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Pharmacologic Management During Therapeutic Hypothermia

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Characteristics of Patients Who Return to the Emergency Department Within 72 Hours in One Community Hospital

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

This study identifies characteristics of patients who return to the emergency department (ED) within 72 hr after an initial visit. An exploratory quantitative descriptive study was conducted to identify characteristics of patients with unscheduled 72 hr ED returns. The sample consisted of all patients with 72 hr ED return visits for the month of January 2009 at the study facility. Data were collected from electronic patient records utilizing the National Hospital Ambulatory Medical Care Survey instrument modified to eliminate patient identifiers. There were 169 individuals who had at least one 72 hr return visit to the ED for a total of 393 initial and return ED visits. The most common diagnoses were for gastrointestinal complaints. Over a third of the patients who returned had chronic hea...

Level 2 and Level 3 Patients in Emergency Severity Index Triage System: Comparison of Characteristics and Resource Utilization

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

There is a lack of studies examining distinctions between patients assigned to Level 2 (high risk) and Level 3 (lower risk) in the 5-level ESI triage system. Describing patients assigned to Level 2 and Level 3 may identify unique characteristics related to chief complaint, interventions, and resource needs. A convenience sample of triage nurses was recruited from 2 emergency department (ED) sites. If, at the completion of the patient–nurse triage interaction, the nurse assigned the patient to either Level 2 or Level 3, additional clinical data related to that patient were collected from the ED medical record. Eighteen triage nurses participated in the study with 334 nurse–patient triage interactions collected. Patients presenting with a chief complaint of nausea and vomiting or having ...

Therapeutic Hypothermia Initiated in the Pre-Hospital Setting: A Meta-Analysis

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

After resuscitation of the cardiac arrest patient, reperfusion to the brain begins a cascade of events that may lead to permanent brain damage. Cooling suppresses the inflammatory response related to ischemia and metabolic demand, improving oxygen supply to anoxic areas. Until recently, cooling was only performed in the hospital setting. Recent studies have questioned whether initiating the cooling process immediately after resuscitation is beneficial in the pre-hospital setting. The primary purpose of this study was to examine the feasibility and safety of pre-hospital hypothermia via data extraction from randomized controlled trials and statistical meta-analysis. Studies included in this analysis did show a significant statistical difference with the ability to lower the body temperature...

“Here Comes Santa Claus”: What Is the Evidence?

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

The purpose of this article is to examine the strength of evidence regarding our holiday Santa Claus (SC) practices and the opportunities for new descriptive, correlation, or experimental research on SC. Although existing evidence generally supports SC, in the end we may conclude, “the most real things in the world are those that neither children nor men can see” (Church, as cited in Newseum, n.d.). (Source: Advanced Emergency Nursing Journal)

Diagnosing and Treating Mild Traumatic Brain Injury in Children

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

Review of recent evidence with translation to practice for the advanced practice nurse role is presented using a case study format for “Mild Traumatic Brain Injury in Children.” This “short review” describes the state of the science regarding diagnosis and treatment of mild traumatic brain injury in children, demonstrating multiple challenges to synthesizing existing research into practice guidelines. Implications of this lack of clear research evidence on advanced practice nursing are discussed along with suggestions for using alternative sources of evidence. (Source: Advanced Emergency Nursing Journal)

Differential Diagnosis of Acute Heart Failure: Brain Versus Heart

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

Arrhythmias to transient cardiac failure have been reported in aneurysmal subarachnoid hemorrhage. The cardiac dysfunction can mimic an acute myocardial infarction, and in the presence of severe neurological compromise, careful observation is needed to differentiate the etiology of cardiac failure. Accurate history, rapid assessment, and interpretation of diagnostics are essential to determine the accurate diagnosis and in identifying appropriate treatment. (Source: Advanced Emergency Nursing Journal)

Why We Need Nurse Practitioner Emergency Specialty Certification

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Management of Hypertensive Emergency and Urgency

Advanced Emergency Nursing Journal — Sat, 01 Oct 2011 05:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

AENJ Adopts Uniform Disclosure Form

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 05:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Use of a Clinical Decision Support Tool to Improve Guideline Adherence for the Treatment of Methicillin-Resistant Staphylococcus aureus: Skin and Soft Tissue Infections

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

This study was conducted to examine whether the development of a CDS tool to guide order entry for the treatment of MRSA-related SSTI's and embed it into the electronic medical record program would improve provider adherence to the North Carolina Consensus Guideline for Management of Suspected Commmunity-Acquired MRSA Skin and Soft Tissue. (Source: Advanced Emergency Nursing Journal)

A 15-Year-Old Male With Persistent Knee Pain

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

Most children and adolescents who present with extremity pain in the emergency department (ED) have minor injuries or musculoskeletal problems that are easily diagnosed and managed. A history of a child or teenager with persistent extremity pain lasting more than a few weeks or pain that wakes the child at night is of clinical concern and requires investigation. There are serious clinical etiologies that must be included in the differential diagnosis of this group of patients. It is essential to take the time during the initial screening examination to determine the real reason for each patient ED visit and review previous medical care. (Source: Advanced Emergency Nursing Journal)

Pharmacologic Anticoagulation Reversal in the Emergency Department

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Touch Wood

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Not All Spinal Cord Injuries Involve a Fracture

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

A middle-aged unrestrained driver involved in a minor motor vehicle crash arrived in the emergency department in complete spinal immobilization. The patient was initially moving both arms and legs spontaneously to commands, crying out in pain and complaining of pain out of proportion to his physical injuries. The only visible injury was a minor abrasion to the forehead. Spinal cord injuries related to trauma are not always obvious. Central cord syndrome (CCS) should be included in the differential diagnosis for spinal cord injuries, even with a minor hyperextension injury without a cervical spine fracture. This case study outlines the etiology, pathophysiology, diagnostic tests, and management of a patient with CCS. (Source: Advanced Emergency Nursing Journal)

Transient Neurologic Syndrome: A Benign but Confusing Clinical Problem

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

Spinal anesthesia has been a safe and popular anesthetic option for patients undergoing outpatient surgical procedures of the trunk and lower extremities. Occasionally, after a spinal anesthetic, patients can develop moderate-to-severe pain in the back, hips, and legs without neurologic deficit. They will often present to the emergency department with complaints of pain and require an extensive diagnostic workup to rule out other more ominous possibilities such as spinal hematoma, infection, or nerve injury. After a negative workup and with a history of recent spinal anesthetic the patient will be diagnosed with transient neurologic syndrome. While often causing significant distress to both the patient and health care provider, transient neurologic syndrome is a benign, self-limited entity...

Pharmacologic Anticoagulation Reversal in the Emergency Department

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

Anticoagulation therapies are 1 of the most commonly encountered therapeutic areas by health care professionals each day. One of the most important adverse effects of anticoagulation therapy is life-threatening hemorrhage, and it may result in visits to the emergency department. Some of the common reversal agents include Vitamin K, protamine sulfate, desmopressin, recombinant Factor VIIa, and prothrombin complex concentrates. Each of these agents has the potential to reverse specific anticoagulation therapies, but each agent has a unique administration procedure and monitoring parameters. However, these agents are not without risk of adverse effects. Knowledge of unique aspects of each reversal agent and the anticoagulation therapy must be considered when selecting or recommending pharmaco...

Primary Headache Disorders in the Emergency Department

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

This article focuses on an important consideration in the management of primary headache disorders provided by ED clinicians—the prevention of headache recurrence through thorough patient education and the identification and modification of risk factors. (Source: Advanced Emergency Nursing Journal)

What Is Effective Acute Migraine Treatment in the Emergency Department?

