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Emergency Nursing

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By Craig Button Clinical Nurse Educator and current grad student
Patricia Conley
The need for highly skilled and knowledgeable critical care nurses continues to evolve today and will in the future. Demands in critical care medicine for nurses with advanced degrees (master's in nursing: clinical nurse specialist; or doctorate in nursing: doctorate of philosophy in nursing or doctor of nursing practice) working in intensive care units or progressive care units can help meet these challenges. Nurses with certification and advanced degrees in nursing can be employed to work in 1 or combined roles such as nurse leaders and nurse researcher or intermittently fulfill roles as bedside nurses...
March 2019: Dimensions of Critical Care Nursing: DCCN
Jennifer L White, Judd E Hollander, Anna Marie Chang, Daniel K Nishijima, Amber L Lin, Erica Su, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino, Carol L Clark, Deborah B Diercks, Bret A Nicks, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, Benjamin C Sun
BACKGROUND: Syncope is a common chief complaint among older adults in the Emergency Department (ED), and orthostatic vital signs are often a part of their evaluation. We assessed whether abnormal orthostatic vital signs in the ED are associated with composite 30-day serious outcomes in older adults presenting with syncope. METHODS: We performed a secondary analysis of a prospective, observational study at 11 EDs in adults ≥ 60 years who presented with syncope or near syncope...
March 25, 2019: American Journal of Emergency Medicine
Chao Liu, Guangming Lu, Dong Wang, Yi Lei, Zhi Mao, Pan Hu, Jie Hu, Rui Liu, Dong Han, Feihu Zhou
INTRODUCTION: Fluid resuscitation is a fundamental component of the management of critically ill patients, but whether choice of crystalloid affects patient outcomes remains controversial. Therefore, we performed this meta-analysis to compare the efficacy and safety of balanced crystalloids with normal saline. METHODS: We searched the MEDLINE, Cochrane Central and EMBASE up to October 2018 to identify randomized controlled trials (RCTs) that compared balanced crystalloids versus normal saline in critically ill patients...
March 1, 2019: American Journal of Emergency Medicine
François Dépret, W Frank Peacock, Kathleen D Liu, Zubaid Rafique, Patrick Rossignol, Matthieu Legrand
PURPOSE: To review the mechanisms of action, expected efficacy and side effects of strategies to control hyperkalemia in acutely ill patients. METHODS: We searched MEDLINE and EMBASE for relevant papers published in English between Jan 1, 1938, and July 1, 2018, in accordance with the PRISMA Statement using the following terms: "hyperkalemia," "intensive care," "acute kidney injury," "acute kidney failure," "hyperkalemia treatment," "renal replacement therapy," "dialysis," "sodium bicarbonate," "emergency," "acute...
February 28, 2019: Annals of Intensive Care
Amy J Barton
No abstract text is available yet for this article.
March 1, 2019: Journal of Nursing Education
Markos Karavitakis, Iason Kyriazis, Muhammad Imran Omar, Stavros Gravas, Jean-Nicolas Cornu, Marcus J Drake, Mauro Gacci, Christian Gratzke, Thomas R W Herrmann, Stephan Madersbacher, Malte Rieken, Mark J Speakman, Kari A O Tikkinen, Yuhong Yuan, Charalampos Mamoulakis
CONTEXT: Practice patterns for the management of urinary retention (UR) secondary to benign prostatic obstruction (BPO; UR/BPO) vary widely and remain unstandardized. OBJECTIVE: To review the evidence for managing patients with UR/BPO with pharmacological and nonpharmacological treatments included in the European Association of Urology guidelines on non-neurogenic male lower urinary tract symptoms. EVIDENCE ACQUISITION: Search was conducted up to April 22, 2018, using CENTRAL, MEDLINE, Embase, ClinicalTrials...
