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    325 results match your criteria Advanced Emergency Nursing Journal[Journal]

    1 OF 7

    Comparison of Sepsis-3 Criteria Versus SIRS Criteria in Screening Patients for Sepsis in the Emergency Department.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):138-143
    Wesley Medical Center, Wichita, Kansas.
    The objective of our study was to assess the percentage of patients who met qSOFA criteria, SIRS criteria, both, or none of either criterion and received an International Classification of Diseases, Tenth Revision (ICD-10) code for sepsis after admission from the emergency department (ED). This was a single-center retrospective chart review of medical patients admitted through the ED. Patients were included if they were older than 18 years, were admitted to an inpatient unit through the ED, and received antibiotics within 48 hr of admission. Read More

    Evaluation of Richmond Agitation Sedation Scale (RASS) in Mechanically Ventilated in the Emergency Department.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):131-137
    Department of Pharmacy Practice, (Dr Pop) University of Illinois College of Pharmacy Rockford, Illinois; Department of Pharmacy Services, (Drs, Dervay, and Dansby) and Emergency Department (Ms Jones), Tampa General Hospital, Tampa, Florida.
    The purpose of this study was to assess Richmond Agitation Sedation Scale (RASS) goal implementation in mechanically ventilated patients sedated in the emergency department (ED), compliance with RASS, and goal achievement. This study was a retrospective chart review at a large Level I trauma academic medical center. Patients who were intubated in the ED or en route to the ED between October 1, 2013, and October 1, 2014, were eligible for inclusion if they met the following criteria: aged 18 years or older, 24 hr or more on mechanically ventilated support receiving continuous sedation and/or analgesia during the first 48 hr of admission, and a hospital stay of 6 days or more. Read More

    An Interprofessional Web-Based Teaching Module to Enhance Competency of the Advanced Practice Nursing Clinical Education in the Emergency Department.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):127-130
    University of Washington Medical Center, Seattle (Drs Ro and Weiland); and Seattle University, Seattle, Washington (Drs Ro and Sin).
    Many advanced practice registered nursing (APRN) students struggle to thrive in their clinical rotation due to the wide variability in their clinical knowledge. To address the variability and gaps in knowledge, we created an interprofessional web-based, self-directed curriculum for APRN students that is clinically relevant and specific to the emergency department (ED) rotation. The modules are a product of collaboration between the medical, nursing, and pharmacy faculty at an academic medical center. Read More

    An Emergency Medicine Residency for Nurse Practitioners: The New York Presbyterian-Weill Cornell Medicine Experience.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):119-126
    Division of Emergency Medicine, New York Presbyterian Hospital-Weill Cornell Medical Center (NYPH-WCMC), New York.
    Growing numbers of nurse practitioners (NPs) are entering emergency medicine at a time when emergency departments are experiencing an increasing practice intensity and acuity. In this context, to further prepare NPs for a career in emergency medicine, postgraduate educational programs have emerged in the United States: from post-master's programs with 300-400 clinical hours in emergency medicine to intense residency or fellowship tracks with 2,000-3,000 clinical hours of training. This article describes the development and general organization of one such residency at New York Presbyterian Hospital-Weill Cornell Medical Center, while also noting several broader trends in emergency medicine and emergency NPs in the workforce. Read More

    Recognizing Measles, Mumps, and Rubella in the Emergency Department.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):110-118
    Georgetown University School of Nursing and Health Studies, Washington, District of Columbia.
    Measles, mumps, and rubella have impacted millions of American lives over the last 100 years. During the last century, researchers have identified viral diseases, developed a combination vaccine, and have continued ongoing research when outbreaks have occurred. Despite the high incidence of vaccinated individuals, these highly communicable diseases continue to flourish within clusters of outbreaks throughout the United States. Read More

    Ocular Chemical Burns Secondary to Accidental Administration of e-Cigarette Liquid.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):104-109
    Emergency Department, Regional Hospital Mullingar, Mullingar, Westmeath, Ireland.
    Chemical burns to the eye represent a true ocular emergency, requiring immediate and proficient attention to preserve visual function. Although there have been very few reports of serious ocular burns secondary to the accidental administration of electronic cigarette liquid, this case report discusses the risk of same because of product confusion between electronic cigarette liquid and ocular preparations. This article presents a patient's case including patient history and management in the emergency department. Read More