Advanced Emergency Nursing Journal — Fri, 01 Jul 2011 00:00:00 +0100

A review of recent evidence with translation to practice for the role of advanced practice nurse is presented using a case study module for “What Is Effective Acute Migraine Treatment in the Emergency Department?” The study results showed patients who received prochlorperazine with diphenhydramine had better pain management than those in the sumatriptan group. The implications and clinical relevance of these findings for advanced practice nurses are discussed, highlighting best evidence. (Source: Advanced Emergency Nursing Journal)

Mild Traumatic Brain Injury: A Midwest Survey of Discharge Teaching Practices of Emergency Department Nurses

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

Research indicates that the assessment and discharge teaching practices for persons with traumatic brain injury are more focused on ruling out severe brain injury and informing the person about “red flags” warranting a return visit to the medical provider. Our primary purpose was to determine the extent to which discharge practices were aligned with the Centers for Disease Control and Prevention guidelines contained within the Acute Concussion Evaluation care plan. Responses from 87 nurses (25.0% response rate) to a tailored survey were analyzed to determine emergency department nurses’ discharge teaching practices for adults who experienced a mild traumatic brain injury (MTBI). Results indicated that nurses in general were focused on injury-specific information and less often provid...

Advanced Practice Registered Nursing Consensus Model: Where Are We Now?

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Health Care in Rural Hospitals: A Role for Nurse Practitioners

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

Disparities in rural health care are associated with poor patient outcomes. There is a need to further evaluate opportunities to bridge the gaps and improve rural health care. This descriptive, exploratory study examined the current and potential expanded use of nurse practitioners (NPs) in rural hospitals of one Midwestern state. Surveys (N = 136) were mailed to chief executive officers (n = 68) and chief nursing officers (n = 68) of rural hospitals in Nebraska with a response rate of 57.3% and 80.8%, respectively. The majority of respondents represented critical access hospitals. A convenience sample of NPs (N = 19) who practiced in rural communities also completed written surveys. Findings identified potential opportunities to expand the use of NPs to provide emergency department covera...

An Update on Hereditary Angioedema: Part I

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

An Update on Hereditary Angioedema

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

Hereditary angioedema affects approximately 1 in 50,000 individuals without gender or ethnic preference. Hereditary angioedema is caused by a decreased level (type I) or function (type II) of C1 inhibitor. Patients experience repeated episodes of angioedema involving sites that include the face, extremities, gastrointestinal tract, and larynx. Treatment involves measures to increase functioning levels of active C1 inhibitor through stimulation of endogenous pathways or exogenous supplementation. Additional therapies targeted at inhibition of bradykinin can also be used to treat episodes of angioedema. Treatment may be indicated for both acute episodes of angioedema and prevention of future episodes. (Source: Advanced Emergency Nursing Journal)

Implementing the Hypothermia Protocol: A Case Study

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

This article discusses the pathophysiology, use of the hypothermia protocol and also inclusion and exclusion criteria. Educational information within the article provides guidelines for the advanced practice nurse regarding the use of therapeutic hypothermia in resuscitated patients. (Source: Advanced Emergency Nursing Journal)

Intimate Partner Violence, Depression, and Substance Abuse in Women Presenting to Emergency Departments for Care

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

The Research to Practice column is intended to elevate the research critique skills of the advanced practice nurse and to assist with the translation of research into practice. For each column, a topic and a particular research study are selected. The stage is set with a case presentation. The research paper is then reviewed and critiqued, and finally, the implications for translation into practice are discussed with particular attention to the case study. In this column, we address the topics of intimate partner violence and substance abuse, among African American women by presenting the following study: Hankin, A., Smith, L. S., Daugherty, J., & Houry, D. (2010). Correlation between intimate partner violence victimization and risk of substance abuse and depression among African American ...

Pressure Ulcer Prevention in the Emergency Department

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

Emergency nurses rescue patients from emergencies everyday through expert prioritization in a rapidly changing environment. After stabilization, the emergency nurse can focus attention on other risk factors that predispose the patient to unnecessary health care events. The demographics of patients visiting the emergency department have changed over the past 5 years, and the length of time spent in an emergency department has increased. A pressure ulcer can develop in several hours, depending upon risk factors and use of pressure ulcer prevention activities. The emergency nurse holds a key position in pressure ulcer prevention. However, the emergency nurse's role in preventing the development of a pressure ulcer warrants further delineation. This focused literature review intends to summari...

Management of Hypertensive Emergency and Urgency

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

Severe hypertension is a frequent condition among patients presenting to emergency departments. Historically, this has been referred to as a hypertensive crisis. In addition, these hypertensive crises have been further divided into either hypertensive emergencies or urgencies depending on the presence or absence of target organ damage, respectively. The management differs between these crises in both the rapidity of blood pressure correction and the medications used. Hypertensive emergencies must be treated immediately with intravenous antihypertensive medications. However, hypertensive urgencies may be treated with oral antihypertensive agents to reduce the blood pressure to baseline or normal over a period of 24–48 hr. Appropriate identification, evaluation, and treatment of these cond...

Shoulder Pain

Advanced Emergency Nursing Journal — Fri, 01 Apr 2011 00:00:00 +0100

This article reviews specific acute injuries, chronic conditions, and radiologic considerations of patients with shoulder complaints encountered in emergency settings. (Source: Advanced Emergency Nursing Journal)

Does Gender and Ethnicity Impact Initial Assessment and Management of Chest Pain?

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

Review of recent evidence with translation to practice for the advanced practice nurse role is presented using a case study module for “racial and sex differences in emergency department triage assessment and test ordering for chest pain.” The study results showed that there might be some differences in how triage nurses approach the management of patients with chest pain on the basis of gender and ethnicity. The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting best evidence. (Source: Advanced Emergency Nursing Journal)

Wound Care and Laceration Repair for Nurse Practitioners in Emergency Care: Part II

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Understanding the Transsexual Patient: Culturally Sensitive Care in Emergency Nursing Practice

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

This article provides an understanding of challenges faced by transsexual individuals in health care access and treatment. The authors explain commonly used terminology and provide an overview of the transition process including the Diagnostic and Statistical Manual, 4th edition criteria for diagnosis and the World Professional Association of Transgender Health's Standards of Care for treatment. The authors provide important details and specific recommendations for the culturally sensitive care of transsexual patients including using the correct name and pronoun, eliminating bias and discrimination, asking appropriate questions, implementing trans-inclusive policies and guidelines, and proper record keeping. (Source: Advanced Emergency Nursing Journal)

A 54-Year-Old Woman With A Rare Case Of Drug-Induced Pancreatitis

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

Drug-induced pancreatitis is a rare cause of acute pancreatitis. Most evidence that exists on drug-induced pancreatitis is presented in case report form. A patient with probable carbamazepine-induced pancreatitis is introduced in this article. In addition to alcoholism and biliary disease as common causes of pancreatitis, this article hopes to raise an awareness of several other differential diagnoses associated with pancreatitis, including drug-induced pancreatitis. (Source: Advanced Emergency Nursing Journal)

Thanks To the Reviewers

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

A Case of Subluxation of the Radial Head: Nursemaids' Elbow

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

Nursemaid's elbow (subluxation of the radial head) is a common pediatric upper extremity injury encountered in the emergency and urgent care settings. Subluxation of the radial head accounts for more than 20% of upper extremity injuries in the pediatric population. A clinical case of a three-year old girl who presented to the emergency department with a nursemaids elbow requiring reduction is presented in this article. The purpose of this article is to discuss the identification and treatment of this injury and delineate the two methods of supination and pronation for reduction of the annular ligament. (Source: Advanced Emergency Nursing Journal)

Use of Alteplase Beyond 3 Hours of Ischemic Stroke Onset

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

Tissue plasminogen activator, alteplase (Activase) is the U.S. Food and Drug Administration (FDA) approved thrombolytic for acute ischemic stroke and is currently FDA approved for administration up to 3 hr from stroke onset. However, new research suggests there are benefits from alteplase beyond the 3 hr window. Utilizing PubMed, a literature review was conducted between the years of 1998 and 2010 for research including the keywords “alteplase and ischemic stroke,” “thrombolytics and ischemic stroke,” “thrombolysis with alteplase” and “stroke protocol.” New research as well as a statement from the American Heart Association and American Stroke Association, supports extending the administration of alteplase after ischemic stroke onset while continuing to acknowledge the risk...

