Collaborative, Innovative Quality Improvement Activity: Development of Queensland Ambulance Service Stickers: Drivers, Approaches, Implementation, and Outcomes
This article discusses the implementation of 3 targeted interventions aimed at reducing infection rates in patients due to prolonged in situ intravascular catheters (IVCs) during their admission to the hospital. These IVCs are inserted by paramedics with Queensland Ambulance Service (QAS) in prehospital settings. The 3 interventions involved were the application of “QAS-IVC” stickers by QAS paramedics to indicate QAS-inserted IVCs, the implementation of mandatory IVC documentation during patient handover, and clinician engagement to provide patient education on IVC infection signs. Audits undertaken in wards reflected ...
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Word Catheter Placement for Bartholin's Gland Abscess: Applications for Clinical Practice and Simulation
This article presents the diagnostic and treatment approaches to Bartholin's abscesses and describes in detail both low- and high-fidelity simulations for Word catheter placements. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Recognizing Fournier's Gangrene in the Emergency Department
Fournier's gangrene is a rare disease with a significant mortality rate. The potentially fatal disease stems from both aerobic and anaerobic bacteria and primarily occurs in men. The majority of Fournier's gangrene cases are idiopathic or derived from perineal and genital skin infections. Comorbid risk factors include diabetes mellitus, alcohol misuse, and immunosuppression (Benjelloun et al., 2013). The infection initially presents as a cellulitis in the perineum or perianal area. As Fournier's gangrene progresses, the infected tissue becomes swollen, significantly painful, and necrotic. The progression of infection can l...
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research
Type A Aortic Dissection Complicated by Renal and Lower Extremity Malperfusion
This article highlights a case of a 49-year-old man who developed renal and lower extremity malperfusion secondary to Stanford Type A aortic dissection. Important historical clues and objective findings characteristic of acute aortic dissection and end-organ ischemia are discussed with the purpose of increasing reader knowledge of aortic dissection and signs of organ malperfusion with the hope that better awareness results in improved patient outcomes. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research
Subdissociative Ketamine Use in the Emergency Department
Ketamine is an anesthetic known globally both for its potent dissociative properties and potential for abuse. More recently, ketamine demonstrates utility in a variety of disease states such as treatment-resistant depression, status asthmaticus, and acute agitation. In addition, ketamine has been shown to demonstrate various effects at different doses, which adds to its pharmacological benefit. As these new indications continue to come to light, it is important to stay current with the dosing for these indications as well as the adverse effects associated with ketamine's use. This review highlights the history and mechanis...
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research
Sever's Disease (Calcaneal Apophysitis)
Sever's disease, or calcaneal apophysitis, is the primary cause of heel pain in pediatric patients between the ages of 8 and 15 years. Primary risk factors in pediatric athletes are obesity and high levels of physical activity. Sever's injury primarily results from high-impact sports such as soccer, track, cross-country, gymnastics, tennis, and ballet. This injury mainly occurs during puberty with an open growth plate in the immature calcaneus. Clinical diagnosis can be confirmed by performing a “squeeze test” of the heel on physical examination. Diagnostic imaging findings include increased sclerosis and fragmentation...
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: IMAGING Source Type: research
Alcohol Use and Sexual Assault Among College Students: Implications for APRN Practice
The Research to Practice column is designed to provide advanced practice nurses (APRNs) with an analysis of a current research topic with implications for practice change within emergency care settings. This review examines a recent study conducted by Tadros, Sharon, Hoffman, and Davidov (2018), titled “Emergency Department Visits for Sexual Assault by Emerging Adults: Is Alcohol a Factor?” The authors conducted a retrospective chart review of emergency department (ED) visits for sexual assault among a college-age population and found most patients were female (98%) and 70% were younger than 21 years. Additionaly, amon...
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research
ENP Theme Issue: Worth the Read!
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2019 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research
Nonstandard Advance Health Care Directives in Emergency Departments: Ethical and Legal Dilemma or Reality A Narrative Review
This article discusses the ethical and legal implications of nonstandard advance health directive tattoos in emergency treatment situations. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Emergency Patients' and Family Members' Experiences of Nonconveyance Situations and Counseling Received From Care Providers
Making nonconveyance decisions can be demanding for care providers in prehospital emergency services. Studies have found homecare instructions and counseling of patients and family members partly insufficient. A descriptive cross-sectional design was applied for this pilot study to explore emergency patients' and family members' experiences of nonconveyance situations and counseling. Data were collected by questionnaires from acutely ill patients (n = 97) treated on-site and not transported to hospital and from their family members (n = 72) in 2015–2016. Responses to quantified statements were analyzed statistically, whe...
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Implementation of an Sexually Transmitted Disease-Screening Protocol in an Emergency Department: A Quality Improvement Project to Increase STD Screenings in Young Adults Aged 15–29 Years With Urinary Symptoms
Urinary symptoms, such as dysuria, urinary urgency, frequency, and suprapubic pain, are frequent complaints made in the emergency department (ED; M. D. Wilbanks, J. W. Galbraith, & W. M. Geisler, 2014). Although it is easy to relate urinary symptoms with a urinary tract infection (UTI), both UTI and sexually transmitted disease (STD) can share same urinary symptoms that mask each other from detection. It presents challenges for ED clinicians to precisely distinguish between two infections, causing misdiagnosis and mistreatment, resulting in patient morbidity and high health care costs. Clinician adherence to clinical guide...
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Point-of-Care Ultrasound for Skin and Soft Tissue Infections
This article reviews the difference in the 2 most common skin and soft tissue infections and discusses implications for point-of-care ultrasound in the emergency care setting to aid in diagnosis. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Herpes Zoster in the Emergency Department: Potential for Severe Outcomes
An estimated one million cases of herpes zoster are reported in the United States annually. Although most cases of herpes zoster are self-limiting and require little interventions, some occurrences can result in potentially debilitating and/or life-threatening outcomes. The purpose of this article is to discuss the incidence, potential complications, treatment, and preventive measures of herpes zoster. A case report is utilized to emphasize the importance of a thorough evaluation and consideration of complications. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research
Evaluation of Pain in the Cognitively Impaired Patient in the Emergency Department
The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse and the emergency nurse, and to assist with the translation of research into practice. For each column, a topic and a 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. In the current column, we examine the findings of A. Agit et al. (2018) from their article titled “An Iceberg Phenomenon in Dementia: Pain.” (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research
Treatment of Life-Threatening ACE-Inhibitor-Induced Angioedema
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: CE Test Source Type: research
