Something's “Fishy” With That Sore Throat...
A 9-year old male presented to the emergency department for the evaluation of a sore throat. Initial history of present illness stated in the triage note was that “the child complained of a sore throat,” suggesting possible pharyngitis. There was no evidence of stridor, sialorrhea, hypoxia, or aphonia. Further investigation of the history of present illness identified the concern for a possible esophageal foreign body. Imaging studies of the neck identified a fishbone in the esophagus. This case presentation discusses an atypical presentation of an esophageal foreign body and the subtle findings on assessment and imagi...
Source: Advanced Emergency Nursing Journal - July 1, 2021 Category: Emergency Medicine Tags: IMAGING Source Type: research
Sulfasalazine-Induced Toxic Epidermal Necrolysis: A Challenging Case During the COVID-19 Pandemic
We present a case of TEN induced following sulfasalazine administration that later on complicated with COVID-19, deep vein thrombosis, pulmonary emboli, and eventually death. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2021 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research
INSTRUCTIONS: Implementation of a Procainamide-Based Cardioversion Strategy for the Management of Recent-Onset Atrial Fibrillation
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2021 Category: Emergency Medicine Tags: NCPD Tests Source Type: research
Implementation of a Procainamide-Based Cardioversion Strategy for the Management of Recent-Onset Atrial Fibrillation
Atrial fibrillation/flutter (AF) remains the most common rhythm disturbance in adult patients presenting to emergency departments (EDs). Although pharmacologic cardioversion has been established as safe and effective in recent-onset AF, its use in U.S. EDs is uncommon. The purpose of this study was to assess the safety and efficacy of intravenous (IV) procainamide for pharmacologic cardioversion in patients presenting to the ED with AF of (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2021 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research
The Undertriage of Older Adults in the Emergency Department: A Review of Interventions
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. A topic and a research study are selected for each column. A patient scenario is presented as a vehicle, in which to review and critique, the findings of the selected research study. In this column, we review the conclusions of A. Malinovska, L. Pitasch, N. Geigy, C. H. Nickel, and R. Bingisser (2019) from their article, titled “Modification of the Emergency Severity Index Improves Mortality Prediction in Older P...
Source: Advanced Emergency Nursing Journal - July 1, 2021 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research
Revisioning the ENP Among Emergency Workforce Changes: Specialty or Population?
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - July 1, 2021 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research
Improving Patient Flow and Decreasing Patient Length of Stay in the Pediatric Emergency Department Through Implementation of a Fast Track
Increased utilization of the emergency department (ED) for low acuity concerns saturates EDs, leading to overcrowding. As the ED becomes crowded, the quality of care threatens patient safety and increases length of stay. To improve the efficiency of evaluation and discharge of low acuity patients in the pediatric ED, a performance improvement project was implemented to develop a Fast Track. An interdisciplinary team developed the process of Fast Track, as well as guidelines for low acuity patients who would be evaluated in the designated area by an advanced practice provider and registered nurse team. Within 14 months of o...
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
A Comparison of the Time Spent in Emergency Departments by Older Adults With and Without Mental Health Needs
This article compares the time spent in emergency departments by older adults who have a mental health need with those who do not. Information on how they access prehospital and inhospital care is examined alongside key factors that impact on time spent in emergency departments. Data were collected from hospital records of older adults presenting at emergency departments in 3 large Health and Social Care Trusts in the United Kingdom using a retrospective, secondary, official personal information database source over 1 year. A total sample of 74,766 attendance records of older adults older than 65 years were examined. adult...
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
Variation in Participation in Nurse-Driven Emergency Department Hepatitis C Screening
In conclusion, wide variation in individual nurse participation in HCV screening suggests individual-level barriers are a more significant barrier to ED screening than previously recognized. Implementation research should expand beyond questions of resource availability and procedural streamlining to evaluate and address staff knowledge, beliefs, attitudes, and motivation. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
Rapid Atrial Fibrillation Masquerade
A 63-year-old man presented to the emergency department for fluttering in the chest. The initial electrocardiogram (ECG) suggested rapid atrial fibrillation with nonspecific RS- and ST-segment abnormalities. Treatment with intravenous β-blocker resulted in conversion to a normal sinus rhythm. The repeat ECG revealed conversion to normal sinus rhythm with an inferior lateral myocardial infarction. This case presentation identifies the importance of an algorithmic approach to identifying narrow complex tachyarrhythmias considering both cardiac and noncardiac causes. Furthermore, evaluating ECG changes when varying rates and...
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
Hematoma Block: An Effective Alternative for Pain Management and Procedural Sedation
This article presents the appropriate technique required to perform a hematoma block for pain control and fracture reduction in patients with closed traumatic injuries. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Clavicle Fractures
Clavicle fractures are commonly seen in children and young adults. A case of a 30-year-old woman sustaining a clavicle fracture while riding a bike is highlighted. The most common cause is strong fall with the injured arm at one's side, often in contact sports injuries. The clavicle is divided into thirds: medial (proximal), middle (midshaft), and lateral (distal) thirds. Eighty percent of clavicle fractures occur in the middle third of the clavicle, and nearly half of those midshaft fractures are displaced. Goals of initial treatment are to reduce pain and limit motion of the fracture fragments until bone union with eithe...
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: IMAGING Source Type: research
INSTRUCTIONS: A Case of Multisystem Inflammatory Syndrome in Children Following SARS-CoV-2 Infection in a Rural Emergency Department
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: NCPD Tests Source Type: research
A Case of Multisystem Inflammatory Syndrome in Children Following SARS-CoV-2 Infection in a Rural Emergency Department
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), also known as COVID-19, has rapidly spread across the globe resulting in a worldwide pandemic. This disease has such varying presentation within the population. Although rare, multisystem inflammatory syndrome in children (MIS-C) is a potentially fatal complication of SARS-CoV2 infection and can be easily missed in the early stages. Because emergency department (ED) providers are often the initial treating providers, knowledge of the clinical manifestations and treatment of MIS-C is essential. The purpose of this article is to present a case of MIS-C in a rural E...
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research
Spontaneous Retropharyngeal Emphysema: A Triage Twist
Spontaneous retropharyngeal emphysema (SRE) is a rare condition, occurring in the absence of trauma. Symptoms usually include acute-onset odynophagia and dyspnea. This is an interesting case of a young, healthy woman who presented to an emergency department with benign upper respiratory symptoms but took a drastic turn while in the waiting room after being triaged. The features and implications of SRE are discussed in this case, including emergent thoracic surgery consultation and additional testing. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research