When Snakes Bite: The Management of North American Crotalinae Snake Envenomation

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

There are more than 120 species of snakes indigenous to the United States, 25 of which are venomous. Although snake envenomation carries a relatively low risk of mortality in the United States, it can result in significant morbidity if left untreated. The venom of Crotalinae snakes contains a complex mixture of enzymatic proteins with various clinical implications. Of these complications, the most significant are consumptive coagulopathy, compartment syndrome, and hypovolemic shock. The development of ovine Crotalidae polyvalent immune Fab antivenin (CroFab) has greatly changed the approach to snake envenomation. Nevertheless, multiple factors complicate its use and the overall management of this clinical presentation. The intent of this review is to discuss relevant management issues asso...

The Effect of Emergency Department Crowding on Patient Outcomes: A Literature Review

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

The purpose of this review was to summarize the findings of published reports that investigated quality-related outcomes and emergency department (ED) crowding. Of 276 data-based articles, 23 reported associations between patient outcomes and crowding. These articles were grouped into 3 categories: delay in treatment, decreased satisfaction, and increased mortality. Although these studies suggest that crowding results in poor outcomes, it is possible that other factors such as nursing care contribute to these adverse outcomes. Nursing care has been shown to contribute to both positive and negative patient outcomes in other settings. Building an understanding of how ED crowding affects the practice of the emergency nurse is essential to examining how nursing care, surveillance, and communic...

Usefulness: Forensic Photo Documentation After Sexual Assault

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

The forensic medical legal evaluation following sexual assault establishes evidence for law enforcement's investigation and criminal prosecution by the legal system. The sexual assault nurse examiner performs the forensic evaluation and uses digital photography to document physical injuries after sexual assault. Photographs have varying degrees of usefulness, but for a photograph to be useful, it must exhibit technical elements for the viewer. There was no tool available to evaluate the usefulness of digital photographs taken during forensic evaluation of genital injuries after sexual assault. The Photo Documentation Image Quality Scoring System (PDIQSS) tool was developed to rate photographic technical elements for usefulness. Using this tool, three experts on two separate occasions evalu...

The Future of Nursing

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Mild Traumatic Brain Injury: A Midwest Survey About the Assessment and Documentation Practices of Emergency Department Nurses

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

Research reported that mild traumatic brain injury (MTBI), the most common neurological condition in the world, isoften undetected in the emergency department. Failure to properly detect and offer treatment therapies has been linkedto chronic complications such as, mood disorders and postconcussion syndrome. This descriptive study used a tailoredsurvey (25.0% response rate) to determine emergency department nurses' practices for the assessment anddocumentation of persons with MTBI. The primary purpose was to determine the extent to which these practices werealigned with the Centers for Disease Control and Prevention guidelines contained within the Acute ConcussionEvaluation care plan. Results indicated that physical and cognitive symptoms were assessed and documented more thanemotional or ...

Wound Care and Laceration Repair for Nurse Practitioners in Emergency Care: Part II

Advanced Emergency Nursing Journal — Sat, 01 Jan 2011 00:00:00 +0100

This is Part II of a 2-part series on wound care and laceration repair for advanced practice nurses. In Part I, the phases and categories of wound healing were outlined. The factors that affected wound healing were also discussed along with an approach for systematic wound management. Patient assessment, special circumstances involving underlying structures, and foreign bodies were also reviewed. Patient preparation, including wound cleansing, irrigation, scrubbing, and debridement were also covered along with anesthetic and analgesic tips and techniques for advanced practice nurses (APNs) in emergency care. In Part II, wound closure (e.g., sutures, staples, and adhesives) and wound closure techniques are discussed along with the pertinent aftercare instructions for patients with these wou...

Initial Evaluation and Management of Bacterial Meningitis in an Emergent Setting: A Review

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

Bacterial meningitis is a severe infection involving the meninges, which surround and protect the brain and spinal cord. The infection leads to a significant host response and inflammation in this area. Potential consequences of this disease include hearing loss, seizures, hydrocephalus, permanent neurological deficits, coma, or death. Timely and effective therapy to treat meningitis is integral to the success of therapy and the prevention of neurological sequalae. The purpose of this review is to discuss the rapid identification and management of bacterial meningitis. (Source: Advanced Emergency Nursing Journal)

An Unusual Presentation: Bilateral Posterior Shoulder Fracture-Dislocations

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

This article discusses the emergency evaluation, mechanism of injury, assessment, differential diagnoses, and management of a patient with bilateral shoulder trauma from a suspected seizure. Advanced practice nursing implications are also described herein. (Source: Advanced Emergency Nursing Journal)

Wound Care and Laceration Repair for Nurse Practitioners in Emergency Care: Part I

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

This article also describes an approach for systematic wound management so as to decrease the risk for infection of nonsurgical wounds. Patient assessment, special circumstances involving underlying structures, and foreign bodies are also discussed herein. Patient preparation, including wound cleansing, irrigation, scrubbing, and debridement are also covered along with anesthetic and analgesic tips and techniques for the advanced practice nurses in emergency care. (Source: Advanced Emergency Nursing Journal)

The Impact of Prehospital Blood Collection on Time to Laboratory Test Results and Emergency Department Length of Stay

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

Conclusions: Collecting samples in the prehospital setting significantly shortens time to results, is not associated with an increase in hemolysis, and may decrease overall emergency department lengths of stay. (Source: Advanced Emergency Nursing Journal)

Wound Care and Laceration Repair for Nurse Practitioners in Emergency Care: Part I

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Assessment and Management of Rotator Cuff Tears

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

This article examines the literature on this subject and gives a detailed reflection on the experience of one emergency nurse practitioner of the diagnosis, physical examination and management of a patient with an RCT. (Source: Advanced Emergency Nursing Journal)

Are Antibiotics Indicated for Pediatric Skin Abscesses?

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

Review of recent evidence with translation to practice for the advanced practice nurse role is presented using a case study module for “Randomized, controlled trial of antibiotics in the management of community acquired skin abscesses in the pediatric patient.” The study results showed that antibiotics were not necessarily associated with better wound resolution than incision and drainage alone. The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting best evidence. (Source: Advanced Emergency Nursing Journal)

The Use of Nurse Practitioners and Physician Assistants in Washington and Oregon Emergency Departments: A Descriptive Study of Current Practice

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

Crowding in emergency departments is threatening the quality and safety of care. Use of nurse practitioners and physician assistants in this setting may be a cost-effective model, but there is little data on how to effectively utilize these providers. The purpose of this research was to determine utilization and current staffing patterns of nurse practitioners and physician assistants in emergency departments. Managers in Washington and Oregon emergency departments were surveyed in March 2009. There was a 59% response rate, with 58% of respondents indicating that they employed this workforce. Larger, urban hospitals employed these providers' more than smaller, rural hospitals. A significant majority reported that current utilization of these providers had a positive impact on timeliness of...

Nurse Practitioners in Emergency Care: Filling the Workforce Gap

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

How to Phrase Feedback in Peer Reviews for Nurse Authors?

