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Advanced Emergency Nursing Journal

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January 2019: Advanced Emergency Nursing Journal
LaʼKita M J Knight, Elijah O Onsomu, Hayden B Bosworth, Regina D Crawford, Theresa DeMartino, Jeffrey Glassberg, Judith A Paice, Christopher N Miller, Lynne Richardson, Paula Tanabe
Treatment of vaso-occlusive episodes (VOEs) is the most common reason for emergency department (ED) treatment of sickle cell disease (SCD). We (1) compared perceptions of the usability and ability to manage VOE pain between ED nurses and other ED provider types, ED sites, and VOE protocols (individualized vs. weight-based), and (2) identified ED nurse and other provider protocol suggestions. A secondary analysis of provider survey data collected immediately after caring for a patient enrolled in a randomized controlled trial comparing weight-based versus individualized opioid dosing for VOE...
January 2019: Advanced Emergency Nursing Journal
Dale Bowers, Melissa Mason, Molly Clinkscales
Salicylates are among the oldest and most widely used medication to date and are utilized for a variety of purposes including the management of fever, inflammation, pain, and cardiovascular prophylaxis. Reports from U.S. Poison Control Centers indicate that over 40,000 Americans are exposed to salicylate-containing substances annually, and although generally deemed safe, fatal intoxications can occur from a single ingestion. Although some ingestions are intentional, many are not, and are a result of the prevalence of salicylates in a wide array of prescription and over-the-counter substances...
January 2019: Advanced Emergency Nursing Journal
Judith K Glann, Margaret Carman, Julie Thompson, David Olson, Cynthia Nuttall, Holly Fleming, Cheryl Reese
Alcoholism continues to be a persistent health problem in the United States, accounting for up to 62% of emergency department (ED) visits. This quality improvement (QI) project examined whether identifying the benefit for early use of Alcohol Use Disorders Identification Test (AUDIT C) and Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIW-ar) in the ED would avoid escalation of care and offset poor outcomes of alcohol withdrawal syndrome (AWS). A preimplementation chart review (N = 99) showed an average of 12%-15% of patients requiring escalation of care at the project site...
January 2019: Advanced Emergency Nursing Journal
Jordan A Woolum, Abby M Bailey, Regan A Baum, Elise L Metts
Stevens-Johnson syndrome and toxic epidermal necrolysis represent a spectrum of severe cutaneous adverse reactions that carry the potential for severe, long-term adverse effects, including death. Although medications are most commonly implicated in the development of these diseases, other factors, including infection and genetics, play a role. Management is generally supportive in nature and includes maintenance of the patient's airway, breathing, and circulation. Special disease considerations include the use of skin barrier management, unique infection prevention measures, and systemic immunomodulatory therapies...
January 2019: Advanced Emergency Nursing Journal
Mehdi Momeni, Elnaz Vahidi, Mohsen Badrizadeh, Zeinab Naderpour, Morteza Saeedi
Pain control is an important concern in limb trauma. The most ideal agent for this purpose varies among different hospitals. The objective of this study was to compare the analgesic effect of oral diclofenac potassium versus intravenous acetaminophen in patients with limb trauma. This was a double-blind randomized clinical trial conducted on 60 adult patients. Oral diclofenac potassium (50 mg) was given in Group D, and intravenous acetaminophen (1 g in 500 ml normal saline over 20 min) was administered in Group A...
January 2019: Advanced Emergency Nursing Journal
Mingshuang Ding, Stephen Aitchison, Edward Pink, Peter Brown, Victoria Ie Ching Tan
This article discusses the implementation of 3 targeted interventions aimed at reducing infection rates in patients due to prolonged in situ intravascular catheters (IVCs) during their admission to the hospital. These IVCs are inserted by paramedics with Queensland Ambulance Service (QAS) in prehospital settings. The 3 interventions involved were the application of "QAS-IVC" stickers by QAS paramedics to indicate QAS-inserted IVCs, the implementation of mandatory IVC documentation during patient handover, and clinician engagement to provide patient education on IVC infection signs...
January 2019: Advanced Emergency Nursing Journal
Amy Lannen, Christopher Destephano, Jennifer Wilbeck
For women who present with Bartholin's abscesses, placement of a Word catheter offers a minimally invasive approach for effective management in urgent care and emergency department settings. Although the procedure is relatively simple, the frequency of placement in the ED setting varies. Provider familiarity with both the device and the procedure can be enhanced using simulation techniques. This article presents the diagnostic and treatment approaches to Bartholin's abscesses and describes in detail both low- and high-fidelity simulations for Word catheter placements...
January 2019: Advanced Emergency Nursing Journal
Tracie Gadler, Sally Huey, Kelly Hunt
Fournier's gangrene is a rare disease with a significant mortality rate. The potentially fatal disease stems from both aerobic and anaerobic bacteria and primarily occurs in men. The majority of Fournier's gangrene cases are idiopathic or derived from perineal and genital skin infections. Comorbid risk factors include diabetes mellitus, alcohol misuse, and immunosuppression (). The infection initially presents as a cellulitis in the perineum or perianal area. As Fournier's gangrene progresses, the infected tissue becomes swollen, significantly painful, and necrotic...