    Time Spent in the Emergency Department and Outcomes in Patients With Severe Sepsis and Septic Shock.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):94-103
    Loyola University Medical Center, Maywood, Illinois (Dr Hirschy); Loyola University Medical Center, Maywood, Illinois (Drs Sterk, Dobersztyn, and Rech); and College of Pharmacy, Midwestern University, Downers Grove, Illinois (Dr Dobersztyn).
    A majority of patients with severe sepsis and septic shock are first evaluated in the emergency department (ED). Methods such as screening tools have proven advantageous in earlier identification, allowing for timely initiation of treatment. Delay in symptom presentation and ED overcrowding contribute to deferment of sepsis bundle components and admission. Read More

    Pneumoperitoneum.
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):87-93
    School of Nursing and Health Sciences, Robert Morris University, Moon Township, Pennsylvania.
    Pneumoperitoneum, usually seen as free air under the diaphragm, is a finding that can be seen on plain abdominal radiographs, signifying a leakage of air, usually from a perforation in the gastrointestinal tract. There are several other potential pathways from other body compartments for air to enter the abdominal cavity. Pneumoperitoneum does not always signify bowel rupture, as it can also result from pneumomediastinum and pneumothorax, and in patients who are being mechanically ventilated. Read More

    Acute Headache in the Emergency Department: Is Lumbar Puncture Still Necessary to Rule Out Subarachnoid Hemorrhage?
    Adv Emerg Nurs J 2018 Apr/Jun;40(2):78-86
    Emory University Hospital, Atlanta, Georgia (Ms Steffens); and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Drs Tucker and Evans).
    The purpose of the Research to Practice column is to review current primary journal articles that directly affect the practice of the advanced practice nurse (APN) in the emergency department. This review examines the findings of Carpenter et al. (2016) from their article, "Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis Describing the Diagnostic Accuracy of History, Physical Exam, Imaging, and Lumbar Puncture With an Exploration of Test Thresholds. Read More

    Evaluating an Order Set for Improvement of Quality Outcomes in Diabetic Ketoacidosis.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):59-72
    Columbus Regional Health, Midtown Medical Center, Columbus, Georgia (Dr Joyner Blair); School of Nursing, Troy University, Montgomery, Alabama (Dr Hamilton); and School of Nursing, Troy University, Troy, Alabama (Dr Spurlock).
    The timely management of diabetic ketoacidosis (DKA) is essential to avoid lengthy hospitalizations and poor clinical outcomes. There is often an absence of ownership for glycemic management in hospitalized patients, most notably in those with a diagnosis other than diabetes. Evidence supports the use of evidence-based DKA protocols. Read More

    Implementation of an Asthma Self-Management Education Guideline in the Emergency Department: A Feasibility Study.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):45-58
    Marcella Niefhoff School of Nursing, Loyola University Chicago, Maywood, Illinois.
    Patients often present to emergency departments (EDs) for the management of chronic asthma. Because of the nature of ED care, national guideline recommendations for asthma education are generally not initiated in the ED. There is evidence that asthma education can have a positive effect on patient outcomes (; ). Read More

    What the Advanced Practice Nurse in the Emergency Department Needs to Know About the Health Risks and Hazards of Electronic Cigarette Use by Youth.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):36-44
    Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois.
    Despite the decline in traditional tobacco use among teens and young adults, the rapid increase in electronic cigarette (EC) use has filled the gap, raising concern that this will usher in a new generation of tobacco users. Although long-term effects have not been clearly established, EC use is not without risks or hazards that may be encountered by the advanced practice nurse in the emergency department (ED). The ED presents an opportune moment for health promotion and risk reduction education for patients and families, but there are also dangers to EC use that the practitioner should be aware of and prepared to manage. Read More