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

This article seeks to convey these themes to the reader. (Source: Advanced Emergency Nursing Journal)

Management of Children With Humeral Supracondylar Fractures in the Emergency Department

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

Supracondylar fractures are common injuries in children who sustain orthopedic trauma. These fractures represents 60% of pediatric elbow fractures and 11% of all fractures sustained by young children. There is significant morbidity associated with supracondylar fractures in children, including nerve and vascular injuries. Therefore, appropriate and timely management of children presenting with this injury to the emergency department is crucial for a satisfactory outcome. A comprehensive physical examination, radiologic assessment and intepretation, and appropriate treatment are imperative in the care of these patients. (Source: Advanced Emergency Nursing Journal)

Morgellons Disease in a 48-Year-Old Female With Dermatologic Complaints

Advanced Emergency Nursing Journal — Fri, 01 Oct 2010 00:00:00 +0100

Morgellons disease, a controversial, newly emerging skin disease, is not usually included in the differential diagnosis of patients presenting to the emergency department with dermatologic complaints. Delay in diagnosis may result in months or years of suffering for patients who are routinely misdiagnosed with incorrect psychiatric or dermatologic conditions. A patient's case is presented in this article. The patient history, differential diagnosis, and distinctive features of Morgellons disease are discussed so that advanced practice nurse and physician providers may gain a knowledge base for clinical practice. (Source: Advanced Emergency Nursing Journal)

Maintaining the Moral High Ground

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

A Cognitive-Representational Approach to Patient Education After Mild Traumatic Brain Injury

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

We propose that before implementing the Centers for Disease Control and Prevention Acute Concussion Evaluation protocol for mild traumatic brain injury, which includes self-monitoring and self-management activities, specific cognitive processes should be evaluated. These include determining the injured person's illness representation of the mild traumatic brain injury diagnosis, his or her capacity for help seeking, and attentional capacity for self-monitoring. Following this thorough assessment, an individualized follow-up action plan using the CDC clinical protocol can be implemented. Such an individualized action plan, at the point-of-care, has the potential to prevent the occurrence of postconcussion syndrome, and restore the injured person to preinjury functioning. (C) 2010 Lippincot...

Psychometrics of the Healthcare Productivity Survey

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

There is an urgent need to understand, measure, and improve the delivery of health care in the United States. No such instrument currently exists to measure the change in work productivity following stressful events such as workplace violence (WPV) or trauma patient care. The origins, development process, and psychometric properties of the Healthcare Productivity Survey (HPS), a new instrument for measuring the change in work productivity related to the cognitive, workload, support, communication, safety, and competency demands of health care providers, are described. The instrument was tested with a sample of emergency nurses who had experienced WPV and/or provided care to traumatically injured patients. The 29-item HPS is a valid and reliable instrument for measuring changes in work prod...

Nurse Perceptions of the Impact of Pediatric Peripheral Venous Access Pain on Nurse and Patient Satisfaction: Results of a National Survey

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

Conclusions: The findings from this survey suggest that improved management of pediatric venous access pain can lead to enhanced job satisfaction among nurses. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Photo Documentation Image Quality Scoring System in the Evaluation of Female Genital Injuries Following Sexual Assault

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

The sexual assault nurse examiner (SANE) not only evaluates and treats injuries following sexual assault but also notes injuries on preprinted traumagrams and in forensic photographs. Forensic photographic images are used by interprofessional teams to evaluate and improve the quality of SANE practice. However, there is no tool to rate the quality or utility of a forensic photographic image. The Photo Documentation Image Quality Scoring System (PDIQSS; Ernst) was developed to evaluate the quality of photographic evidence using images of female genital injuries following sexual assault. The purpose of the study was to (1) develop a scoring system to rate actual images from sexual assault case with female genital injuries and (2) establish face and content validity as well as preliminary reli...

Over-the-Counter Pain Management Gone Awry: Acetaminophen Poisoning

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

Acetaminophen is one of the most popular nonnarcotic analgesic-antipyretic agents available. Inappropriate use of this agent can lead to significant morbidity and mortality secondary to hepatic necrosis. Several patient-specific factors impact its metabolism and the subsequent production of its toxic metabolite when consumed in excess. Rapid diagnosis and treatment with N-acetylcysteine in the first few hours following overdose is imperative in preventing permanent hepatic damage and death. It is essential for all health care providers to be familiar with the etiology and progression of this poisoning, as well as the necessary steps in treatment, to provide the highest level of care for this often-treatable condition. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergenc...

Acuity Assignation: An Ethnographic Exploration of Clinical Decision Making by Emergency Nurses at Initial Patient Presentation

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

The purpose of the study was to explore nurses' understanding of patient acuity levels at the initial patient encounter in the emergency department (triage). The current literature describes factors that are thought to influence decision making in triage; there is still a lot of uncertainty about the processes and strategies used to assign acuity, and therefore, possible strategies for improving nursing practice. Twelve emergency nurses were observed in their triage role over 120 initial patient encounters during a 3-month period at a critical access hospital and a level II trauma center in the eastern United States. Emergency nurses in this environment understood acuity to be a function of patient presentation, complaint, duration of symptoms, and body habitus. Acuity determinations were ...

A "Texting" Facial Trauma From the Backseat

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

Much of the research regarding orbital fractures focuses on front-seat automobile passengers. There is little evidence discussing this type of trauma to rear-seated passengers. This case presents a restrained, rear-seated, forward leaning passenger who was texting on his phone at the type of time of the frontal impact. The diagnosis and management of orbital fracture are discussed to assist the advanced practice nurse in gaining a better understanding of this facial trauma to prevent significant morbidity. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Over-the-Counter Pain Management Gone Awry: Acetaminophen Poisoning

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Identifying Psychiatric Disorders in Emergency Department Patients Presenting With Minor Injury

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

This study revealed that a significant number of patients with minor injuries had past or current psychiatric disorders. The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting the best evidence. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Do Not Underestimate the "Otherwise Healthy" Patient

Advanced Emergency Nursing Journal — Thu, 01 Jul 2010 00:00:00 +0100

Clinical Management of Skin and Soft Tissue Infections in the Emergency Department of a Suburban Hospital

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

Skin and soft tissue infections (SSTIs) caused by Staphylococcus aureus are among the most common infections encountered by emergency department (ED) physicians and nurse practitioners. Until recently, clinical management of such infections consisted of incision and drainage and antibiotic therapy. Of concern is the growing prevalence of community-acquired methicillin-resistant S. aureus as the cause of SSTIs, thus requiring a change in clinical evaluation and management. In 2007, the Centers for Disease Control and Prevention issued management guidelines, but research indicates a wide variation in how ED clinicians manage patients. This research project describes the prevalence and clinical management of SSTIs in a suburban hospital's ED. (C) 2010 Lippincott Williams & Wilkins, Inc. (Sou...

Anterior Cruciate Ligament Injuries in the Pediatric Population: A Case Study

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

There are many injuries that are clinically challenging musculoskeletal disorders in emergency department patients. One of those is an anterior cruciate ligament (ACL) injury. Injuries to the ACL are among the most common injuries incurred to the knee in sports. ACL tears in children and adolescents are becoming more common as participation in formalized sports increases. This injury typically occurs with trauma to the knee. The purpose of this article is to discuss the assessment and management of patients with ACL injuries using an actual case presentation. It is imperative for the healthcare provider to appropriately assess and manage the patient with an ACL injury promptly to ensure that outcome is improved. Failure to recognize the severity of the problem may lead to increased morbidi...

Getting to the Heart of Back and Shoulder Pain

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

This article also emphasizes the need for an astute review of this patient's "triage" vital signs and other presenting signs and symptoms that will assist the advanced practice nurse in making an accurate diagnosis so as to provide appropriate patient management. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Evidence-Based Sickle Cell Pain Management in the Emergency Department

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

This quality improvement project addressed the gaps in sickle cell pain management at a suburban teaching hospital emergency department. The aims were to (1) measure baseline pain management practices for patients with sickle cell disease in the ED and (2) implement an adapted emergency department sickle cell pain management clinical pathway. A retrospective chart review was conducted for data abstraction on pain management practices. Medical record review from 44 patient visits showed a high use of monotherapy, delay in time to medical evaluation, medication order, and time to first and subsequent analgesic administration and pain reassessments. Results were used by a multidisciplinary team to develop and implement an evidence-based clinical pathway to improve sickle cell disease pain man...

