Effects of Video Discharge Instructions on Patient Understanding: A Prospective, Randomized Trial
Previous studies demonstrated that patients have difficulty understanding and retaining discharge instructions due to the lack of time spent counseling patients and low health literacy rates. The purpose of this study was to evaluate the effects of video instructions on patient understanding of their discharge instructions. This was a prospective, randomized, controlled trial of a convenience sample conducted in a military hospital emergency department. Adult patients with a diagnosis of upper respiratory tract infection, pharyngitis, or gastroenteritis were included into the study. Investigators randomized subjects to eit...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Improved Concussion Discharge Instructions in a Pediatric Emergency Department
The objective of this study was to determine whether the use of the Acute Concussion Evaluation-Emergency Department Discharge Instructions (ACE-ED DI) improves the caregiver's knowledge of injury management, specifics about returning to school and sports activities, and outpatient follow-up. This was a quasi-experimental study conducted in an urban Level 1 trauma center pediatric emergency department (PED). A convenience sample of caregivers of children aged 5–18 years who presented to the PED with a concussion was recruited and consented to participate. Caregivers completed a 16-item survey to assess overall unders...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Evaluation of the (qSOFA) Tool in the Emergency Department Setting: Nurse Perception and the Impact on Patient Care
In the emergency department (ED) setting, nurses perform the initial evaluation of patients, thereby placing ED nurses in a prime position to recognize sepsis and greatly influence prompt implementation of treatment. The quick Sequential Organ Failure Assessment (qSOFA) tool was first introduced as part of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) as a predictor of both increased mortality and longer intensive care unit (ICU) stays. Designed for use outside the ICU, the qSOFA tool functions as a simple bedside tool to quickly identify patients at risk for developing sepsis. As a m...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Noninvasive Wound Closure in the Emergency Department
Emergency department (ED) providers spend a significant amount of time treating low-acuity medical conditions, such as simple laceration repairs. Lacerations account for 5% of all ED visits in the United States (Centers for Disease Control and Prevention, 2016). An extended period of time by the provider is required for traditional wound repair, and there is perceived pain reported by patients (Song et al., 2017). The closure devices (Zip Closure device) are a latex-free, noninvasive alternative to staples, sutures, and glue and make wound closure an easy, fast process, allowing patients to remove the device after the woun...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Atypical Variant of Cutaneous Tuberculosis Presentation in an Adult HIV-Infected Patient in an Emergency Department in Haiti
The incidence of tuberculosis (TB) has increased in the 21st century due to a high prevalence of the human immunodeficiency virus (HIV) infection and multidrug-resistant (MDR) pulmonary TB. HIV infection, diabetes mellitus, and other immune deficiencies decrease cure rates, increase mortality, and increase the incidence of MDR pulmonary TB. Tuberculosis is the most virulent opportunistic pathogen worldwide for patients living with HIV. This case documents rare clinical manifestation of cutaneous tuberculosis (CTB) seen in an emergency department in Gonaives, Haiti. Cutaneous TB can occur either from the spread of TB from a...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research

Marijuana Use: Early Recognition for a Cannabinoid Hyperemesis Syndrome
There is an emerging subset of patients who present to the emergency department (ED) with cannabinoid hyperemesis syndrome (CHS). Cannabinoid hyperemesis syndrome is a relatively new clinical condition and despite a long documented marijuana use in humans, little is known about the pathophysiology of this emerging problem. The focus of this article is to present a patient who presented with CHS. The clinical presentation, diagnostics, and treatment for this patient will be discussed. The nurse practitioner can anticipate high utilization of patients presenting to the ED with CHS. Nurse practitioners need to provide early r...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research

Management of Acute Idiopathic (Viral) Pericarditis in the Emergency Department: A Review for the Nursing Professional
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: CE Tests Source Type: research

Management of Acute Idiopathic (Viral) Pericarditis in the Emergency Department: A Review for the Nursing Professional
Acute pericarditis is an inflammatory disorder that contributes to chest pain admissions in the emergency department (ED). Nursing professionals can play a vital role in the differential, triage and management of acute pericarditis in the ED. First-line pharmacotherapy to specifically treat acute pericarditis of viral or idiopathic origin is paramount in improving patients' quality of life and reducing the risk of further recurrences of pericarditis and consists of combination therapy with aspirin (acetylsalicylic acid [ASA]) or a nonsteroidal anti-inflammatory drug (NSAID), in combination with colchicine. Corticosteroids ...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research

