NURSING CARE OF PATIENTS WITH INSECT STINGS IN THE EMERGENCY DEPARTMENT OF MAELAO HOSPITAL: A COMPARISON OF 2 CASE STUDIES ACCORDING TO THE SEVERITY OF ALLERGIC REACTIONS
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Abstract
BACKGROUND: Insect sting allergy is a major cause of anaphylaxis in patients. This is an acute systemic allergic reaction and may cause death. Nurses in the emergency department are important in assessing symptoms and providing immediate nursing care to assist patients with anaphylaxis safe from a crisis.
Objective: To study and compare the history, triage, treatment, outcome, nursing diagnosis, and nursing care plan of 2 case studies according to the severity of allergic reactions.
METHODS: A specific case study was conducted in 2 cases by collecting retrospective data from medical records during 2020. Selection criteria include 21 years old, or more, having insect sting allergy at the emergency department, Maelao Hospital, Chiangrai province. Comparative analysis of case studies according to the clinical practice guidelines for anaphylaxis 2017 and the emergency severity index (ESI) triage algorithm.
RESULTS: Both case studies of insect stings had a different severity of allergic reactions. Chief complaint of case study 1 was dyspnea, chest pain, and hypotension. He was diagnosed with anaphylactic shock due to a wasp sting and triaged as ESI level 1. Provide nursing care according to nursing diagnoses such as anaphylactic shock and hypoxia due to constricted airway. Chief complaint of case study 2 was pain and swelling in the head. He was diagnosed with an acute allergic reaction and triaged as ESI level 2. Provide nursing care according to nursing diagnoses such as headache at the sting site due to tissue injury and the risk of a severe allergic reaction from an insect sting. The following 2 case studies were discharged and safe from complications.
CONCLUSIONS AND DISCUSSIONS: The nurse's role in caring for patients with insect stings in the emergency department is very important in assessing and screening accurately and quickly, according to the clinical practice guidelines for anaphylaxis 2017 and the ESI triage algorithm. Thus, patients receive appropriate care according to the severity of allergy symptoms.
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