Carotid Artery Dissection Masquerading as Horner Syndrome

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

A 44-year-old man was referred to the emergency department by his ophthalmologist because of persistent drooping and swelling of his right eyelid. Horner syndrome was diagnosed. Horner syndrome refers to a constellation of signs produced when sympathetic innervations to the eye are interrupted. Horner syndrome is a rare condition that affects the nerves to the eye and face. Symptoms included decreased sweating on the affected side of the face, drooping eyelid (ptosis), sinking of the eyeball into the face, and constricted pupil. Although Horner syndrome is commonly an incidental finding related to a benign cause, it occasionally may be a manifestation of a serious and life-threatening disorder, such as carotid artery dissections (CAD). Careful direction of the history to rule out life-thre...

Developing and Sustaining an Ultrasound-Guided Peripheral Intravenous Access Program for Emergency Nurses

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

Ultrasonography use in the emergency department (ED) has been well established. The use of ultrasonography that falls into the traditional practice of the emergency nurse is peripheral intravenous (IV) access. Benefits of using ultrasonography for peripheral IV access include decreasing patient throughput, cost reduction, decreasing complications, increased patient and emergency medicine physician satisfaction, and emergency nurse autonomy. Review of the literature demonstrates no discernable differences in ability and efficacy with ultrasound (US)-guided peripheral IV access when comparing data from studies about emergency medicine physicians, certified registered nurses anesthetists, emergency department technicians, physician assistants, and emergency registered nurses. In 2006, Duke Un...

The Lived Experience of Adolescent Females Who Self-injure by Cutting

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

Self-injury behavior is the nonsuicidal, deliberate infliction of a wound to oneself in an attempt to seek expression. Self-injury is more prevalent in the adolescent population, and often emergency and advanced practice nurses are the health professionals who encounter this phenomenon. The purpose of this study was to explore self-injury by cutting as experienced by adolescent females. The researcher utilized phenomenology to discover the participants' descriptions of their experiences with cutting. Research was guided by the theoretical framework of the Humanistic Nursing Theory. The Giorgi method of data analysis was utilized to discover the themes that emerged from the participants' stories. The themes which emerged from the raw data were living with childhood trauma, feeling abandoned...

Resuscitating Healthcare Reform

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Standardizing Intoxication Assessments in the Emergency Department

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

Determining capacity for consented treatment begins every patient encounter. While most assessments are unambiguous, emergency department personnel may be lacking in ability to accurately assess mild to moderately intoxicated patients. These assessments are often based on subjective evaluations leading to a high degree of variability among clinicians. The resulting legal and patient care ramifications can be devastating to both patient and provider. Establishing standardized capacity assessments for intoxicated patients will help mitigate poor clinical decisions and legal repercussions. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Clinical Pharmacists: Coming Soon to an Emergency Department Near You!!

Advanced Emergency Nursing Journal — Wed, 31 Mar 2010 23:00:00 +0100

The emergency department (ED) is a fast-paced, but error-prone work environment. Clinical pharmacists based in the ED can assist with the selection, acquisition, preparation, administration, and monitoring of appropriate evidence-based therapeutic drug regimens. These services may be particularly useful during emergent and code situations. Emergency pharmacists can also provide drug information to the department. Clinical pharmacists in the ED serve as a liaison between the departments of pharmacy and emergency medicine, and can help develop policies and procedures that are beneficial and amenable to both departments. Having the right pharmacist in the ED may improve nursing and physician satisfaction with pharmacy services, reduce costs, and improve patient safety. (C) 2010 Lippincott Wi...

Thanks to the Reviewers

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Advanced Practice Nursing: Do We Have an Identity Issue?

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Family Presence During Adult Resuscitation: A Survey of Emergency Department Registered Nurses and Staff Attitudes

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

Discussion: Despite fear of families interfering and increased stress, most ED registered nurses and staff support FPDAR. There is a need for education to increase understanding of FPDAR. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Esophageal Foreign Body in a 13-Month-Old

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

Ingestion of a foreign body (FB) is a common occurrence for pediatric patients presenting to the emergency department (ED) for emergent care. The purpose of this article is to present the case of a 13-month-old pediatric patient who presented to the ED with an incidental complaint (i.e., foot laceration) and was also found to have a FB in the esophagus. The assessment, diagnostics, patient management, and implications for advanced practice nurses who care for pediatric patients with FBs of the aerodigestive tracts are discussed herein. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

A Case of Hematuria

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

Hematuria is a very common finding in patients who present to the emergency department. The origins of hematuria are diverse and numerous. Hematuria can be a benign finding, such as in exercise-induced hematuria, or a symptom of a serious condition, such as a urinary malignancy. The purpose of this article is to discuss the incidence, risk factors, basic pathophysiology, and etiology of hematuria. Included within the discussion of the etiology are diagnostics and basic treatment. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Alcohol Withdrawal Syndrome

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Rebrand Nurses: What's in a Name? Your Health, and Possibly More

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Violence Against Healthcare Workers in a Pediatric Emergency Department

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

Workplace violence (WPV) perpetrated by patients and visitors against nurses and physicians is a problem in adult emergency departments (EDs), but largely unrecognized and unreported in pediatric EDs. The purpose of this qualitative study was to describe the WPV that occurred in a pediatric ED and the negative effects on the workers. Data included transcribed interviews with 31 pediatric ED workers, nonparticipant observations, digital photographs, and archival records and were analyzed using a modified constant comparative analysis method. Participants perceived that both genders and all occupational groups were at risk for experiencing verbal and physical WPV. Common perpetrator characteristics were patients receiving a psychiatric evaluation and visitors exhibiting acute anxiety. Effect...

Alcohol Withdrawal Syndrome

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

Alcohol withdrawal syndrome is a significant problem that can complicate underlying disease states and lead to serious clinical consequences. The recognition of the early signs and symptoms of this syndrome, as well as the identification of those at highest risk for developing it, is crucial for effective prevention and management. Multiple pharmacotherapy options exist, and therapy should be guided on the basis of patient-specific factors and clinical presentation. The optimal care of these patients is dependent on a multidisciplinary approach to provide appropriate evaluation, treatment, and follow-up. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Undiagnosed Hypertension in the Emergency Department

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

The Research to Practice column is intended to elevate the research critique skills of the advanced practice nurse and to assist with translation of research to practice. For each column, a topic and a particular research study are selected. The stage is set by introducing the importance of the topic. The research paper is then reviewed and critiqued, and finally, the implications for translation into practice are discussed. In this column, the following research article is reviewed: Tanabe et al. (2008) "Increased Blood Pressure in the Emergency Department: Pain, Anxiety, or Undiagnosed Hypertension." The implications of these findings for advanced practice nurses are discussed. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Takotsubo Cardiomyopathy: Implications for Nursing Practice

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

A 67-year-old woman with chest pain, shortness of breath, and electrocardiogram changes presented to the emergency department. Her care is described in terms of differentiating her diagnosis of takotsubo cardiomyopathy from acute myocardial infarction. Prompt recognition, distinguishing features, and advanced practice nursing management are described herein. The importance of astute nursing interventions is also emphasized in this article on takotsubo cardiomyopathy. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Grading Evidence for Practice

Advanced Emergency Nursing Journal — Fri, 01 Jan 2010 00:00:00 +0100

Advanced emergency nurses are frequently called upon to endorse or recommend changes in practice. The purpose of this article is to summarize the current literature on evaluating evidence for practice and to recommend strategies for advanced emergency nurses to identify best practices when faced with multiple sources of different kinds of evidence. (C) 2010 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Toward Clarification of the Doctor of Nursing Practice Degree

Advanced Emergency Nursing Journal — Thu, 01 Oct 2009 00:00:00 +0100

The doctor of nursing practice (DNP) degree has been recommended by the American Association of College of Nursing (AACN) as the terminal degree in nursing practice by 2015 (AACN, 2004). However, confusion regarding this degree still exists. To promote understanding of this degree, the pertinent history of doctrol education in nursing is reviewed. In addition, a clear definition of the degree, including the competencies of the DNP degree, is provided. A comparison of the PhD in nursing and the DNP degree is also reviewed to provide further clarificaion. DNP graduates may engage in various roles such as leadership, health policy advocate, and scholarship. These roles will be reviewed as well as the relevant issues associated with this degree such as use of the title "Dr.," educating others ...