    Tranexamic Acid: Promise or Panacea: The Impact of Air Medical Administration of Tranexamic Acid on Morbidity, Mortality, and Length of Stay.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):27-35
    Department of Anesthesia, University Health-Shreveport, Shreveport, Louisiana (Drs Cornelius and Hylan); Capstone College of Nursing, University of Alabama, Tuscaloosa (Drs Cornelius and McCarty); Department of Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport (Dr Cornelius); Pafford Air One, Ruston, Louisiana (Mr Carter); and Laboratory for Advanced Biomedical Informatics, Department of Computer Science, Louisiana State University-Shreveport (Messrs Smith, Ristic, and Vining and Drs Cvek and Trutschl).
    The MATTERs and CRASH-2 studies demonstrate that tranexamic acid (TXA) reduces mortality in patients with traumatic hemorrhage. However, their results, conducted in foreign countries and with U.S. Read More

    Spontaneous Vertebral Artery Dissection in a Healthy 26 Year Old Female Patient: A Case Study.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):21-26
    Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York.
    Spontaneous vertebral artery dissection (SVAD) is an extremely rare, yet life-threatening, event that can potentially result in ischemic stroke or subarachnoid hemorrhage, depending on the origin and extension of the dissection. Vertebral artery dissection is more commonly associated with traumatic injury to the neck, resulting in compromised structural integrity of the vertebral artery wall. This case study discusses the clinical presentation, physical examination, diagnosis, clinical course, and outcome for a young, otherwise healthy, female patient who presented to the emergency department with a SVAD. Read More

    A Case of Drug-Induced Severe Endocrinopathies: What Providers in the Emergency Department Need to Know.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):16-20
    University of Washington Medical Center, Seattle.
    The purpose of this article is to present a discussion of immune checkpoint inhibitors (ICIs) that are relatively new, yet growing, form of cancer therapy. Immune checkpoint inhibitors increase host immune response against neoplastic cells. Strengthened immunological response increases the potential for adverse events such as life-threatening endocrinopathies. Read More

    Hip Fractures.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):8-15
    School of Nursing and Health Sciences, Robert Morris University, Moon Township, Pennsylvania (Drs Ramponi and Kaufmann); Heritage Valley Health System, Pittsburgh, Pennsylvania (Dr Ramponi); St. Clair Health System, Bridgeville, Pennsylvania (Dr Kaufmann); and Novartis Pharmaceuticals, Basel-City, Switzerland (Ms Drahnak).
    Hip fractures are associated with significant morbidity and mortality and a major health problem in the United States (). Eighty percent of hip fractures are experienced by 80-year-old women. Plain radiographs usually confirm the diagnosis, but if there is a high level of suspicion of an occult hip fracture, magnetic resonance imaging or bone scan is the next step to confirm the diagnosis. Read More

    Emergency Department Use of Contrast Computed Tomography in Patients With Renal Dysfunction.
    Adv Emerg Nurs J 2018 Jan/Mar;40(1):2-7
    Piedmont Mountainside/HospitalMD, Blue Ridge, Georgia (Dr Newberry); and Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia (Drs Newberry and Evans).
    The Research to Practice Column is designed to improve translational research critique skills of advanced practice nurses. In this issue, the article "Risk of Acute Kidney Injury After Intravenous Contrast Media Administration" () is discussed in the context of a patient presenting to the emergency department with acute abdominal pain. The study was designed to assess the risk of acute kidney injury and adverse clinical outcomes in patients receiving intravenous contrast for computed tomography. Read More

    The Effect of Apneic Oxygenation on Reducing Hypoxemia During Rapid Sequence Induction and Intubation in the Acutely Ill or Injured.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):309-317
    Emergency Department, Naval Medical Center Portsmouth, Portsmouth, Virginia.
    Apneic oxygenation during intubation is the application of oxygen via a nasal cannula, which is left in place throughout laryngoscopy. The flow rate of oxygen is set to at least 15 L/min and theoretically reduces the risk of oxygen desaturation and hypoxemia during the procedure. Over the last 5 years, there have been several studies published on this topic with differing results. Read More

