Impact of Advanced Practice Prehospital Programs on Health Care Costs and ED Overcrowding: A Literature Review
Health care costs in the United States continue to increase, requiring solutions that permit safe, quality care with a lower financial investment. Utilization of the emergency department for nonemergent care is considered to be one of the costliest, and most preventable methods of health care delivery. This review seeks to demonstrate how advanced practice prehospital programs can potentially decrease the cost of health care without sacrificing quality or safety. Utilization of the emergency department for nonemergent care contributes to the escalating cost of health care as well as to emergency department overcrowding. Ad...
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
A Review of Central Venous Access Using Ultrasound Guidance Technology
More than 5 million central lines are placed in the United States each year. Advanced practice providers place central lines and must understand the importance of ultrasound guidance technology. The use of anatomic landmarks to place central lines has been employed in the past and in some instances is still used. This method may make accessing the target vessel difficult in the patient with anomalous anatomy or in the obese patient. These characteristics decrease successful placement and increase complications. Different organizations have agreed that the use of ultrasound during central venous access has decreased rates o...
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Allopurinol-Induced Drug Reaction With Eosinophilia and Systemic Symptoms: A Case Report
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: CE Tests Source Type: research
Allopurinol-Induced Drug Reaction With Eosinophilia and Systemic Symptoms: A Case Report
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an uncommon yet serious adverse cutaneous drug reaction that results from a hypersensitivity reaction. Drug reaction with eosinophilia and systemic symptoms is often misdiagnosed because of vague and confounding signs and symptoms. The most common clinical manifestations of DRESS are shared with many other diseases and include rash, lymphadenopathy, and fever. Because the syndrome can be difficult to diagnose, patients are often in the late stages of the disease process before treatment is initiated. The mainstay of treatment is stopping the culprit ...
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research
Angiotensin-Converting Enzyme Inhibitor Angioedema
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: CE Tests Source Type: research
Angiotensin-Converting Enzyme Inhibitor Angioedema
This article focuses on angioedema caused by using ACEIs. The presentation, pathology, diagnostic testing, treatment, and patient education of angioedema are explored. This article explores using fresh frozen plasma as an initial approach to the treatment of ACEI angioedema. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research
Ketamine for Migraine in the Emergency Department
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: CE Tests Source Type: research
Ketamine for Migraine in the Emergency Department
Ketamine is utilized often in the emergency department (ED) for rapid sequence intubation, procedural sedation, and acute pain management. The treatment of migraine headache in the ED varies widely and is dependent on several factors including migraine cause, previous successful abortive methods, and provider preference. Several medications are currently employed to treat acute migraine including nonsteroidal anti-inflammatory drugs, triptans, antihistamines, prochlorperazine, and corticosteroids, among others. Interest in ketamine as an abortive agent to treat migraine has increased as evidenced by recent studies evaluati...
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research
Vaping: What Every Emergency Nurse Practitioner Should Know!
As of December 10, 2019, according to the Centers for Disease Control and Prevention (CDC), more than 2,668 hospitalized cases of lung injury and 60 deaths associated with use of electronic nicotine delivery systems, or “vaping.” In many cases, patients required multiple health care visits prior to diagnosis. Recognition of the risk factors, symptoms, and examination findings that have been consistently reported is critical to making the diagnosis and initiating treatment early in the progression of disease. The precise mechanism and causative agent have yet to be elucidated, but the association with vaping has been es...
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: IMAGING Source Type: research
Death and Dying in the Emergency Department
The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse (APRN) 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 article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. Our current column discusses factors associated with the quality of the death and dying experience in the emergency department (ED) from the perspective of health care providers with implications for AP...
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research
American Academy of Emergency Nurse Practitioners Mourns Loss of Founder
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2020 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research
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 understand...
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