Fibromatosis Colli: A Case Report
Fibromatosis colli is a rare, usually self-limiting condition caused by a benign tumor in the sternocleidomastoid muscle. The tumor occurs most often during infancy and can be clinically associated with torticollis. Accurate diagnosis of fibromatosis colli is important to avoid unnecessary invasive interventions. Radiographic imaging is fundamental to differentiating this benign tumor from other causes of neck masses/swelling in infants. In this article, we discuss the case of a 4-month old child who presented with a head tilt and had imaging that favored a diagnosis of fibromatosis colli. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: IMAGING Source Type: research

Acute Treatment of Pediatric Migraine: A Review of the Updated Guidelines
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: CE Tests Source Type: research

Acute Treatment of Pediatric Migraine: A Review of the Updated Guidelines
The purpose of the Research to Practice column is to review and critique current research articles that directly affect the practice of the advanced practice nurse (APN) in the emergency department. This review examines the findings of M. Oskoui et al. (2019) from their article, “Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society.” The authors completed an extensive literature review and created eight recommendations f...
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research

AAENP Celebrates 5 Years!
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2020 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research

Nursemaid's Elbow Reduction
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: CE Tests Source Type: research

A Practical Guide for Managing Antibiotic Allergies in the Emergency Department
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: CE Tests Source Type: research

The Use of Ultrasonography in the Emergency Department to Screen Patients After Blunt and Penetrating Trauma: A Clinical Update for the Advanced Practice Provider
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: CE Tests Source Type: research

Leveraging a Public Health Framework and Community Advisory Board to Innovate Workplace Violence Intervention Strategies
Even with extensive evidence documenting the incidence, risk factors, and negative outcomes of workplace violence (WPV) against emergency department (ED) employees, there is a lack of intervention strategies reported that could be subjected to a clinical trial in the ED setting. The purpose of this article is to report the outcomes of a novel process adapted from the Framework for Program Evaluation in Public Health for soliciting intervention strategies from a WPV Community Advisory Board (CAB) organized by the U.S. Occupational Safety and Health Administration's WPV prevention guidelines. Ten professionals comprising bot...
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Implementation of a Team-Focused High-Performance CPR (TF-HP-CPR) Protocol Within a Rural Area EMS System
Team-focused, high-performance cardiopulmonary resuscitation (TF-HP-CPR) improves the return of spontaneous circulation (ROSC) among patients with out-of-hospital cardiac arrest (OHCA) events. In 2010, the American Heart Association began endorsing TF-HP-CPR (Meaney et al., 2013). A rural-area Virginia emergency medical services (EMS) system receives assistant medical oversight from an emergency nurse practitioner (ENP). The ENP is responsible for assisting the physician medical director in promoting continuous quality improvement (QI) within the EMS system. In January 2018, a QI project implemented a TF-HP-CPR protocol. T...
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Safe Management of Nausea and Vomiting During Pregnancy in the Emergency Department
This article discusses the incidence, prevalence, and economic costs regarding medical visits for pregnancy-associated nausea and vomiting. It also discusses ACOG guidelines and furthermore outlines special considerations, management, admission, and discharge criteria for pregnant patients presenting to the emergency department for nausea and vomiting. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Nursemaid's Elbow Reduction
This article explores epidemiology, pathophysiology, clinical presentation, reduction techniques, and parent education. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Skin and Soft Tissue Infections: A Case of Necrotizing Fasciitis
Necrotizing fasciitis is a rapidly progressing soft tissue infection associated with a high rate of mortality. Vibrio vulnificus, a gram-negative bacillus found in warm seawater, is a rare but serious cause of necrotizing fasciitis. Definitive treatment is often delayed because of the vague clinical manifestations associated with the early stages of the disease. Delays in diagnosis are directly associated with increased mortality. Because infection with V. vulnificus progresses more rapidly than other causes of necrotizing fasciitis, patients presenting with soft tissue symptoms and who have been in contact with raw seafoo...
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research

Encephalopathic Presentation of West Nile Virus Neuroinvasive Disease Confounded by Concomitant History of Acute Alcohol Withdrawal
This article highlights a case of a 55-year-old man whose history and symptoms of WNND were confounded with an alternate diagnosis, acute alcohol withdrawal. An overview of WNV infections, and important historical clues and objective findings characteristic of neuroinvasive disease, is discussed to increase readers' knowledge of WNV and awareness of when to consider WNND in the diagnostic differential. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research

