Tibial Plateau Fractures
Tibial plateau fractures can result from direct trauma or indirect compressive forces. These injuries often result in significant soft tissue disruption, ligamentous disturbance in addition to bone fractures. Diagnostic imaging findings in plain radiographs include fat-fluid level in the suprapatellar bursa, malalignment of the femoral condyles and tibial edges, and increased trabecular density in the lateral epicondyle. Patients in whom a tibial plateau fracture is suspected with negative radiographs should have computerized tomography imaging performed. Most patients will require surgical intervention for fracture fixati...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Imaging Source Type: research
Emergency Department Use of Intravenous Prochlorperazine for Acute Migraine
The Research to Practice Column is designed to improve translational research critique skills of nurse practitioners (NPs). In this issue, the article “Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine” is discussed in the context of a patient with an acute headache presenting to the emergency department (ED). The study was designed to assess the efficacy of intravenous prochlorperazine and diphenhydramine as compared with intravenous hydromorphone for patients with acute migraine in the ED. With the growing trend to avoid the use of opiates to curb potential addiction and in...
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: Research to Practice Source Type: research
Building Bridges to Advance Specialty Practice: Updates and Accomplishments by the American Academy of Emergency Nurse Practitioners
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2018 Category: Emergency Medicine Tags: From the Editor Source Type: research
Comparison of Sepsis-3 Criteria Versus SIRS Criteria in Screening Patients for Sepsis in the Emergency Department
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. All patients included were evaluated for the presence of SIRS and qSOFA criteria a...
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Dermatology Dilemmas Source Type: research
Evaluation of Richmond Agitation Sedation Scale (RASS) in Mechanically Ventilated in the Emergency Department
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. There were 205 patients identified; 104 failed inclusion, 101 were enrolled, and 62 were excluded. Thirty-nine patients (94.9%) had an RASS goal implemented in the ED, o...
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Dermatology Dilemmas Source Type: research
An Interprofessional Web-Based Teaching Module to Enhance Competency of the Advanced Practice Nursing Clinical Education in the Emergency Department
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. This web-based curricular preceptorship model that incorporates new technology and innovation in clinical rotations can prov...
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Dermatology Dilemmas Source Type: research
An Emergency Medicine Residency for Nurse Practitioners: The New York Presbyterian–Weill Cornell Medicine Experience
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. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Dermatology Dilemmas Source Type: research
Recognizing Measles, Mumps, and Rubella in the Emergency Department
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: CE Test Source Type: research
Recognizing Measles, Mumps, and Rubella in the Emergency Department
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. Emergency medicine providers play a key role in early recognition and diagnosis of the disease. The proper management and reporting reflect the emphasis on prevention of widespread outbreaks. (Source...
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Dermatology Dilemmas Source Type: research
Ocular Chemical Burns Secondary to Accidental Administration of e-Cigarette Liquid
This article presents a patient's case including patient history and management in the emergency department. The significance of chemical burns to the eye and its management is discussed in relation to significance to clinical practice for all nurses, nurse practitioners, and physicians working in the emergency department. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Time Spent in the Emergency Department and Outcomes in Patients With Severe Sepsis and Septic Shock
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. To examine the impact of time from ED arrival to inpatient admission on mortality and length of stay (LOS) in patients with severe sepsis or septic shock. A retrospective analysis of adult patients with severe sepsis or septic shock was completed for those presenting bet...
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Applied Pharmacology Source Type: research
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. Patient history and physical examination can assist in a preliminary diagnosis before diagnostic imaging. Plain chest/abdominal radiograph or comput...
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Imaging Source Type: research
Acute Headache in the Emergency Department: Is Lumbar Puncture Still Necessary to Rule Out Subarachnoid Hemorrhage?
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.” The authors concluded that although no history or physical examination finding can be used to rule in or rule out spontaneous subarachnoid hemor...
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: Research to Practice Source Type: research
Emergency Nurse Practitioners State by State: A Call to Action
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2018 Category: Emergency Medicine Tags: From the Editor Source Type: research
What the Advanced Practice Nurse in the Emergency Department Needs to Know About the Health Risks and Hazards of Electronic Cigarette Use by Youth
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2018 Category: Emergency Medicine Tags: CE Test Source Type: research
