Barriers to Research Recruitment of Women Experiencing a Pregnancy Loss in the Emergency Department
This study implemented an EMR-based prompt to assist participant screening completed by ED nurses: (a) The prompts were based on criteria built into triggers that activated a recruitment screening form to print upon discharge; (b) nurses completed the form with patients, asking for willingness to be contacted at home; and (c) participants were subsequently contacted and enrolled in the study. Our research screening program was implemented continuously in 2 EDs: a large, urban, academic medical center and a community academic hospital. Data were analyzed through descriptive statistics of reports built within the EMR. These ...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Changing the Emergency Department's Practice of Rapid Sequence Intubation to Reduce the Incidence of Hypoxia
Rapid sequence intubation (RSI) is an advanced procedure performed by nurse practitioners in the emergency department (ED). Hypoxia is one of the most common complications associated with RSI, which may lead to serious sequela, including death. Hypoxia may result from medications that are given to facilitate the procedure or the underlying disease process. Without preventive measures, oxygen levels may fall rapidly when patients are no longer actively breathing. The incidence of RSI-induced hypoxia may be mitigated with proper education, preoxygenation, positioning, and the utilization of passive (apneic) oxygenation. The ...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Postpartum Headache
Approximately 40% of all women report experiencing headaches during the postpartum period, regardless of a previous headache history. This case narrative describes the clinical case of a 22-year-old woman who presented for the evaluation of an intractable headache for 2½ weeks. It demonstrates the inherent difficulty in diagnosing patients not presenting with “textbook” symptoms and highlights the fact that signs and symptoms of eclampsia/preeclampsia, such as elevated blood pressure, may fall below the threshold for hypertensive emergencies and not be considered in the differential. Emergency department providers mus...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Sugammadex for Neuromuscular Blockade Reversal
Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Sugammadex, a modified γ-cyclodextrine compound, is a recently approved agent for the reversal of blockade with aminosterodial neuromuscular blockers. Randomized controlled trials, in addition to a meta-analysis and a systematic...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Applied Pharmacology Source Type: research
Orbital Floor Fractures
The orbital bones are thin and exposed, making the orbital walls vulnerable to fractures. The floor of the orbit is the weakest portion of this 4-sided pyramid structure. Blunt force trauma is the primary mechanism of injury in young men between the ages of 18 and 30 years. Computerized tomography is the primary imaging technique to diagnose orbital fractures. Conservative versus surgical management is determined by maxillofacial and ophthalmology specialists. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Imaging Source Type: research
Does Suprapubic Stimulation in Infants Facilitate Collection of a Clean Catch Urine Specimen?
This study highlights the important role of the APN in ordering clean catch urine specimen collection and avoidance of invasive procedures. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Research to Practice Source Type: research
The Specialty of Emergency Nurse Practitioner Practice
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: From the Editor Source Type: research
Orbital Floor Fractures
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: CE Test Source Type: research
The Effect of Apneic Oxygenation on Reducing Hypoxemia During Rapid Sequence Induction and Intubation in the Acutely Ill or Injured
Apneic oxygenation during intubation is the application of oxygen via a nasal cannula, which is left in place throughout laryngoscopy. The flow rate of oxygen is set to at least 15 L/min and theoretically reduces the risk of oxygen desaturation and hypoxemia during the procedure. Over the last 5 years, there have been several studies published on this topic with differing results. Despite conflicting results, use of apneic oxygenation is becoming more prevalent and is being implemented into standard operating procedures in some clinical settings. Because of the low risk of adding a nasal cannula during intubation and the p...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Reducing Unnecessary Head Computed Tomography in Mild Traumatic Brain Injury
This article examines recent research to determine which of these tools has proven to be the most effective at safely reducing the use of head CT scans. The reviewed studies concluded that both the Canadian CT Head Rule and the New Orleans Criteria had similar sensitivities, but the Canadian CT Head Rule showed superior specificity in predicting the presence of a clinically significant brain injury. The authors of this article recommend that the Canadian CT Head Rule be used in the evaluation of minor head injury to reduce unnecessary CT scans. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Intravenous Push Cephalosporin Antibiotics in the Emergency Department: A Practice Improvement Project
Delays in administration of appropriate antibiotics to patients with septic shock are associated with increased mortality. To improve the care of patients with sepsis within our 73-bed emergency department (ED), a “first-dose” intravenous push (IVP) cephalosporin antibiotic protocol was initiated. This project was aimed at improving the time from provider order of antibiotic to administration, which follows the Sepsis Core Measure of timely antibiotic administration.
This was a single-center, retrospective analysis of a practice improvement study. Time from provider order of an IV cephalosporin antibiotic to administr...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
A Randomized, Double-Blind Trial to Determine if Vapocoolant in the Adult Population Improves Patient Perception of Pain With Peripheral Intravascular Access
The purpose of this study was to investigate whether the use of a topical anesthetic spray (vapocoolant) at the site of intravenous access reduces pain and anxiety associated with peripheral intravenous (PIV) catheter insertion in an adult emergency department population. A randomized, double-blind, placebo-controlled, single-center trial, conducted from July to August, in an adult emergency department where 72 patients with orders for PIV insertion receiving either topical vapocoolant spray (n = 38) or placebo spray (n = 34). Vapocoolant or placebo was applied to the intravenous site and allowed to evaporate before cleans...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Barriers to Research Recruitment of Women Experiencing a Pregnancy Loss in the Emergency Department
This study implemented an EMR-based prompt to assist participant screening completed by ED nurses: (a) The prompts were based on criteria built into triggers that activated a recruitment screening form to print upon discharge; (b) nurses completed the form with patients, asking for willingness to be contacted at home; and (c) participants were subsequently contacted and enrolled in the study. Our research screening program was implemented continuously in 2 EDs: a large, urban, academic medical center and a community academic hospital. Data were analyzed through descriptive statistics of reports built within the EMR. These ...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Changing the Emergency Department's Practice of Rapid Sequence Intubation to Reduce the Incidence of Hypoxia
Rapid sequence intubation (RSI) is an advanced procedure performed by nurse practitioners in the emergency department (ED). Hypoxia is one of the most common complications associated with RSI, which may lead to serious sequela, including death. Hypoxia may result from medications that are given to facilitate the procedure or the underlying disease process. Without preventive measures, oxygen levels may fall rapidly when patients are no longer actively breathing. The incidence of RSI-induced hypoxia may be mitigated with proper education, preoxygenation, positioning, and the utilization of passive (apneic) oxygenation. The ...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Postpartum Headache
Approximately 40% of all women report experiencing headaches during the postpartum period, regardless of a previous headache history. This case narrative describes the clinical case of a 22-year-old woman who presented for the evaluation of an intractable headache for 2½ weeks. It demonstrates the inherent difficulty in diagnosing patients not presenting with “textbook” symptoms and highlights the fact that signs and symptoms of eclampsia/preeclampsia, such as elevated blood pressure, may fall below the threshold for hypertensive emergencies and not be considered in the differential. Emergency department providers mus...
Source: Advanced Emergency Nursing Journal - October 1, 2017 Category: Emergency Medicine Tags: Cases of Note Source Type: research
