European Society of Emergency Medicine †Free Samples to Students

Question: Discuss about the European Society of Emergency Medicine. Answer: Introduction: Congestive heart failure can be described as the progressive heart condition that is seen to mainly affect the pumping power of the different heart muscle in the affected individual. In this condition, the heart is seen to fail miserably to pump efficiently like the way it should pump in normal individuals. Researchers are of the opinion that certain strenuous conditions like narrowing of the arteries of the heart causes coronary artery disease that results in these symptoms. High blood pressure may result in leaving the heart in weak condition or make it stiff in such a way by which it fails to fill and pump effectively. Researchers are of the opinion that the main pumping chambers of the heart may become stiff and may not fill properly in between the beats (Feltner et al., 2014). This may result in occurrence of situations of congestive heart failures. In many other cases, the muscles of the heart are seen to be weakened as well as damaged resulting in a condition when the ventricl es become stretched to a large point. In such condition, the heart cannot pump efficiently throughout the body resulting in occurrence of negative symptoms of the disorders. As time passes, heart no longer can keep up with the demand of pumping adequate amount of blood to the rest of the body and this causes the disorder. Coronary heart disease and heart attack are also causes of the disorder where fatty deposits called plaques are built and deposited in the arteries resulting in the narrowing if the arteries. Often in many situations, damaged valves are observed which mainly occurs from heart disorders or heart defects. Such faulty valves are seen to make the heart work harder resulting in its weakening over time. Genetic factors, excessive alcohol uptake, or tobacco smoking may result in damaging of the heart muscles called myopathy for which congestive heart failures may also occur (Carthon et al., 2015). Hypertension may cause the heart to work harder and therefore the extra exe rtion in turn make the heart muscles stiff for which they can no longer pump blood effectively. These causes result in the occurrence of congestive heart failure. The different risk factors that are associated with congestive disorders are high blood pressure and heart attack. Coronary heart disorders resulting in narrowing of the blood vessels also result in occurrence of the disorder. Diabetes as well as certain diabetic medications all results in occurrence of the disorders (Vedel Khanassov, 2015). Congenital heart defects, sleep dyspnoea, alcohol use, valvular heart diseases, viruses and tobacco use are also certain risk factors. Obesity and irregular heart diseases also result in this disorder. The patient suffering from coronary heart disorders may develop complications like kidney damage and heart valve problems, liver problems and heart problems. All these situations will make her life restricted as she has to undergo a strict routine of healthcare and self-management that might be strenuous and frustrating for her. She may become depressed and anxious about his ill health that may make her suffer emotionally and mentally (Mebaza et al., 2015). Her family members will be affected emotional from the suffering of the patient and ma become depressed. Moreover, the family members also gave to go through financial and physical turmoil for which quality of life am be affected. One of the most important symptom of the congestive heart failure is the retention of fluid and water in the body which cases swollen of different parts of the body. Less amount of blood is seen to reach the kidney. This in turn results in a situation of edema where ankles, legs as well as abdomen get swollen. Another important symptom that occurs in patients suffering with the disorder is the shortness of breath. Congested lungs are also seen to occur and this mainly takes place de to accumulation of fluid in the lungs. When fluid becomes collected in the lungs, it may result in development of shortness of breath that in turn cases extreme difficulty in breathing. Wheezing as well as development of dry cough is also a common phenomenon that takes place due to lung congestion (Carpenter et al., 2015). Another important symptom that is quite common in the disorder is the feeling of dizziness and fatigue and occurrence of weakness. Restricted flow of blood to the brain than it is requi red results in development of confusion in the patients. This causes dizziness in the person. Moreover, limited flow of blood to the muscles and other major organs of the body make the patient feel weak and tired, as successful respiration cannot take place