January 2019: Advanced Emergency Nursing Journal
Hillary R Gargotta
Acute aortic dissection is a life-threatening condition with the potential for serious complications such as myocardial infarction, heart failure, stroke, paraplegia, renal failure, mesenteric ischemia, and limb ischemia. Emergency department clinicians must be aware of the potential ischemic complications of aortic dissection and act quickly to prevent irreversible organ damage and death. This article highlights a case of a 49-year-old man who developed renal and lower extremity malperfusion secondary to Stanford Type A aortic dissection...
January 2019: Advanced Emergency Nursing Journal
Kayla A Nichols, Christopher A Paciullo
Ketamine is an anesthetic known globally both for its potent dissociative properties and potential for abuse. More recently, ketamine demonstrates utility in a variety of disease states such as treatment-resistant depression, status asthmaticus, and acute agitation. In addition, ketamine has been shown to demonstrate various effects at different doses, which adds to its pharmacological benefit. As these new indications continue to come to light, it is important to stay current with the dosing for these indications as well as the adverse effects associated with ketamine's use...
January 2019: Advanced Emergency Nursing Journal
Denise R Ramponi, Caron Baker
Sever's disease, or calcaneal apophysitis, is the primary cause of heel pain in pediatric patients between the ages of 8 and 15 years. Primary risk factors in pediatric athletes are obesity and high levels of physical activity. Sever's injury primarily results from high-impact sports such as soccer, track, cross-country, gymnastics, tennis, and ballet. This injury mainly occurs during puberty with an open growth plate in the immature calcaneus. Clinical diagnosis can be confirmed by performing a "squeeze test" of the heel on physical examination...
January 2019: Advanced Emergency Nursing Journal
Trisha Sheridan, Dian Dowling Evans
The Research to Practice column is designed to provide advanced practice nurses (APRNs) with an analysis of a current research topic with implications for practice change within emergency care settings. This review examines a recent study conducted by , titled "Emergency Department Visits for Sexual Assault by Emerging Adults: Is Alcohol a Factor?" The authors conducted a retrospective chart review of emergency department (ED) visits for sexual assault among a college-age population and found most patients were female (98%) and 70% were younger than 21 years...
January 2019: Advanced Emergency Nursing Journal
(no author information available yet)
No abstract text is available yet for this article.
January 2019: Advanced Emergency Nursing Journal
Julia Gilbert, Jane Boag
People have tattooed themselves for thousands of years, and it remains popular with various groups across mainstream society. Although many people choose tattoos that express their life philosophy, epic events in their life, or their personal mantra, the use of tattooing in medicine such as a "do not resuscitate" tattoo is increasingly becoming more common (; ). As these tattoos do not meet the legal requirements for an advance health directive, they are at best a guide to the person's wishes and at worst a useless, painful exercise...
October 2018: Advanced Emergency Nursing Journal
Päivi Leikkola, Riitta Mikkola, Mari Salminen-Tuomaala, Eija Paavilainen
Making nonconveyance decisions can be demanding for care providers in prehospital emergency services. Studies have found homecare instructions and counseling of patients and family members partly insufficient. A descriptive cross-sectional design was applied for this pilot study to explore emergency patients' and family members' experiences of nonconveyance situations and counseling. Data were collected by questionnaires from acutely ill patients (n = 97) treated on-site and not transported to hospital and from their family members (n = 72) in 2015-2016...
October 2018: Advanced Emergency Nursing Journal
Binnara Yoo, Brigit Vangrafeiland
Urinary symptoms, such as dysuria, urinary urgency, frequency, and suprapubic pain, are frequent complaints made in the emergency department (ED; ). Although it is easy to relate urinary symptoms with a urinary tract infection (UTI), both UTI and sexually transmitted disease (STD) can share same urinary symptoms that mask each other from detection. It presents challenges for ED clinicians to precisely distinguish between two infections, causing misdiagnosis and mistreatment, resulting in patient morbidity and high health care costs...
October 2018: Advanced Emergency Nursing Journal
Amanda B Comer
Skin and soft tissue infections are a common complaint seen in the emergency setting, with diagnosis traditionally made by history and physical examination alone. Cellulitis and cutaneous abscesses are often misdiagnosed. Because cellulitis and cutaneous abscesses can appear similar in presentation, they are often misdiagnosed and thus treated inappropriately. To improve accuracy of diagnosis and thus treatment, evidence now supports the use of point-of-care ultrasound for diagnosis of skin and soft tissue infections...
October 2018: Advanced Emergency Nursing Journal
Nicole Martinez, Serena Arts
An estimated one million cases of herpes zoster are reported in the United States annually. Although most cases of herpes zoster are self-limiting and require little interventions, some occurrences can result in potentially debilitating and/or life-threatening outcomes. The purpose of this article is to discuss the incidence, potential complications, treatment, and preventive measures of herpes zoster. A case report is utilized to emphasize the importance of a thorough evaluation and consideration of complications...
October 2018: Advanced Emergency Nursing Journal
Philip Davis, Paula Tucker
The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse and the emergency nurse, and to assist with the translation of research into practice. For each column, a topic and a research study are selected. The stage is set with a case presentation. The research article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. In the current column, we examine the findings of A. from their article titled "An Iceberg Phenomenon in Dementia: Pain...
October 2018: Advanced Emergency Nursing Journal
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