The Advanced Practice Practitioner in Emergency Care works as an educator, advocate and care provider and is responsible for the care and well-being of patients in the Michael and Susan Smith Emergency Department by functioning as a direct provider of emergency services

SUPPLEMENTAL JOB FUNCTIONS:

• Assess and triages a patient’s condition by obtaining a focused and pertinent history, identifying risk factors, performing an appropriate focused/complete physical examination, and by ordering and/or providing preventive or diagnostic procedures.
• Develops a differential diagnosis and/or diagnoses of both life threatening and non-life threatening conditions by utilizing critical thinking while simultaneously synthesizing and
analyzing patient data. ENPs establish a differential diagnosis based on the patient’s medical history, physical exam findings, interpretation of diagnostic studies, while continually establishing priorities to meet the needs of the patient, their family, and or the community.
• Utilize critical thinking during medical screenings and diagnostic processes by synthesizing and analyzing the data to execute a plan of care including stabilization, resuscitation of unstable conditions and the transfer of care when appropriate.
• Provides medical screening evaluations in accordance with the EMTALA. This includes:
o Documentation of the chief complaint and pertinent history incorporating health risk factors
o Physical exam findings
o Interpretation of diagnostic data including the rationale for the medical necessity of tests
o Medical decision making with differential diagnosis
o On-going evaluation of patient progress and response to treatment to determine the plan of care.
• Collaborates with staff of affiliated institutional facilities to provide care for patients receiving care in the Michael and Susan Smith Emergency Department
• Collaborates with transitional support team, inpatient teams, physical therapy and other health care providers to ensure a seamless transition to inpatient units or care within the community.
• Determines most appropriate patient disposition
• Confers with patient’s primary care provider as needed
• Communicates via Epic outstanding patient problems and issues requiring follow up care
• Management of patient health/illness status
o Triages patients’ health needs/problems
o Completes EMTALA-specified medical screening examinations
o Responds to the rapidly changing physiological status of emergency care for the assessment, treatment, and disposition of acute and chronically ill and injured emergency patients.
o Specifically assesses and initiates appropriate interventions for violence, neglect and abuse.
o Specifically assess and initiates appropriate interventions and disposition for suicide risk
o Participates in internal and external emergencies, disasters, and pandemics.
o Maintains awareness of known causes of mass casualty incidents and treatment modalities required for emergency care.

The following may be done independently based on scope of practice and credentialing or in partnership with the ER staff physician:
o Assess and manages a patient in cardiopulmonary arrest
o Assess and obtain advanced circulatory access
o Ultraviolet examination of skin and secretions
o Treat skin lesions
o Injects local anesthetics
o Nail trephination
o Toe nail removal
o Nail bed closure
o Wound revision for closure
o Debridement of wounds/ minor burns
o Incision, drainage, irrigation of wounds and packing.
o Eye dilatation
o Tonometry to asses intraocular pressure
o Slit lamp examination
o Cerumen impaction curettage
o Control epistaxis
o Needle thoracotomy for life threatening conditions in emergency situations.
o Replace gastrostomy tube
o Assess and manage cervical spine injuries
o Lumbar puncture
o Incise and drain Bartholin’s cyst
o Assist with imminent childbirth and post-delivery maternal care
o Fecal impaction removal
o Incision of thrombosed hemorrhoids
o Digital nerve block
o Reduction of fractures of small bones
o Reduction of fractures of large bones with vascular compromise (ie. traction splint)
o Application of immobilization devices
o Remove casts
o Arthrocentesis (knee/elbow)

• ACLS certification
• Additional privileging as requested to perform procedures independently:
o Arterial line placement
o Arthrocentesis
o Nerve block
o Fracture reduction
o Lumbar puncture.
o Cast and splint
o Chest tube placement/removal
o Chest x-ray review
o Digital, hematoma, and intraarticular blocks
o Central and femoral venous catheter placement/removal
o Joint aspiration
o Joint injection: tendon sheaths, ligaments, trigger points, ganglion cysts, bursa
o Paracentesis
o Taping and bracing
o Fracture reduction
• Maintains competency in area of expertise
• Specialty certification if available/eligible