A Practical Guide for Managing Antibiotic Allergies in the Emergency Department
Up to 30% of patients report at least one antibiotic allergy, but oftentimes these antibiotic allergies are misdiagnosed. In fact, of the 10% of patients reporting penicillin allergies, 90%–98% are not truly allergic. In an era of increasing antibiotic resistance coupled with a limited number of new antibiotics, evaluating antibiotic allergies is critical in providing optimal patient care. Differentiating adverse drug reactions from antibiotic allergies may seem like a daunting task for clinicians and providers, especially in the emergency department, where decisions are made quickly. However, a systemic approach, in...
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research

The Use of Ultrasonography in the Emergency Department to Screen Patients After Blunt and Penetrating Trauma: A Clinical Update for the Advanced Practice Provider
Use of bedside ultrasonography to identify life-threatening injuries for patients with blunt and penetrating trauma is the standard of care in the emergency department. The “FAST” examination—focused assessment with sonography for trauma—ultrasound scan of the chest and abdomen allows clinicians to assess critical regions for free fluid without use of invasive procedures as quickly and as often as needed. In addition, ultrasonography has a high degree of sensitivity and specificity and is safe during pregnancy. For patients requiring evaluation of the pleura, the “eFAST” (or extended FAS...
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: IMAGING Source Type: research

Are Pelvic Exams Necessary Anymore?
This article, “Is the pelvic examination still crucial in patients presenting to the emergency department (ED) with vaginal bleeding or abdominal pain when an intrauterine pregnancy is identified on ultrasonography? A randomized controlled trial,” by J. A. Linden et al. (2017) seeks to determine whether excluding a pelvic examination among patients presenting to the ED with first-trimester vaginal bleeding or lower abdominal pain, and indication of intrauterine pregnancy recorded on ultrasound increases morbidity. The findings are discussed in the context of changing practice and patient preference. Emergency n...
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research

Appropriateness Criteria for Neuroimaging of Adult Headache Patients in the Emergency Department: How Are We Doing?: Erratum
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: Erratum Source Type: research

Moving the Emergency Nurse Practitioner Specialty from Resistance to Acceptance: The Wyoming Experience
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2019 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research

Choosing the Correct “-ase” in Acute Ischemic Stroke: Alteplase, Tenecteplase, and Reteplase
Alteplase is a tissue plasminogen activator approved for treating acute ischemic stroke (AIS), acute myocardial infarction (AMI), and acute massive pulmonary embolism. Two additional tissue plasminogen activators, tenecteplase and reteplase, are also approved for AMI treatment. However, neither tenecteplase nor reteplase is approved for AIS treatment. The U.S. Food and Drug Administration has received reports of accidental administration of tenecteplase or reteplase instead of alteplase in patients with AIS, which can lead to potential overdose. Primary factors contributing to medication errors include use of the abbreviat...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Improving the Care of Individuals With Sickle Cell Disease in the Emergency Department Using a Quality Improvement Framework: The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS)
Sickle cell disease (SCD) is a severe chronic disease that leads to premature mortality caused by serious complications of the disease such as acute chest syndrome, stroke, and sepsis. Patients presenting to the emergency department (ED) with pain due to vaso-occlusive crisis (VOC) are at a higher risk for complications, making it imperative that emergency nurses, nurse practitioners, and physicians are knowledgeable about SCD and understand the other associated complications besides VOC. Because of the complexity of disease and misperceptions about SCD among ED nurses, physicians, and nurse practitioners, a quality improv...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Using Survivors' Voices to Guide the Identification and Care of Trafficked Persons by U.S. Health Care Professionals: A Systematic Review
Evidence suggests that trafficked persons in the United States frequently seek health care, yet little is known of their experiences, including reasons for seeking assistance, interactions with professionals, and barriers to obtaining care. To gain a better understanding, a search was conducted for empirical data collected directly from trafficked persons about their US health care experiences, published in peer-reviewed journals within the past 10 years, and in the English language. Four databases were searched and of the 1,605 articles initially identified, 8 met all inclusion criteria. Data from 420 participants demonst...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Advanced Practice Provider Burnout in a Large Urban Medical Center
Burnout is characterized by 3 facets: the presence of emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. It arises when stress becomes so severe relative to a person's own resources that he or she loses motivation to perform, and it is associated with many negative outcomes. Emergency medicine (EM) physicians ranked highest in a study of burnout rates among physician subspecialties. However, there is an overall lack of robust research examining the work-related psychological states in advanced practice providers (APPs). Because the utilization of APPs in emergency departments (EDs) is ...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Dental Pain Relief in the Age of ALTO
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: CE Tests Source Type: research