de to limited flow of blood (Mebaza et al., 2015). Another important symptom would be the occurrence of the nausea and feeling of loss of appetite by the patient. It mainly occurs when fluid is seen to accumulate in the places that surround the digestive tract as well as the liver. The fifth symptom that can be also suggested here is the presence of rapid heartbeats where the heartbeats also get quite irregular. As the heart fails to keep up with the pace that is required to send blood to the different parts of the body, they try their best to beat fast and send blood but fail miserably. Therefore, the heartbeats become rapid but irregular. In case of the patient, all the above mentioned symptoms are present like loss of appetite , nausea, irregular heartbeat, shortness of breath, dizziness, weakness, fatigue and others (Rai et al., 2017). All these symptoms will ensure the nursing professionals that the patient is suffering from congestive heart failure. One of the most important classes of drugs is called the Angiotensinogen-converting enzyme called the ACE inhibitors. They are fond to be highly successful in management of congestive heart failure cases. This class of drug is seen to be helping in the blocking of the activity of angiotensin in blood. Angiotensin is mainly responsible for making the blood vessels narrow which makes the person more exposed to the occurrence of the heart disorders. This class of the drugs is also seen to relax the pressure of the blood and thereby improve the flow of the blood through the blood vessels. The blood pressure is lowered and therefore, it becomes important easier for the heart to pump blood (Luttik et al., 2016). This class of the enzyme is also seen to be releasing a considerable amount of water and salt. This also contributes in lowering of the blood pressure. Many randomized control trial had been conducted which had shown that drugs like ramipril, quinapril, captopril, enalapril and lis inipril. Another one of the most important class of drugs that are important to manage congestive heart disorder is beta-blocker. Researchers have seen through their experiments that people who are suffering from congestive heart disorders are seen to produce specific types of hormones called the catecholamine. This hormone is therefore responsible for worsening the condition of the heart of the patients. This class of drug is also seen to help in the widening if the blood vessels helping the blood to flow smoothly through the arteries thereby reducing blood pressure. Researchers have stated that this drug mainly helps the left ventricle of the heart to fill in more blood completely which it was unable to do in the diseased condition. Researchers have also stated that this drug is extremely useful for the patients who have heart failure along with high blood sugar levels. Randomized control trial of this class of medication as put forward a number of drugs like bisoprolol, carvediol as well a s metoprolol (Ong et al., 2016). They have already proven to be one of the most successful drug categories that are helpful in overcoming the symptoms of congestive heart failure. This class of drug is seen to be reducing the different destructive effects of the stimulation of catecholamine and thereby helps in treating both systolic dysfunction and diastolic heart failure. Patients who develop congestive heart disorders are usually seen to go through a number of similar sequential symptoms as their conditions worsen. Shortness of breath and irregular and rapid beating results in poor condition of the patient that makes them anxious. Their symptoms also remain associated with the occurrence of edema, weight loss, nauseas, and loss of weight as well as fatigue. Therefore, when such patients are admitted to the emergency ward, the professionals should follow a sequential pattern of attending the emergency so that the patient remains to danger. The first step of the professionals is to set focus on the in-patient admission which sold be followed by faster diagnosis of the acute and decompensate condition of the heart failure (Hasanpour et al., 2016). This would be followed by proper management in-patient care and then planned discharge of the individual patient after reassessment or transferring her to the general ward. The priority of the professionals wo uld not be on the long-term management of the disorders but solely on the making, the patient come out of risk and danger situations. On arrival of the patient in the emergency department, the healthcare professionals should first take into consideration prompt recognition of the condition of the patient after properly assessing the signs and symptoms of the disorder. Secondly, it is very important for the professionals to alleviate the different emotional