February 14, 2019: European Urology
Corey Heitz, Justin Morgenstern, Christopher Bond, William K Milne
Atrial fibrillation is the most common cardiac dysthrymia. Several rate-control strategies have been used, and magnesium sulfate has been investigated as an adjunct. In this review, we look at a trial by Bouida et al in which magnesium sulfate was studied in two different doses for rate control in atrial fibrillation. In addition, we review the social media commentary in response to the Skeptics Guide of Emergency Medicine Hot of the Press podcast. This article is protected by copyright. All rights reserved...
February 27, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Derek C Angus
No abstract text is available yet for this article.
February 17, 2019: JAMA: the Journal of the American Medical Association
Robert G Hendrickson
While the traditional intravenous N-acetylcysteine (NAC) dosing regimen works well for the vast majority of acetaminophen overdoses, there may be cases of massive overdose where additional NAC may be necessary. Recent evidence suggests that patients with acetaminophen concentrations above the "300-line" develop hepatotoxicity at a higher rate than those below the 300-line, suggesting that an increase of dose may be beneficial at this cut-off. Additional clinical data suggest a further increase in doses at the 450-line and 600-lines...
February 19, 2019: Clinical Toxicology
Sercan Yalçınlı, Funda Karbek Akarca, Özge Can, Alper Şener, Cemile Akbinar
AIMS AND OBJECTIVES: To determine the factors affecting the first-attempt success of peripheral intravenous catheter (PIVC) placement in older emergency department patients. BACKGROUND: In older patients who require intravenous treatment, establishing a PIVC as fast as possible is clinically important. DESIGN: This is a prospective, observational, descriptive study. METHODS: Using a data collection form, researchers questioned both the patient and the nurse performing the procedure in terms of patient- and operator-related factors...
February 20, 2019: Journal of Clinical Nursing
Elisabeth De Waele, Manu L N G Malbrain, Herbert D Spapen
PURPOSE OF REVIEW: To review recent literature on the management of patients with severe acute pancreatitis (SAP) admitted to an ICU. RECENT FINDINGS: SAP is a devastating disease associated with a high morbidity and mortality. Recent evidence advocates adequate risk assessment and severity prediction (including intra-abdominal pressure monitoring), tailored fluid administration favoring balanced crystalloids, withholding prophylactic antibiotic therapy, and early detection and treatment of extra-pancreatic and fungal infections...
April 2019: Current Opinion in Critical Care
Stephen Y Liang, Daire R Jansson, Patrick G Hogan, Tyler W Raclin, Melanie L Sullivan, Carol E Muenks, Satish Munigala, Stacey L House, Stephanie A Fritz
STUDY OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) transmission dynamics in the emergency department (ED) are not well defined; environmental surfaces may serve as reservoirs for transmission. This study investigates the effect of patients with a history of MRSA colonization or infection on subsequent MRSA contamination of the ED environment. METHODS: Adult ED patients with evidence of an MRSA-positive surveillance result or clinical microbiologic culture in the year preceding their current ED visit were enrolled...
February 4, 2019: Annals of Emergency Medicine
Thomas W L Scheeren, Jan Bakker, Daniel De Backer, Djillali Annane, Pierre Asfar, E Christiaan Boerma, Maurizio Cecconi, Arnaldo Dubin, Martin W Dünser, Jacques Duranteau, Anthony C Gordon, Olfa Hamzaoui, Glenn Hernández, Marc Leone, Bruno Levy, Claude Martin, Alexandre Mebazaa, Xavier Monnet, Andrea Morelli, Didier Payen, Rupert Pearse, Michael R Pinsky, Peter Radermacher, Daniel Reuter, Bernd Saugel, Yasser Sakr, Mervyn Singer, Pierre Squara, Antoine Vieillard-Baron, Philippe Vignon, Simon T Vistisen, Iwan C C van der Horst, Jean-Louis Vincent, Jean-Louis Teboul
BACKGROUND: Vasopressors are commonly applied to restore and maintain blood pressure in patients with sepsis. We aimed to evaluate the current practice and therapeutic goals regarding vasopressor use in septic shock as a basis for future studies and to provide some recommendations on their use. METHODS: From November 2016 to April 2017, an anonymous web-based survey on the use of vasoactive drugs was accessible to members of the European Society of Intensive Care Medicine (ESICM)...