Psychiatric Crash Cart: Treatment Strategies for the Emergency Department

Advanced Emergency Nursing Journal — Thu, 01 Oct 2009 00:00:00 +0100

Emergency department staff are often frustrated when treating patients with psychiatric disorders. Nurses may feel that these patients are taking time away from the truly sick and may react by avoiding, ignoring, or using force with patients with psychiatric disorders. Psychiatric patients will often present with exacerbations of their illnesses, as do our patients with medical conditions. Ignoring or disregarding these symptoms will worsen them, much like ignoring dyspnea will cause a patient to deteriorate physically. Instead, it is important to understand the common psychiatric diagnoses and their associated symptomology. Symptom management is critical in the treatment of patients with psychiatric disorders; it reduces anxiety, builds trust, and allows the patients to feel safer. The st...

Use of the Ottawa Ankle Scale in Pediatric Patients

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

Review of recent evidence with translation to practice for the APN role is presented using a case study module for "Accuracy of Ottawa Ankle Rules to Exclude Fractures of the Ankle and Midfoot in Children: A Meta-Analysis" (S. Dowling et al., 2009). The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting the best evidence. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

5-Year Survival of Geriatric Patients Following Trauma Center Discharge

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

Little is known about the impact of trauma on geriatric injury survivors' life expectancy. Does trauma in older adults influence time to death? What key patient and injury variables can predict 5-year postdischarge survival? This retrospective study used Cox proportional hazards models to quantify seniors' risk for death within 5 years of injury and identify variables associated with life expectancy. The hazard ratio for death in subjects versus matched controls was 6.26. Six patient and injury variables were identified that predicted 5-year vital status in the final multivariate model. There is an ongoing relationship between injury and shortened lifespan in geriatric trauma survivors. This relationship appears to be largely influenced by host factors, rather than by injury variables. (C...

Abusive Head Trauma: A Case Study

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

This article also discusses AHT prevention and implications for advanced practice nurses caring for these patients. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

So Much to Learn, So Little Time: Educational Priorities for the Future of Emergency Nursing

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

In this study, 3 rounds of questioning resulted in a total of 42 societal and healthcare priorities and 63 educational priorities with moderate to high consensus achieved in all categories. Societal and healthcare trends that were ranked as having the most significant impact on emergency nursing included emergency department overcrowding, increasing patient complexity and acuity, access to healthcare, mental and behavioral health needs, and an aging population. Educational themes or topics that were ranked as being an extremely high priority for emergency nursing included critical thinking, core emergency nursing competencies, triage, pediatric patient care, medication and patient safety, and individualized orientation programs for emergency nurses. An analysis of the highest priority educ...

Lisfranc Fractures

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

Injuries of the tarsometatarsal, or Lisfranc, joint are rarely seen. Lisfranc fractures and fracture dislocations are among the most frequently misdiagnosed foot injuries in the emergency department. A misdiagnosed injury may have severe consequences including chronic pain and loss of foot biomechanics. Evaluation of a foot injury should include a high level of suspicion of a Lisfranc injury, and a thorough work-up is needed for correct diagnosis. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Factors Affecting Fluid Resuscitation in the Burn Patient: The Collaborative Role of the APN

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Weighing in on the DNP Examination for NPs

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Factors Affecting Fluid Resuscitation in the Burn Patient: The Collaborative Role of the APN

Advanced Emergency Nursing Journal — Wed, 30 Sep 2009 23:00:00 +0100

Throughout the first critical 24 hr after the injury is sustained, the burn patient must receive fluid resuscitation to prevent hypovolemia and ensure adequate tissue perfusion. Delayed or inadequate fluid resuscitation results in suboptimal tissue perfusion, which can lead to multisystem organ failure and death. Overresuscitation can be more problematic than underresuscitation and has been associated with the development of abdominal compartment syndrome, compartment syndrome of the extremities, airway obstruction, and pulmonary edema. The term fluid creep is used to describe the tendency to give too much fluid and can result from the hemodynamic consequence of opioid creep. Experts in the field agree that fluid resuscitation of the burn patient is a priority. Factors affecting fluid resu...

Introduction to Reading and Clearing Cervical Spines for Advanced Practice Nurses, Part II: C-spine Injuries-Causes, Cases, and Treatments (Including CT Scan)

Advanced Emergency Nursing Journal — Wed, 01 Jul 2009 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Predictors of Genital Injury After Nonconsensual Intercourse

Advanced Emergency Nursing Journal — Wed, 01 Jul 2009 00:00:00 +0100

Understanding differences in genital injuries after nonconsensual and consensual intercourse is an important element of prosecuting sexual assault cases. In order to determine if the injury patterns and total surface area of genital injuries can differentiate between the types of intercourse (consensual or non-consensual), eighty women were examined after non-consensual (retrospective chart review, n = 40) and consensual (recruited, n = 40) intercourse within 48 hours using colposcopy, toluidine blue dye, and digital photography to document genital injuries. Differences between types of injuries found in the nonconsensual and consensual groups, based on the univariate analysis, were found with the number of sites (NoS) with ecchymosis (p < 0.01) and NoS with redness (p < 0.01). Based on th...

Disaster Dilemma: Factors Affecting Decision to Come to Work During a Natural Disaster

Advanced Emergency Nursing Journal — Wed, 01 Jul 2009 00:00:00 +0100

The objective of this study was to identify factors influencing decision to come to work during a fire disaster. The authors' hospital experienced a 17-fold increase in no-shows during a fire. Phenomenography was used to explore staff experiences immediately following wildfires. Factors affecting decision to work during a disaster included vulnerability of family, personal safety, and fire proximity. Modifiable factors were identified as follows: past experience with disasters, perceived importance, relationship with the organization, and caring connection with the organization. Employees experienced tension between obligations to family, community, and organization. Pets were seen as family and as important as biological family. Further research is indicated to determine predictive modeli...

Introduction to Reading and Clearing Cervical Spines for Advanced Practice Nurses, Part II: C-spine Injuries-Causes, Cases, and Treatments (Including CT Scan)

Advanced Emergency Nursing Journal — Wed, 01 Jul 2009 00:00:00 +0100

Part I of this two-part series discussed the anatomy, radiographic reading, and clearing of the cervical spine for advanced practice nurses. Part II reviews the mechanisms of injury, pathophysiology, diagnostic evaluation, and patient management of the most common cervical spine injuries. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Scrotal Pain After a Fall

Advanced Emergency Nursing Journal — Wed, 01 Jul 2009 00:00:00 +0100

Trauma to the male urethra must be efficiently diagnosed in the emergency department setting. Many patients will need to undergo immediate surgical reconstruction. Traumatic urethral injuries are rarely life-threatening; however, they can lead to sexual dysfunction and psychological stress for the patient. For example, patients who develop urethral stricture disease from poorly managed traumatic events are likely to have significant voiding problems and recurring need for further interventions. Additionally, associated injuries to the pelvis and vascular structures also frequently occur and must be identified rapidly and treated promptly to prevent long-term complications. Specifically, a delay in diagnosing a traumatic urethral injury may significantly lead to serious long-term sequelae. ...

A Patient Survey on Emergency Department Use of Nurse Practitioners

Advanced Emergency Nursing Journal — Wed, 01 Jul 2009 00:00:00 +0100

The purpose of this descriptive study was to determine the willingness of emergency department patients, triaged to fast track areas, to be treated by an advanced practice registered nurse. A survey was distributed to a convenience sample of patients triaged to fast track areas in three southeastern emergency departments. The survey contained basic demographic information, four multiple-choice questions, and a section for comments. A majority of patients (65%) responded that they were willing to be treated by a nurse practitioner. Patients who had been treated by a nurse practitioner in the past were more willing to be treated by a nurse practitioner during this visit. Implications for practice: The results of this study support the addition of nurse practitioners to fast track emergency d...