Dental Pain Relief in the Age of ALTO
This article presents the techniques required to safely and effectively administer 3 types of dental nerve blocks, allowing the emergency nurse practitioner to provide effective pain control to patients with dental pain. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Kawasaki Disease in Infancy
Kawasaki disease (KD) is an acute vasculitis that primarily affects young children and, if untreated, is associated with development of coronary artery aneurysms in approximately 25% of those affected. Infants, especially those younger than 6 months, often have atypical (incomplete) presentations of KD and are most at risk for development of aneurysms. Identification of KD requires a careful and thorough history and physical examination because multiple other conditions cause similar findings. Providers in acute care settings need to have a high degree of suspicion for KD so that those affected may receive appropriate and ...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research

An Atypical Case of Abdominal Pain in a Toddler: A Diagnostic Challenge
This article describes a case of a young toddler with an acute appendicitis complicated by perforation and abscess formation. Although acute appendicitis is uncommon in infants and younger children, it does occur and, as this case illustrates, is often misdiagnosed, which leads to delayed treatment and a higher incidence of complications. This article includes a discussion of the challenges faced by ED providers in the clinical-decision making process when caring for a pediatric patient with abdominal pain due to an acute appendicitis. This discussion includes the age-associated epidemiology, pathophysiology, clinical pres...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research

Orolingual Angioedema After Tissue Plasminogen Activator Administration in Patients Taking Angiotensin-Converting Enzyme Inhibitors
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: CE Tests Source Type: research

Orolingual Angioedema After Tissue Plasminogen Activator Administration in Patients Taking Angiotensin-Converting Enzyme Inhibitors
Orolingual angioedema is a rare adverse effect (1%–5%) of tissue plasminogen activator (tPA) that can lead to significant morbidity in patients with acute ischemic stroke. It is thought that increased levels of bradykinin and histamine resulting from tPA administration can result in angioedema. Angiotensin-converting enzyme (ACE) inhibitors can also lead to increased levels of bradykinin and appear to be a risk factor for tPA-associated angioedema. A literature review was conducted to examine previous cases of orolingual angioedema associated with tPA administration in patients also taking ACE inhibitors to better un...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research

Mallet Finger
This article provides an overview of issues associated with traumatic injury to the distal finger that results in extensor tendon disruption or bony avulsion at the base of the distal phalanx. Commonly referred to as mallet finger, drop finger, or baseball finger, terminal extensor tendon injuries are a common presentation to the emergency department. Providers need to be advised of evidence-based management of these extensor tendon injuries in order to prevent decreased function and permanent deformity. Current evidence supports nonoperative interventions, but injuries need to be addressed in a timely manner in order to a...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: IMAGING Source Type: research

The Modified Valsalva Maneuver for Reversion of Stable Supraventricular Tachycardia: Lessons Learned From the REVERT Trial
The REVERT trial was a randomized multicenter trial that investigated the efficacy of using a modified Valsalva maneuver for the reversion of stable supraventricular tachycardia back to a sinus rhythm. Although no improvement in discharge to home from the emergency department (ED) or ED length of stay was observed, the REVERT trial demonstrated that the modified Valsalva maneuver was superior to the standard Valsalva maneuver. The modified Valsalva maneuver should be considered first-line treatment for patients who present with a stable supraventricular tachycardia. A case presentation illustrates the methodology for utili...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research

AAENP and ACEP: Cultivating Interprofessionalism
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research

Utilizing Ultrasound-Guided Femoral Nerve Blocks and Fascia Iliaca Compartment Blocks for Proximal Femur Fractures in the Emergency Department
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: CE Tests Source Type: research

The Use of Ketamine for the Management of Acute Pain in the Emergency Department
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: CE Tests Source Type: research