    Reducing Unnecessary Head Computed Tomography in Mild Traumatic Brain Injury.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):300-308
    Medical Associates, LLP, Emergency Department, Community Health Network, Indianapolis, Indiana (Mr Webster); Gulf Coast Internists, Palm Harbor, Florida (Mr Moore); and Advanced Practice Nursing Dept, Indiana State University, Terre Haute (Dr Stewart).
    There is growing concern about the frequency of computed tomographic (CT) scans performed for evaluation of adults with suspected mild traumatic brain injury. The Canadian CT Head Rule and the New Orleans Criteria are the most studied head CT decision tools that aid providers in determining which patients do not require a CT scan. This article examines recent research to determine which of these tools has proven to be the most effective at safely reducing the use of head CT scans. Read More

    Intravenous Push Cephalosporin Antibiotics in the Emergency Department: A Practice Improvement Project.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):295-299
    UCHealth, University of Colorado Hospital, Aurora, Colorado (Dr McLaughlin and Ms Scott); UCHealth, Longs Peak Hospital, Longmont, Colorado (Ms Koenig); and Skaggs School of Pharmacy, University of Colorado, Aurora, Colorado (Dr Mueller).
    Delays in administration of appropriate antibiotics to patients with septic shock are associated with increased mortality. To improve the care of patients with sepsis within our 73-bed emergency department (ED), a "first-dose" intravenous push (IVP) cephalosporin antibiotic protocol was initiated. This project was aimed at improving the time from provider order of antibiotic to administration, which follows the Sepsis Core Measure of timely antibiotic administration. Read More

    A Randomized, Double-Blind Trial to Determine if Vapocoolant in the Adult Population Improves Patient Perception of Pain With Peripheral Intravascular Access.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):288-294
    Parkland Health & Hospital System, Dallas, Texas.
    The purpose of this study was to investigate whether the use of a topical anesthetic spray (vapocoolant) at the site of intravenous access reduces pain and anxiety associated with peripheral intravenous (PIV) catheter insertion in an adult emergency department population. A randomized, double-blind, placebo-controlled, single-center trial, conducted from July to August, in an adult emergency department where 72 patients with orders for PIV insertion receiving either topical vapocoolant spray (n = 38) or placebo spray (n = 34). Vapocoolant or placebo was applied to the intravenous site and allowed to evaporate before cleansing and insertion. Read More

    Barriers to Research Recruitment of Women Experiencing a Pregnancy Loss in the Emergency Department.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):280-287
    University of Cincinnati College of Nursing, Cincinnati, Ohio (Drs Punches, Johnson, Felblinger, and Gillespie); and University of Cincinnati School of Social Work, Cincinnati, Ohio (Dr Acquavita).
    Women often come to the emergency department (ED) with signs and symptoms suggesting an early pregnancy loss; yet, little is known about their experience and how it relates to future outcomes. To improve patient outcomes and experiences of women seeking care for a pregnancy loss, research is required. However, recruitment of participants experiencing an event such as a pregnancy loss is challenging. Read More

    Changing the Emergency Department's Practice of Rapid Sequence Intubation to Reduce the Incidence of Hypoxia.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):266-279
    Vanderbilt University School of Nursing and Vanderbilt University Medical Center-LifeFlight, Nashville, Tennessee (Dr Gooch); TeamHealth at Maury Regional Medical Center, Columbia, Tennessee (Dr Gooch); Middle Tennessee School of Anesthesia, Madison, Tennessee (Dr Gooch); and Loyola University Chicago Marcella Niehoff School of Nursing, Chicago, Illinois (Dr Roberts).
    Rapid sequence intubation (RSI) is an advanced procedure performed by nurse practitioners in the emergency department (ED). Hypoxia is one of the most common complications associated with RSI, which may lead to serious sequela, including death. Hypoxia may result from medications that are given to facilitate the procedure or the underlying disease process. Read More