January 30, 2019: Annals of Intensive Care
A Harley, A N B Johnston, K J Denny, G Keijzers, J Crilly, D Massey
AIM: Sepsis is a significant and time-sensitive clinical concern for patients who present to Emergency Departments (EDs). Existing guidelines do not define nurses' roles in managing sepsis. This study explored ED nurses' experiences and perceptions around recognising and responding to patients with sepsis, and their awareness of sepsis screening and prognostic tools. The knowledge and insights gained from this study may be used to inform local and international ED policies, and enrich nursing educational packages that may be used to improve quality of patient care and patient outcomes...
March 2019: International Emergency Nursing
Olivier Lesur, Eugénie Delile, Pierre Asfar, Peter Radermacher
BACKGROUND: Improving sepsis support is one of the three pillars of a 2017 resolution according to the World Health Organization (WHO). Septic shock is indeed a burden issue in the intensive care units. Hemodynamic stabilization is a cornerstone element in the bundle of supportive treatments recommended in the Surviving Sepsis Campaign (SSC) consecutive biannual reports. MAIN BODY: The "Pandera's box" of septic shock hemodynamics is an eternal debate, however, with permanent contentious issues...
October 29, 2018: Annals of Intensive Care
Michael Joannidis, Sebastian J Klein, Marlies Ostermann
No abstract text is available yet for this article.
January 14, 2019: Intensive Care Medicine
Diane K Newman
Urinary incontinence (UI) is one of the most common conditions among residents of post-acute and long-term care facilities. UI is seen in at least 55% of nursing home residents and is the second leading cause of institutionalization of older adults. UI has been shown to be an independent risk factor for unplanned hospitalization of home care individuals. Prompted voiding (PV) is a toileting program that combines scheduled voiding with "prompting" from a caregiver and is appropriate for older adults with all types of UI and in individuals who may have impaired cognitive function...
February 1, 2019: Journal of Gerontological Nursing
Christopher W Jones, Lauren B Remboski, Brian Freeze, Valerie A Braz, John P Gaughan, Samuel A McLean
STUDY OBJECTIVE: The objective of this pilot study is to assess the feasibility and necessity of performing a large-scale trial to measure the effect of intravenous fluid therapy on migraine headache pain. METHODS: This was a single-center, pilot randomized controlled trial. We randomized adult emergency department migraine headache patients to receive 1 L of normal saline solution during 1 hour (fluid group) or saline solution at 10 mL/hour for 1 hour (control group)...
February 2019: Annals of Emergency Medicine
Christopher E Grigoriadis, David P Cork, Walter Dembitsky, Brian E Jaski
BACKGROUND: The United States has recently undergone increases in the legalization and use of marijuana. There have been previous reports on the association of cannabis use and myocardial dysfunction, however, few on the association with acute stress cardiomyopathy and cardiogenic shock. CASE REPORT: This is a case of a 58-year-old female with a history of inhaled cannabis use, no history of diabetes, and no known history of cardiac disease, that illustrates an association between cannabis use and the recurrent development of stress cardiomyopathy and cardiogenic shock...
January 10, 2019: Journal of Emergency Medicine
Teresa Bigand, Cristina Lee Anderson, Mary Lee Roberts, Michele Rose Shaw, Marian Wilson
BACKGROUND: Increasingly, states are legalizing cannabis for recreational use. Improved accessibility may allow adults with pain to use cannabis more liberally. Greater understanding is needed about how adults with pain perceive the effects of cannabis, particularly those who also use opioid analgesics. PURPOSE: To examine the perceived effects of cannabis among adults who have been prescribed opioids for persistent pain. METHODS: A survey-based study was conducted on 150 adults with persistent pain...
December 13, 2018: Nursing Outlook
2019-01-22 12:25:36
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