Toxic Alcohol Ingestions: Focus on Ethylene Glycol and Methanol

Advanced Emergency Nursing Journal — Wed, 01 Jul 2009 00:00:00 +0100

The ingestion of toxic alcohols, specifically ethylene glycol (EG) and methanol, provides unique therapeutic challenges for emergency personnel. If untreated, these agents can result in significant morbidity and mortality. The toxicity of EG and methanol is dependent on endogenous metabolic processes rather than the actual parent compound ingested. These metabolites lead to the characteristic metabolic acidosis and cellular dysfunction typically seen with toxic alcohol ingestions. Fortunately, several options exist for the treatment of these ingestions, which, if implemented in the appropriate time period, can significantly decrease associated morbidity and mortality. The intent of this review is to discuss relevant management issues associated with EG and methanol intoxication in the emer...

Cost-effectiveness of Trauma Diagnostic Screenings

Advanced Emergency Nursing Journal — Tue, 30 Jun 2009 23:00:00 +0100

The purpose of this study was to evaluate the utility and cost-effectiveness of the standard laboratory and radiographic screening panels used at a level-2 trauma center. Healthcare providers and payers are raising questions as to the need for such a broad-based approach in the evaluation and diagnosis of critically ill and injured patients. One rationale for casting a wide net is to reduce the potential for missed injuries that increase morbidity and mortality. In addition, it is well documented that significant incidental findings (e.g., lung mass, horseshoe kidney) are often identified first in these screening studies during trauma (T. R. Paluska, M. J. Sise, D. L. Sack, B. C. Sise, M. C. Egan, & M. Biondi, 2007). (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency...

Last Call: Ethanol Metabolism and the Implications for Emergency Department Clinicians Managing Patients With Extreme Ethanol Intoxication

Advanced Emergency Nursing Journal — Tue, 30 Jun 2009 23:00:00 +0100

This article expounds on many of the subtle presentations that may be featured by the intoxicated patient and discusses the current treatment modalities and pitfalls utilized by today's emergency clinician. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

The Zen of Hand Washing

Advanced Emergency Nursing Journal — Tue, 30 Jun 2009 23:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Unexpected Birth in the Emergency Department: The Role of the Advanced Practice Nurse.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 170DOI: 10.1097/TME.0b013e3181a4154eAuthors: Schorn, Mavis N. PhD, CNM; Wilbeck, Jennifer MSN, APRN-BC, CEN (Source: Advanced Emergency Nursing Journal)

Noninvasive Ventilation in Emergency Care.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 161DOI: 10.1097/TME.0b013e3181a72818Authors: Wilbeck, Jennifer MSN, APRN-BC, CEN; Fischer, Michael RRT (Source: Advanced Emergency Nursing Journal)

Methylbromide Intoxication: A Clinical Case Study.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 153DOI: 10.1097/TME.0b013e31819dca1bAuthors: Breeman, Wim M-ANP, RN, RPN, CFRN, CRNA (Source: Advanced Emergency Nursing Journal)

Pediatric Sexual Abuse: Emergency Department Evaluation and Management.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 140DOI: 10.1097/TME.0b013e31819ca035Authors: Matkins, Preeti Patel MD, FAAP, FSAM; Jordan, Kathleen S. MS, RN, FNP-BC, SANE-P (Source: Advanced Emergency Nursing Journal)

Identifying Transverse Myelitis in the Emergency Care Arena.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 131DOI: 10.1097/TME.0b013e3181a2957eAuthors: Waldrup, Bridgette C. CGRN, ADN (Source: Advanced Emergency Nursing Journal)

Ovarian Torsion in a 23-Year-Old Female With Pelvic Pain.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 123DOI: 10.1097/TME.0b013e3181a1b585Authors: Campo, Theresa M. DNP, RN, NP-C (Source: Advanced Emergency Nursing Journal)

Selecting Antibiotics for Community-Acquired Skin and Skin Structure Infections in the Emergency Department: Erratum.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 122DOI: 10.1097/TME.0b013e3181ae2189 (Source: Advanced Emergency Nursing Journal)

Selecting Antibiotics for Community-Acquired Respiratory Infections in the Emergency Department.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 117DOI: 10.1097/TME.0b013e3181a2c747Authors: Francis, Kerry E. PharmD (Source: Advanced Emergency Nursing Journal)

Introduction to Reading and Clearing Cervical Spines for Advanced Practice Nurses, Part I.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 115DOI: 10.1097/01.TME.0000352204.71431.d8 (Source: Advanced Emergency Nursing Journal)

Workplace Violence.

Advanced Emergency Nursing Journal — Sat, 23 May 2009 03:53:20 +0100

Page: 94DOI: 10.1097/TME.0b013e3181a34a14Authors: Howard, Patricia Kunz PhD, RN, CEN, FAEN; Gilboy, Nicki MS, RN, CEN, FAEN (Source: Advanced Emergency Nursing Journal)

Competencies and Certification for Advanced Practice Nurses in Emergency Care.

Advanced Emergency Nursing Journal — Fri, 22 May 2009 23:44:04 +0100

Page: 91DOI: 10.1097/TME.0b013e3181a2e402Authors: Hoyt, Karen Sue RN, PhD, FNP-BC, CEN, FAEN, FAANP; Proehl, Jean A. RN, MN, CEN, CCRN, CPEN FAEN (Source: Advanced Emergency Nursing Journal)

Selecting Antibiotics for Community-Acquired Skin and Skin Structure Infections in the Emergency Department: Erratum

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Pediatric Sexual Abuse: Emergency Department Evaluation and Management

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

This article presents the essential information required to assume a leadership role in the medical management of the sexually abused child/adolescent in the ED, including mandatory reporting, triage, assessment, treatment, and follow-up. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Introduction to Reading and Clearing Cervical Spines for Advanced Practice Nurses, Part I

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Noninvasive Ventilation in Emergency Care

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

This article provides an overview of the types and potential uses of noninvasive ventilation, the risks and benefits of its use, and current evidence to support its use in specific patient populations. Guidelines for appropriate selection of patients for noninvasive ventilation therapy are provided. Management considerations, assessment techniques, troubleshooting, and transportation of patients receiving noninvasive ventilation are also discussed. Advanced practice nurses in the emergency department can provide leadership and advocacy for its use in appropriate patients, and this article provides the foundational knowledge to do so. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Introduction to Reading and Clearing Cervical Spines for Advanced Practice Nurses, Part I

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

This article is Part I of a two-part series and will focus on the key concepts of radiographic interpretation, functional cervical anatomy, and the interpretation and clearance of cervical spines in emergency care. In the subsequent issue, Part II will cover the additional epidemiology of cervical-spine injuries, specific injuries, case studies, and advanced diagnostic imaging. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Identifying Transverse Myelitis in the Emergency Care Arena

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

The objective of this article is to educate emergency nurses and nurse practitioners about how to recognize, diagnose, and treat TM. A comparison of the neurological findings of TM and Guillain-Barre syndrome is presented. In addition, this article will include an algorithm and specific diagnostic criteria to assist in the diagnosis of acute idiopathic TM. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Methylbromide Intoxication: A Clinical Case Study

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

The port of Rotterdam, The Netherlands, is the world's largest container port. In 2006, one of these containers caused a chemical incident. Methylbromide is used in some countries as a pesticide for the fumigation of maritime containers. Because of an insufficiently performed detoxification, this insecticide intoxicated several employees and some of the ambulance crew and Mobile Medical Team (MMT). The victims displayed symptoms of sore throat, irritated eyes, and hypersalivation. One of the victims suffered from multiple epileptic seizures. Two victims were admitted to the intensive care unit for respiratory support. Three other employees showed milder symptoms and received supportive care but were not admitted to the hospital. This complicated case shows that the safety of the ambulance ...