    Postpartum Headache.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):258-265
    Pacific Lutheran University School of Nursing, Tacoma, Washington. Dr Richardson is a retired Army Nurse Corps officer.
    Approximately 40% of all women report experiencing headaches during the postpartum period, regardless of a previous headache history. This case narrative describes the clinical case of a 22-year-old woman who presented for the evaluation of an intractable headache for 2½ weeks. It demonstrates the inherent difficulty in diagnosing patients not presenting with "textbook" symptoms and highlights the fact that signs and symptoms of eclampsia/preeclampsia, such as elevated blood pressure, may fall below the threshold for hypertensive emergencies and not be considered in the differential. Read More

    Sugammadex for Neuromuscular Blockade Reversal.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):248-257
    Emory University Hospital, Atlanta, Georgia.
    Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Read More

    Orbital Floor Fractures.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):240-247
    School of Nursing and Health Sciences, Robert Morris University, Moon Township, Pennsylvania (Dr Ramponi); and Department of Nursing, Edinboro University, Edinboro, Pennsylvania (Drs Astorino and Bessetti-Barrett).
    The orbital bones are thin and exposed, making the orbital walls vulnerable to fractures. The floor of the orbit is the weakest portion of this 4-sided pyramid structure. Blunt force trauma is the primary mechanism of injury in young men between the ages of 18 and 30 years. Read More

    Does Suprapubic Stimulation in Infants Facilitate Collection of a Clean Catch Urine Specimen?
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):236-239
    Makenna David Pediatric Emergency Department, University of Kentucky Chandler Hospital, Lexington (Dr Hall-Million); University of Kentucky College of Nursing, Lexington (Dr Hall-Million); and Emergency Services, University of Kentucky HealthCare, Lexington (Dr Howard).
    Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Faster Clean Catch Urine Collection (Quick Wee Method) From Infants: Randomised Controlled Trial." This prospective study enrolled 344 infants between 1 and 12 months of age seeking care in an emergency department with a complaint that led to the ordering of a clean catch urine specimen. Use of the Quick Wee procedure yielded clean catch urine specimens without the use of an invasive procedure. Read More

    The Specialty of Emergency Nurse Practitioner Practice.
    Adv Emerg Nurs J 2017 Oct/Dec;39(4):231-235
    Editor Advanced Emergency Nursing Journal Chair American Academy of Emergency Nurse Practitioners Clinical Professor & Emergency Nurse Practitioner Specialty Coordinator Emory University Nell Hodgson Woodruff School of Nursing Atlanta, GA Founder American Academy of Emergency Nurse Practitioners Professor of Clinical Nursing & Director of Emergency/Trauma Nurse Practitioner Concentration University of Texas Health Science Center Houston Houston, TX Founding Chair American Academy of Emergency Nurse Practitioners Associate Professor & Emergency Nurse Practitioner Specialty Coordinator Vanderbilt University School of Nursing Nashville, TN Guest Editors.

    Postgraduate Emergency Nurse Practitioner Fellowships: Opportunities for Specialty Education.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):224-230
    Vanderbilt University School of Nursing, Nashville, Tennessee.
    Specialty trained emergency nurse practitioners (ENPs) can meet the demands of an unpredictable emergency care environment within an overburdened health care system. Although existing literature supports fellowship training as a method for bridging academic knowledge with clinical experiences for the novice nurse practitioner, the currently available emergency care postgraduate fellowship programs are inconsistent in approach. Building upon descriptive data provided by the existing 9 postgraduate ENP fellowship programs, a comparison and gap analysis of program content was conducted to identify perceived standards for ENP specialty education and the congruence with published ENP competencies. Read More

    Importance of Early Detection and Cardiovascular Surgical Intervention in Marfan Syndrome.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):217-223
    Texas Woman's University, Houston, Texas (Dr DelloStritto and Mss Chemmachel, Patel, Skolkin, Gilani, and Uleanya); and Texas Tech University, Lubbock, Texas (Dr Branham).
    Marfan syndrome is an autosomal dominant connective tissue disorder that affects multiple systems, including the skeletal, ligamentous, oculofacial, pulmonary, abdominal, neurological, and cardiovascular systems. Cardiovascular complications, which involve the aorta and aortic valve, contribute most significantly to patient morbidity and mortality. A literature review was conducted on pathophysiology of the disease and recommendations for early diagnosis and treatment. Read More

