Healthcare

Supreme Court rules that the emergency room nurse must assess the severity of patients

The Supreme Court emphasises the crucial role of the nurse in assessing the severity of patients in the emergency room

La Cassazione stabilisce che l’infermiere del pronto soccorso deve valutare la gravità dei pazienti (Ansa)

2' min read

2' min read

The emergency room nurse is not only required to fill in the person's data, but also to offer an assessment of the severity of their condition.

This was pointed out by the Court of Cassation in its ruling No. 15076 of the Fourth Criminal Section, filed yesterday, in which the appeal of a nurse's defence against the ruling that there was no need to proceed due to the statute of limitations and the sentence, however, to repay damages in a case brought for manslaughter, was rejected.

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Facts

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The nurse on duty in an emergency room was alleged to have neglected to correctly assess the gravity of the clinical picture of a woman, an asthmatic subject, when she entered the facility, giving her a green access code, which led to a delay in medical intervention, causing the death of the patient from cardiac arrest due to a severe asthma attack.

The 2001 Guidelines

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Central, as is usually the case in medical malpractice proceedings was the Court of Cassation's assessment of the guidelines of reference, consisting of those on triage published by the State-Regions Conference on 25 October 2001. This is a fundamental element in determining the degree of culpability.

The role of triage

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More in detail then, the 2001 Guidelines emphasised how triage must be carried out by an experienced and specifically trained nurse, always present in the reception area of the emergency room, who is able to consider the signs and symptoms of the patient to identify potentially life-threatening conditions. The nurse is then entrusted with the determination ofa severity code to prioritise access to the medical examination.

The steps to be followed

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Properly understood triage activity then comprises, the Guidelines specify, a number of steps: collection of data from any medical records, information from family members and rescuers, detection vital parameters and registration.

The interventions

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Hence the need, recalls the Court of Cassation, for an intervention that cannot be limited to the detection of vital parameters but must include an assessment of the symptoms detected. And so the nurse's task cannot be limited to a mechanical filling in of forms but, even if it is not up to him the formulation of the diagnosis, it must include a series of actions that can help prevent the clinical situation from precipitating, such as, in the case examined by the judges, a punctual auscultation with a stethoscope that would have highlighted all the symptoms of a serious attack.

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