Unexpected Birth in the Emergency Department: The Role of the Advanced Practice Nurse

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

Emergency department (ED) births are relatively uncommon, but when they occur, the advanced practice nurse is in a unique position to assist the mother through unexpected vaginal delivery in the ED. The purpose of this article is to guide the advanced practice nurse through the process of care for a woman giving birth in the emergency department. Anticipation, preparation, "the catch," the newborn, the placenta, stabilization, and transport are the individual steps reviewed in this article. The focus of this manuscript is also to discuss the management of a mother and neonate during and following an unexpected vaginal birth. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Selecting Antibiotics for Community-Acquired Respiratory Infections in the Emergency Department

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

Annually, millions of patients are treated in emergency departments across the country for upper and lower respiratory infections. The purpose of this article was to articulate optimal antibiotic therapy for community-acquired respiratory infections. A table format has been selected to serve as a direct reference for nurse practitioners and physician assistants. In addition, background, common pathogens, and follow-up are discussed for each disease state. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Workplace Violence

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

The purpose of this study is to investigate emergency department (ED) workplace violence and assess staff perceptions of safety. Healthcare workers, in particular emergency care professionals, are often the recipients of workplace violence. The majority of staff (73%) reported that they felt safe most of the time or always, and 8% responded that they never or rarely felt physically safe in the ED. Most of the sites (94%) reported the presence and availability of in-hospital security 24 hr per day. In total, more than 3,461 attacks were reported by the respondents over 5 years, with a median of 11 incidences of physical violence per site for the 5-year period. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Ovarian Torsion in a 23-Year-Old Female With Pelvic Pain

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

Ovarian torsion is infrequently seen in the emergency department, however, a delay in diagnosis and treatment can lead to necrosis and loss of the ovary (E. D. Shraga & M. Blanda, 2008). A patient with pelvic pain diagnosed with ovarian torsion is presented in this article. The diagnosis and treatment of ovarian torsion is discussed to help the advanced practice nurse gain a better understanding of this frequently missed problem. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Competencies and Certification for Advanced Practice Nurses in Emergency Care

Advanced Emergency Nursing Journal — Tue, 31 Mar 2009 23:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Asthma Education Delivered in an Emergency Department and an Asthma Education Center: A Feasibility Study.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 73DOI: 10.1097/TME.0b013e31818bf23dAuthors: Szpiro, Kim A. RN, MSc; Harrison, Margaret B. RN, PhD; VanDenKerkhof, Elizabeth G. RN, DrPH; Lougheed, M. Diane MD, MSc, FRCPC (Source: Advanced Emergency Nursing Journal)

Cardiovascular Health in Women: An Overview of Gender-Related Issues.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 63DOI: 10.1097/TME.0b013e318195ef15Authors: Franceski, Barbara D. RN, MSN, NP-C (Source: Advanced Emergency Nursing Journal)

Mitochondria: The Hemi of the Cell.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 54DOI: 10.1097/TME.0b013e3181956200Authors: Cusimano, Elizabeth M. BSN, RN; Knight, Amanda R. BA; Slusser, Joyce G. PhD; Clancy, Richard L. PhD; Pierce, Janet D. DSN, ARNP, CCRN (Source: Advanced Emergency Nursing Journal)

Emergency Department Adult Asthma Care Pathway: Healthcare Providers' Perceived Utility and Barriers to Implementation.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 44DOI: 10.1097/TME.0b013e3181946f76Authors: Olajos-Clow, Jennifer RN, MSc, CAE, APN; Szpiro, Kim RN, MSc; Julien, Brianna BSc; Minard, Janice RN, MSc; Lougheed, M. Diane MD, MSc, FRCPC (Source: Advanced Emergency Nursing Journal)

Management of Acute Cardiogenic Pulmonary Edema: A Literature Review.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 36DOI: 10.1097/TME.0b013e3181946fd8Authors: Johnson, Jeremy M. MS, RN, CEN, CCRN (Source: Advanced Emergency Nursing Journal)

Patient With a Globe Rupture.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 34DOI: 10.1097/01.TME.0000346652.44604.66 (Source: Advanced Emergency Nursing Journal)

Selecting Antibiotics for Community-Acquired Skin and Skin Structure Infections in the Emergency Department.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 19DOI: 10.1097/TME.0b013e31819adabaAuthors: Francis, Kerry E. PharmD (Source: Advanced Emergency Nursing Journal)

Erratum.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 18DOI: 10.1097/TME.0b013e31819fa92c (Source: Advanced Emergency Nursing Journal)

Patient With Intracranial Subarachnoid Hemorrhage Requiring an Endovascular Coiling Procedure.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 12DOI: 10.1097/TME.0b013e3181921d86Authors: Norton, Colleen K. PhD, RN, CCRN; Linenfelser, Paula MSN, RN (Source: Advanced Emergency Nursing Journal)

Comprehension of Discharge Instructions.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 14:12:02 +0100

Page: 4DOI: 10.1097/TME.0b013e318196e839Authors: Gilboy, Nicki RN, MS, CEN, FAEN; Howard, Patricia Kunz PhD, RN, CEN, FAEN (Source: Advanced Emergency Nursing Journal)

Too Much Information.

Advanced Emergency Nursing Journal — Sun, 22 Feb 2009 00:37:48 +0100

Page: 1DOI: 10.1097/TME.0b013e3181968555Authors: Proehl, Jean A. RN, MN, CEN, CCRN, FAEN; Hoyt, K. Sue RN, PhD, FNP-BC, CEN, FAEN, FAANP (Source: Advanced Emergency Nursing Journal)

Cardiovascular Health in Women: An Overview of Gender-Related Issues

Advanced Emergency Nursing Journal — Thu, 01 Jan 2009 00:00:00 +0100

In 2004, the American Heart Association launched its "Go Red for Women" campaign. This campaign was an effort to educate women of all ages regarding cardiovascular (CV) disease. CV disease is a major health threat not just for men but also for women. In 2003, 483,842 women died as a result of CV disease; this number is increasing annually. More than half of these deaths were the result of an acute myocardial infarction. Unfortunately, many women with CV disease sought treatment so late that significant CV damage already occurred; more unfortunate was the fact that many of these women never even reached the hospital. For women who do seek medical attention, emergency department personnel are often the first providers of care. Therefore, it is imperative that emergency department providers r...

Too Much Information

Advanced Emergency Nursing Journal — Thu, 01 Jan 2009 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Patient With a Globe Rupture

Advanced Emergency Nursing Journal — Thu, 01 Jan 2009 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Erratum

Advanced Emergency Nursing Journal — Thu, 01 Jan 2009 00:00:00 +0100

No abstract available (Source: Advanced Emergency Nursing Journal)

Selecting Antibiotics for Community-Acquired Skin and Skin Structure Infections in the Emergency Department

Advanced Emergency Nursing Journal — Thu, 01 Jan 2009 00:00:00 +0100

The number of patients treated in emergency departments across the United States for community-acquired skin and soft tissue infections is on the rise. The purpose of this article is to articulate optimal antibiotic therapy for community-acquired skin and soft tissue infections. A table format has been selected to serve as a direct reference for nurse practitioners and physician assistants. In addition, background, common pathogens, and follow-up are discussed for each disease state as well as how cost might affect nurse practitioner's and physician assistant's antibiotic selection. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)

Patient With Intracranial Subarachnoid Hemorrhage Requiring an Endovascular Coiling Procedure

Advanced Emergency Nursing Journal — Thu, 01 Jan 2009 00:00:00 +0100

A 53-year-old man with a sudden onset of visual disturbances and a severe headache is transported to the emergency department, triaged as emergent, and seen immediately. His care is described on the basis of embolization and coiling in interventional radiology. Prioritization and nursing management postprocedure are discussed, and the importance of astute nursing interventions in the emergency department is presented. (C) 2009 Lippincott Williams & Wilkins, Inc. (Source: Advanced Emergency Nursing Journal)