    Implementing Interprofessional Alcohol Screening, Brief Intervention, and Referral to Treatment in the Emergency Department: An Evidence-Based Quality Improvement Initiative.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):199-216
    School of Nursing, Loyola University Chicago, Maywood, Illinois (Drs Bacidore and Letizia); and Health and Community Systems Department, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania 15261 (Dr Mitchell).
    Alcohol misuse is one of the leading causes of illness, disease, injury, and death in the Unites States. For many patients, the emergency department (ED) visit may provide the only therapeutic opportunity to influence problematic drinking behavior. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach that may reduce alcohol-related morbidity and mortality and improve health outcomes and quality of life. Read More

    Chemical Burns of the Eye.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):193-198
    School of Nursing and Health Sciences, Robert Morris University, Moon Township, Pennsylvania.
    Chemical burns of the eye are one of the most common eye injuries. The extent of the ocular surface damage is influenced by the type, temperature, volume, and pH of the corrosive substance and duration of exposure. Limbal ischemia found on eye assessment is the primary determinant of eventual visual outcome. Read More

    Cerebellar Stroke: A Missed Diagnosis.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):184-192
    School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Dr Berry); School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Dr Platt-Mills); Emergency Department, University of North Carolina Health Care, Chapel Hill, North Carolina (Drs Berry and Platt-Mills and Mss Rafferty and Tiu).
    Cerebellar strokes account for less than 10% of all strokes but lead to significantly poor outcomes. Cerebellar strokes that are initially missed have a mortality rate of 40%, and half of the patients who survive have long-term deficits. The patient's history may provide clues that point to a cerebellar stroke. Read More

    Update on Sepsis Treatment in the Emergency Department.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):176-183
    Pharmacy Services, Medical University of South Carolina, Charleston (Dr Weant); Department of Pharmacy Services, University of Kentucky HealthCare, Lexington (Dr Bailey); and Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington (Dr Bailey).
    Sepsis continues to be a devastating, costly, and challenging syndrome to manage in emergency departments (ED) across the nation, and its impact seems to be only increasing. Recently, consensus recommendations have made some profound changes in the way we approach, classify, and treat sepsis. The ED serves as an important initial screening and intervention point for sepsis, and ED care can have a profound impact on overall morbidity and mortality. Read More

    Metatarsal Stress Fractures.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):168-175
    School of Nursing and Health Sciences, Robert Morris University, Moon Township, Pennsylvania (Dr Ramponi); and Department of Nursing, Edinboro University, Edinboro, Pennsylvania (Drs Hedderick and Maloney).
    Metatarsal stress fractures are also called "march fractures" or "marcher's foot." They most commonly occur in the distal second and third metatarsals. The second and third metatarsals receive the majority of stress during ambulation and are less mobile compared with the other metatarsals. Read More

    Prevalence of Pulmonary Embolism in Patients Presenting to the Emergency Department for Syncope.
    Adv Emerg Nurs J 2017 Jul/Sep;39(3):161-167
    Emory University, Atlanta, Georgia.
    The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse and the emergency nurse (RN) and to assist with the translation of research into practice. For each column, a topic and a research study are selected. The research article is then reviewed and critiqued, and the findings are discussed in relation to a patient scenario. Read More

    The Utility of Point-of-Care Testing at Emergency Department Triage by Nurses in Simulated Scenarios.
    Adv Emerg Nurs J 2017 Apr/Jun;39(2):152-158
    Center for Healthcare Innovation and Policy Research (Dr Pines and Mr Zocchi), Department of Emergency Medicine (Dr Pines), and School of Medicine and Health Sciences (Ms Buchanan), The George Washington University, Washington, District of Columbia; Department of Emergency Medicine, The University of Wisconsin-Madison (Dr Shah); and School of Nursing (Dr Travers) and Department of Emergency Medicine (Dr Travers), The University of North Carolina at Chapel Hill.
    We developed and tested simulated patient scenarios to assess how normal or abnormal point-of-care (POC) test results at triage change prioritization decisions. This was a cross-sectional study where our team developed simulated scenarios and presented them to triage nurses from 3 academic medical centers. Twenty-four scenarios were constructed on the basis of 12 clinical indications from a protocol previously developed by our team. Read More

