Treatment of Life-Threatening ACE-Inhibitor–Induced Angioedema
Incidence of angioedema associated with angiotensin-converting enzyme inhibitors (ACE-I) has been estimated at 0.1%–2.2% of patients receiving treatment. Despite the potential severity of this disease state, standardized treatment is lacking. Traditional pharmacotherapy options include medications that target inflammatory mediators and the angiotensin pathway. However, because ACE-I-induced angioedema is caused by accumulation of bradykinin, these medications fail to target the underlying pathophysiology. Recently, novel therapies that target the kallikrein–bradykinin pathway have been studied. These include icatibant,...
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research
Emergency Department Presentation of a New-Onset Seizure: A Case Report
A seizure is a symptom of brain dysfunction, resulting in 1.6 million emergency department visits each year. The evaluation of new seizures in the emergency department is a process looking for triggers of seizures such as toxins, mass lesions, or metabolic derangements. Maintaining a broad differential diagnosis is essential to prevent premature closure of the diagnostic evaluation. Timing of neurologic imaging and electroencephalogram depends on the clinical situation. In this case, a young woman presents with a “new-onset” seizure with subsequent elevation of white blood cells and serum lactate levels. Neurologic ima...
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: IMAGING Source Type: research
Pulmonary Arterial Hypertension Emergency Complications and Evaluation: Practical Guide for the Advanced Practice Registered Nurses in the Emergency Department
Pulmonary hypertension (PH) complicates common diseases and can lead to worsening symptoms and increased mortality. A specific group of PH, pulmonary arterial hypertension (PAH), World Health Organization Group 1, may present to the emergency department (ED). We review common ED presentations of patients with PAH such as cardiac arrest/sudden death, right ventricular failure, syncope, hypoxemic respiratory failure, arrhythmias, hemoptysis, pulmonary embolism, chest pain/left main compression syndrome, infection, and considerations for PAH medication administration. We include a case study to illustrate a real example with ...
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research
Practice Standards for the Emergency Nurse Practitioner Specialty
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research
From ENP Competencies to ENP Practice Standards
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2018 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research
Outpatient Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: CE Test Source Type: research
Synthesis of Research Articles to Examine Reporting of the Educational Preparation and Practice Parameters of Emergency Nurse Practitioners
It has been reported that the outcomes of care are affected not only by the educational preparation and experience of the practitioner but also by the parameters of his or her practice. Given differences that exist internationally in the enactment of the emergency nurse practitioner (ENP) role, a synthesis of research articles was conducted to examine the educational preparation and experience of ENPs, the role(s) they assume as determined by their patient population, and the outcomes used to evaluate their practice. The synthesis was informed by Sidani and Irvine's (1999) conceptual framework for evaluating the nurse prac...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Procedural Column Source Type: research
Exploring the Sexual Assault Response Team Perception of Interprofessional Collaboration: Implications for Emergency Department Nurses
There is little research on the dynamics of the sexual assault response team (SART) members' interprofessional collaboration (IPC) practice. The study purposes were to (1) explore the perceptions of IPC among SART members; (2) evaluate the use of Perception of Interprofessional Collaboration Model Questionnaire with the SART; and (3) discuss the implications of the Interprofessional Core Competencies for emergency department nurses and sexual assault nurse examiners. This cross-sectional mixed-methods study (n = 49) was implemented using 4 SART teams in a mid-Atlantic state. There were no statistically significant differen...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Procedural Column Source Type: research
Implementation of a Smoking Cessation Education Program in the Emergency Department
Tobacco use is a major threat to public health. Current guidelines suggest that healthcare professionals in the emergency department provide routine smoking cessation screening and interventions. Evidence suggests that an educational intervention among registered nurses in the emergency department may increase education and referral for smoking cessation of patients who use tobacco products. An educational module regarding smoking cessation counseling was provided to registered nurses in the emergency department at a private hospital in South Florida. A pre- and postintervention self-reported survey evaluated changes in nu...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Procedural Column Source Type: research
Interdisciplinary Design to Improve Fast Track in the Emergency Department
Delays in medical care will increase risks for patients. For this reason, timeliness of care is a public health priority and the one of the missions for this facility. The goal of this process improvement project was to enhance timeliness of care by restructuring fast track. Door-to-provider time, treat and release time, and the number of patients who left without being seen by a provider were monitored. Nurse practitioners were introduced into advanced practice provider mix and the development of care teams was implemented. The number of fast-track visits increased significantly to a projected 23,710 in 2017, whereas the ...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Procedural Column Source Type: research
Educational Innovations for Continuing Education: JumpStart Modules for Advanced Practice Providers
There is increasing interest and evidence for the “flipped classroom” as a learner-centered approach to promote active engagement and enhance translation of knowledge into practice. However, there is little published work regarding application of the pedagogical approach to continuing education (CE) for advanced practice providers. The goal of CE is for providers to stay up-to-date with current best practices and skills, yet most CE activities employ teacher-centered, lecture-based methods focused on transmission of knowledge rather than application of knowledge. The purpose of this article is to describe successful us...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Procedural Column Source Type: research
Maximizing Success With Rapid Sequence Intubations
This article describes tools for the procedure of RSI, including the “7 Ps” checklist of intubation. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Procedural Column Source Type: research
Stevens–Johnson Syndrome: A Challenging Diagnosis
Stevens–Johnson syndrome is a rare, yet life-threatening, delayed-type hypersensitivity reaction characterized by mucocutaneous epidermal necrolysis. Toxic epidermal necrolysis is a severe manifestation of Stevens–Johnson syndrome, defined as greater than 30% skin detachment. Stevens–Johnson syndrome with toxic epidermal necrolysis is characterized as an adverse cutaneous drug reaction and is associated with the use of sulfonamides, antiepileptics, and some classes of nonsteroidal anti-inflammatory drugs. The case presented in this report is that of a 17-year-old female who presented to her primary care provider with...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Dermatology Dilemmas Source Type: research
A 20-Year-Old-Trauma Patient With Suspected Malignant Hyperthermia Following Induction With Succinylcholine: A Case Study
Malignant hyperthermia (MH) is a life-threatening hypermetabolic state that can occur following induction with depolarizing neuromuscular blockade and volatile anesthesia gases. Because succinylcholine is a common choice for prehospital and emergency department inductions, it is important for staff to be able to recognize and effectively treat an MH crisis. This case study highlights a 20-year-old male trauma patient who presented to a Level I trauma center and was intubated for declining mental status. He developed suspected MH following his anesthetic induction with succinylcholine. The following outlines the case, clini...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Outpatient Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department
The objective of this review is to assess the available literature to isolate which antibiotics and approaches to care are the most appropriate options for treating uncomplicated outpatient urinary tract infections in the ED. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Applied Pharmacology Source Type: research