as well as the physical symptoms of the breathlessness and therefore the professionals should transfer her to a proper and safe environment to assure optimization of the outcomes. Researchers are of the opinion that every emergency department should possess the triage nurses for acute heart failure but a nurse practitioner can also perform the activity of such nurses are not present in the ward. The professionals should conduct an assessment of the severity only after properly eliciting the history of the patient. Following this, the nurse should be referring a proper multidisciplinary team and appoint the team to the patient at the same time of helping the membe rs for properly distinguishing the case of breathlessness and thereby initialing prompt symptom for relieving therapy (Buck et al., 2015). The nurses of the emergency department need to possess an important number of skills that help them to provide best care to patients. These are proper critical thinking skills and proper decision-making ability as well as be rapid and self confident in the activities. The expanded skills set of the nurses would be mainly helping in conducting of proper diagnostic assessment of the patient through clinical examination. They should identify proper signs of the congestions by conducting diagnostic tests like sonograms, heart scan, electrocardiogram, chest x ray and others. This would be followed by properly transferring the patient to appropriate level for care like the cardiology ward, general medial ward or coronary care unit (Rai et al., 2017). In order to know, whether the person is responsive to the interventions like medical administrations given to her under emergencies, the nurses should conduct objective monitoring to identify different changes in the signs and symptoms of the patient after administration. Immediately after medicine administration, the nurse should properly monitor from time to time to assess the objective measurement of hemodynamic status, heart rhythm, dyspnoea severity, and cardiac output as well as others. However, before shifting the patient to general ward, the nurse should re-assess the patient for symptoms of congestion, management of the levels of anxiety as well as the analyzing of the laboratory blood tests. References: Buck, H. G., Harkness, K., Wion, R., Carroll, S. L., Cosman, T., Kaasalainen, S., ... Strachan, P. H. (2015). Caregivers contributions to heart failure self-care: a systematic review.European Journal of Cardiovascular Nursing,14(1), 79-89. Carpenter, J. E., Short, N., Williams, T. E., Yandell, B., Bowers, M. T. (2015). Improving congestive heart failure care with a clinical decision unit.Nursing Economics,33(5), 255. Carthon, J. M. B., Lasater, K. B., Sloane, D. M., Kutney-Lee, A. (2015). The quality of hospital work environments and missed nursing care is linked to heart failure readmissions: a cross-sectional study of US hospitals.BMJ Qual Saf, bmjqs-2014. Feltner, C., Jones, C. D., Cen, C. W., Zheng, Z. J., Sueta, C. A., Coker-Schwimmer, E. J., ... Jonas, D. E. (2014). Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis.Annals of internal medicine,160(11), 774-784. Hasanpour-Dehkordi, A., Khaledi-Far, A., Khaledi-Far, B., Salehi-Tali, S. (2016). The effect of family training and support on the quality of life and cost of hospital readmissions in congestive heart failure patients in Iran.Applied Nursing Research,31, 165-169. Luttik, M. L., Jaarsma, T., Strmberg, A. (2016). Changing needs of heart failure patients and their families during the illness trajectory: a challenge for health care. Mebazaa, A., Yilmaz, M. B., Levy, P., Ponikowski, P., Peacock, W. F., Laribi, S., ... McDonagh, T. (2015). Recommendations on pre?hospital early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine.European journal of heart failure,17(6), 544-558. Mebazaa, A., Yilmaz, M. B., Levy, P., Ponikowski, P., Peacock, W. F., Laribi, S., ... McDonagh, T. (2015). Recommendations on pre?hospital early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine.European journal of heart failure,17(6), 544-558. Ong, M. K., Romano, P. S., Edgington, S., Aronow, H. U., Auerbach, A. D., Black, J. T., ... Ganiats, T. G. (2016). Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the better effectiveness after transitionheart failure (BEAT-HF) randomized clinical trial.JAMA internal medicine,176(3), 310-318. Rai, M., Sharma, K. K., Seth, S., Pathak, P. (2017). A randomized controlled trial to assess effectiveness of a nurse-led home-based heart failure management program.Journal of the Practice of Cardiovascular Sciences,3(1), 28. Vedel, I., Khanassov, V. (2015). Transitional care for patients with congestive heart failure: a systematic review and meta-analysis.The Annals of Family Medicine,13(6), 562-571.