    Emergency Nurse Practitioner Core Educational Content.
    Adv Emerg Nurs J 2017 Apr/Jun;39(2):141-151
    Emergency Nurse Practitioner Program, Vanderbilt University School of Nursing, Nashville, Tennessee (Drs Wilbeck and Rudy); Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois (Dr Roberts); and Vanderbilt Adult Emergency Department, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Rudy).
    Increasing numbers of patients are presenting to national emergency departments (EDs). This is occurring simultaneously with reductions in providers along with ED closures, creating a significant gap in emergency care. According to the advanced practice registered nurse consensus model, specialty-specific knowledge and practice build upon generalist nurse practitioner (NP) population foci. Read More

    Application of Primary Care Guideline for Chronic Low Back Pain in the Emergency Department.
    Adv Emerg Nurs J 2017 Apr/Jun;39(2):123-140
    Thomas More College, Crestview Hills, Kentucky, (Dr Tacy); and University of Cincinnati College of Nursing, Cincinnati, Ohio (Drs Donaworth and Ballman).
    Chronic low back pain (CLBP) is a primary care condition that overflows into the emergency department (ED). No ED-specific practice guideline exists for the management of patients with CLBP in the ED setting. Back pain is a common chief complaint, with cases of CLBP making up to 50% of the patients seen with back pain in an urban, freestanding ED affiliated with a multicampus health system in the Midwest where 25% of patients live below the poverty line and 21. Read More

    Measuring Fatigue in Triage: A Pilot Study.
    Adv Emerg Nurs J 2017 Apr/Jun;39(2):114-122
    Duke University Health System, Durham, North Carolina (Ms McMahon and Drs Hudson, Prewitt, and Carman); and Duke University Health System, Raleigh, North Carolina (Ms Engleson).
    : Given the critical nature of triage in facilitating emergency department (ED) functions, an understanding of the factors that impact triage nurses' ability to accurately assign triage scores and the ways in which these factors may affect various patient outcomes is extremely important; yet, there exists a paucity of such research in the literature. To further develop this knowledge base, an investigation of triage nurse fatigue and the role it may play in the ability to accurately assign triage scores was developed. The purpose of this pilot study was to determine how the length of a triage shift affects perceived fatigue levels among triage nurses. Read More

    A Case of Exertional Rhabdomyolysis: When Exertion Exceeds Capacity.
    Adv Emerg Nurs J 2017 Apr/Jun;39(2):106-113
    Mid-Atlantic Emergency Medicine Associates, Charlotte, North Carolina (Dr Jordan); School of Nursing, The University of North Carolina at Charlotte (Dr Jordan); and Western Carolina University and Haywood Regional Hospital, Clyde, North Carolina (Dr Mannle).
    The purpose of this article is to present a discussion of a young adult patient with exertional rhabdomyolysis. Rhabdomyolysis is the process of muscle tissue destruction and damage to the cell membrane, with subsequent release of the intracellular myocyte contents into the systemic circulation. This leads to the potential for the life-threatening systemic complications of electrolyte abnormalities, cardiac dysrhythmias, acute kidney injury, compartment syndrome, and disseminated intravascular coagulopathy. Read More

    Antiemetic Use in the Emergency Department.
    Adv Emerg Nurs J 2017 Apr/Jun;39(2):97-105
    Pharmacy Services, Medical University of South Carolina, Charleston (Drs Weant and Calhoun); Department of Pharmacy Services, University of Kentucky HealthCare, Lexington (Drs Bailey and Baum); Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington (Drs Bailey and Baum); and Clinical Pharmacy Services, St. Claire Regional Medical Center, Morehead, Kentucky (Dr Justice).
    Nausea and vomiting are 2 of the most common complaints of patients presenting to the emergency department (ED). In addition, antiemetics are the most commonly prescribed medications in the ED behind analgesics. Treating these conditions can be complex, especially as one considers that nausea and/or vomiting could be the primary presenting illness or simply a symptom of a more complex etiology. Read More

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