to the Emergency Department. • Please have your badge visible for staff

5. Appearance • Please arrive to the clinical area on time, and in professional uniform dress. • Uniform should be neat, pressed and clean, shirts tucked in. • Artificial nails are not allowed at GCH per infection prevention policy • There is a room available for backpacks and jackets. Please have your name badge/ID badge visible at all times in the hospital. • Your badge should be placed on your left chest area where it can be easily seen and identified by security. • If you arrive to clinical without a badge, you will be directed to security for a visible Pass for patient and staff identification.

6. Lunches • Lunches: • There is a refrigerator, microwave and a toaster available for your use. • The Hospital Cafeteria is available at various times throughout the day • The Garden Café is open from 7am to 7pm • There is a vending machine area called Fast Track in the main hospital that has vended sandwiches and snacks. • Please when going to break, inform your preceptor

7. Start of Clinical Day • Upon arrival to the Emergency Department. Ask to see the Clinical Coordinator or Charge nurse. • If you do have not done clinical’s at GCH before, ask where the sign in book is at. • Inform them of your level of practice, eg. Basic, etc. so they may assign you to a preceptor. • Check in immediately with your preceptor • Introduce yourself and your level of practice • If unfamiliar with equipment, please ask. • Bring your evaluation sheets with you and have your preceptor sign off on them at the end of your clinical day. • The preceptor is to sign you out of the log book at the end of your shift.

8. Are blue and there are approximately 2 in each zone Capabilities: BP HR Temp Oral Rectal Pulse Ox Manual BP CUFFS Are on the walls in the patient care areas Dinamaps

9. Adult Pediatric/Infant BP CUFFS

10. Thermometer Probes There are two types • Oral (BLUE) For use on Adults/Children who are able to tolerate, cooperate with the oral probe. If the patient is prone to biting, seizing, has any condition that risks the patient, or the probe being broken do NOT use. • Rectal (RED) For use on infants, intubated patients, or any patient that can NOT tolerate the oral probe. Probe must be have surgi-lube applied prior to use. • A Temporal Scanner available for use, please ask the staff to demonstrate how to use this instrument

11. Thermometer Probes KEY POINTS: • All thermometer probes must have a disposable probe cover for every patient use • Dispose of probes after each use • Before using a rectal probe, see the RN or Tech Partner. Safety must be in place when using these probes • NEVER use a RED probe for anything other than a rectal temp • NEVER use a BLUE probe for a rectal temp

12. There are two types of Pulse Oximeter probes Pediatric Resembles a band-aid Adult Non-Disposable Pulse Oximetry

13. Vital Sign Requirements for GCH All patients must have a full set of vital signs • At triage • Every 2 hours • PRN • And for medications that affect a patients hemodynamic status • Any drug that has the ability to affect HR, BP, RR, T, SPO2 • 1 hour before discharge or transfer to the floor or unit • When patients can not tell us their pain, GCH uses the Wong-Baker Scale

14. Definition of VITAL SIGNS for GCH • Blood Pressure • Heart Rate • Respiratory Rate • Temperature • Pain level • Pulse Ox KEYPOINT: if any of the patients vital signs are not within normal limits, you need to notify the nurse

15. Bio-hazard Bins Found throughout department and in dirty utility room Items saturated with body fluids or blood should be disposed of in these bins Hopper NEVER throw towels or Maslin towels in the hopper. Only body fluids or liquids. Bio-Hazard Bins & Hoppers

16. IV Carts All used needles are to go into sharp’s containers No paper products, gloves, gauze or labels are to go into the sharp containers Do not attempt to force sharps in if container is full GCH has a company that maintains our sharps containers. NEVER reach into a sharps container ALWAYS use caution with a sharps container IV CARTS & Sharps Containers Sharps Containers

17. Phlebotomy Angiocaths Phlebotomy supplies Vacutainer adapters Drawer 1 & 2

18. Drawer 3 & 4 • Syringes • Pre-filled Saline Syringes • 2 x 2 Gauze pads • Tegaderms • Vacutainers • Silk Tape • Blood CultureVacutainers • Tourniquet's • Chloraprep • Butterfly sets • 18G needles • Band-aids • Betadine swabs • Needles adapters

19. Saline locks IV tubing Blood Identification Bands IV start Kits Secondary medication sets Drawer 5 & 6

20. Crash Carts Adult Pediatrics

21. Intubation Kits

22. Trauma Bay GT/OBS/FT Patient Care Area

23. Resources • If you have any questions or concerns, please let the charge nurse or coordinators know. • Additionally, you can leave a voicemail for the educator, Kelly at 734-458-3231 or email her at kbanasky@gchosp.org • Thank you for coming to our facility to complete your clinical rotation, we look forward to helping you be successful in your future • MAES REQUIREMENT • Must have completed this orientation before doing any clinical rotations at GCOH • Print the next page, completely fill out, turn into staff to file • Eligible for GCOH clinicals

24. Certificate of Completion • I have completed a review of the Garden City Hospital EMT & Paramedic Clinical Orientation. • Date: _________ • Name:_______________ • Signature:_______________ • Date Received by Staff______ • Staff Initials___