Sex Trafficking: A Concept Analysis for Health Care Providers
This article is intended to provide clarification on the concept distinctly specific to victims of sex trafficking. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Appropriateness Criteria for Neuroimaging of Adult Headache Patients in the Emergency Department: How Are We Doing?
The American College of Radiology (ACR) developed Appropriateness Criteria (ACR-AC) for diagnostic imaging to reduce overuse and promote high-yield, cost-effective, evidence-based decision-making. For adult headaches, there are 16 variants with specific imaging recommendations. Headache accounts for 4.5% of emergency department (ED) visits, and 61% are chronic. Imaging for headaches has increased in the past 2 decades, with intracranial pathology diagnoses going down. Evidence suggests that there is poor knowledge of the ACR-AC among advanced practice nurses (APNs) and nonradiologist physicians. The ACR-AC recommendations ...
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Relationship Between Changes in Prehospital Blood Pressure and Early Neurological Deterioration in Spontaneous Intracerebral Hemorrhage
The aim of this study was to explore the relationship between changes in prehospital blood pressure (BP) and the incidence of early neurological deterioration (END) after spontaneous intracerebral hemorrhage (SICH) in patients who arrive at the emergency department (ED) with a normal Glasgow Coma Scale (GCS) score. Records of consecutive adults with SICH transported by ambulance and treated in our ED from January 2015 to December 2017 were retrospectively reviewed. The study cohort included all patients with SICH occurring within the previous 6 hr who had a normal GCS score on ED arrival. Detailed information was retrieved...
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Pharmacologic Management of Acute Migraines in the Emergency Department
This article reviews the best evidence behind some of the medications frequently used to treat acute migraines in the ED setting, including dopamine receptor antagonists, serotonin receptor agonists, anti-inflammatory medications, opioids, magnesium, valproate, and propofol. The evaluation of patients presenting to the ED with an acute headache, the diagnostic criteria for migraines, and implications for advanced practice are also discussed. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

A Survey of Emergency Department Quality Improvement Activities: Effective Fast Track Waiting Area Management
This article describes the quality improvement process used to implement a waiting area within fast track. Staff and patient survey data indicated a significant decrease in workload, with a subsequent high satisfaction of both groups following the redesign process. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Utilizing Ultrasound-Guided Femoral Nerve Blocks and Fascia Iliaca Compartment Blocks for Proximal Femur Fractures in the Emergency Department
Proximal femur fractures (PFF) are one of the many common injuries that present to the emergency department (ED). The current practice for pain management utilizes systemic opioid analgesics. The use of opioids is an excellent analgesic choice, but they carry a significant burden for potential adverse effects. It is vital that providers have a variety of approaches to acute pain control. The use of femoral nerve blocks (FNBs) and fascia iliaca compartment blocks (FICB) are an alternative method of pain control in the ED. They have advantages over systemic opiates in that they do not require hemodynamic monitoring, have les...
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Staphylococcal Scalded Skin Syndrome: A Pediatric Dermatological Emergency
Staphylococcal scalded skin syndrome (SSSS) is a major exfoliating skin infection primarily seen in neonates and young children that can lead to serious morbidity. Although this condition is not commonly encountered, evidence indicates that the incidence and prevalence of this infection is increasing. It is essential that emergency care providers are knowledgeable regarding the differential diagnosis and clinical-decision making process for accurate and timely diagnosis and treatment. This case study highlights the challenges faced in the emergency department in the diagnosis and management of SSSS, including pathophysiolo...
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research

Evaluation of Traumatic Uveitis in the Emergency Department
This article focuses on traumatic uveitis. It addresses the elements of history and examination that should suggest uveitis as the cause of pain and redness following trauma to the eye. It also outlines specific findings that can help differentiate uveitis from other causes of eye pain and redness following trauma. Included is a brief description of the pathophysiology of uveitis and the mechanism by which this inflammatory condition can result in loss of vision. Discussion includes recommended treatment. It offers a straightforward approach to making the diagnosis of traumatic uveitis. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research

The Use of Ketamine for the Management of Acute Pain in the Emergency Department
Ketamine has been used as an anesthetic agent for over 50 years. At the upper end of the dosing range, it displays dissociative anesthetic and amnestic effects, while at lower doses, it acts as an analgesic and demonstrates opioid-sparing capabilities. Ketamine is unique in its preservation of hemodynamic stability and respiratory function, and is used extensively in the emergency department (ED) for procedural sedation and the facilitation of brief painful procedures. Despite evidence supporting its safety and efficacy as an analgesic agent at sub-dissociative doses, its use in the ED for the management of acute pain rema...
Source: Advanced Emergency Nursing Journal - April 1, 2019 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research