INSTRUCTIONS: Pathophysiology and Treatment of Malignant Hyperthermia
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
Pathophysiology and Treatment of Malignant Hyperthermia
Malignant hyperthermia (MH) is caused by a genetic disorder of the skeletal muscle that induces a hypermetabolic response when patients are exposed to a triggering agent such as volatile inhaled anesthetics or depolarizing neuromuscular blockers. Symptoms of MH include increased carbon dioxide production, hyperthermia, muscle rigidity, tachypnea, tachycardia, acidosis, hyperkalemia, and rhabdomyolysis. Common scenarios for triggering agents are those used are during surgery and rapid sequence intubation. Hypermetabolic symptoms have a rapid onset; hence, prompt recognition and treatment are vital to prevent morbidity and m...
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research
Racial Bias Among Emergency Providers: Strategies to Mitigate Its Adverse Effects
The Research to Practice column presents an analysis of current and controversial research findings with implications for practice change relevant to emergency care settings. This review critiques Johnson et al.'s (2016) investigation, titled “The Impact of Cognitive Stressors in the Emergency Department on Physician Implicit Racial Bias,” that examined emergency department characteristics and stressors and their effects on physician racial bias and decision making. Their findings suggest that unconscious biases can affect clinical decisions when providers experience increased cognitive stress. The implications are sig...
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: RESEARCH TO PRACTICE Source Type: research
Diversity, Equity, and Inclusion: Is It Just Another Catchphrase?
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - April 1, 2021 Category: Emergency Medicine Tags: FROM THE EDITOR Source Type: research
A Systems Approach to Front-End Redesign With Rapid Triage Implementation
The most common site for hospital sentinel events due to care delays, secondary to waiting and/or inefficient processes, occurs in the emergency department (ED). Decreasing patient length of stay in an ED is a key initiative for many hospitals in order to maximize both quality and efficiency. The purpose of this practice improvement project was to (1) standardize front-end processes across a 6-hospital health system, (2) move non-sorting-related clinical questions out of triage, and (3) improve door-to-triage and door-to-provider times. The project occurred within a 6-hospital East Coast health system. This was a continuou...
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
Improving Outpatient Follow-Up Through Innovative Appointment Scheduling at Emergency Department Discharge
This quality improvement (QI) project evaluates a comprehensive, patient-centered plan to reduce the emergency department (ED) revisit rate by improving outpatient follow-up after initial ED visits. Patients with low-acuity complaints discharged from the ED are often instructed to schedule a follow-up appointment with their primary care team or a specialty service after leaving the ED. In this QI project, patients either had a follow-up visit scheduled at the time of ED discharge or received a phone call within 2 days of discharge to schedule outpatient follow-up visit. The number of ED visits per patient was significantly...
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
Proceed With Caution: Integrating Newly Graduated Nurses Into an Emergency Department
Virtually, no published research is available on the relationship between employing newly graduated nurses (NGNs) in the emergency department (ED) and the advancing of nursing practice and the optimization of patient care outcomes. Traditionally, nurses hired into these practice areas have required advanced skills in clinical assessment and experience with a variety of situations that were assumed to offer them a framework by which they could recognize and respond to potentially life-threatening changes in a patient's status. This qualitative study explored the issues of integrating NGNs into the ED. Findings clearly estab...
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
Takotsubo Cardiomyopathy: An ST-Elevation Myocardial Infarction Mimic
Takotsubo cardiomyopathy (TC), a rare syndrome often preceded by an emotional or physical trigger, which earned the nickname broken heart syndrome, was first diagnosed in 1990. Takotsubo cardiomyopathy can mimic an ST-elevation myocardial infarction (STEMI). Originally, TC was thought to be self-limiting and benign. However, there is a 4%–5% mortality rate, which is associated with serious complications. The majority of people diagnosed with TC are postmenopausal women, but it can affect all ages. Patients will often present to the emergency department with chest pain and dyspnea. An electrocardiogram (ECG) often demonst...
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: EKG COLUMN Source Type: research
Shotblocker Use in Emergency Care: A Randomized Clinical Trial
This study was conducted to evaluate the effect of ShotBlocker on the intramuscular injection pain and satisfaction in emergency adult patients. This research was designed as a randomized controlled, double-blind, experimental study. The study was conducted with 74 patients who applied to the adult emergency department. Patients were randomized to ShotBlocker and control groups. Patient Assessment Form, Visual Analog Scale, and Visual Analog Patient Satisfaction Scale were used. The mean scores of postinjection pain and satisfaction level were analyzed between the groups; it was determined that while postinjection pain mea...
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Bladder Scan Misleading a Vascular Emergency as Urinary Retention
A middle-aged man arrives from a nursing facility to the emergency department with urinary retention and abdominal pain. A bladder scan was performed to identify the amount of urine in the bladder. Multiple attempts were made to place a urinary catheter without difficulty, but no urine was identified. When several attempts are made to insert a urinary catheter without success of urinary output, one must stop and rule out other causes. This case study outlines the etiology, diagnostics tests, and management of a patient with urinary retention. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: IMAGING Source Type: research
INSTRUCTIONS: A New Rash Differential: CoVID-19
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: NCPD Tests Source Type: research
A New Rash Differential: CoVID-19
The CoVID-19 pandemic has impacted all areas of health care, especially emergency medicine. Most commonly, CoVID-19 is associated with respiratory and typical viral presentations. However, nonrespiratory presentations are becoming more common. Reported CoVID-19 dermatological changes include maculopapular and urticarial rashes, chilblain-like and livedo reticularis discolorations, and less commonly vesicular and petechial rashes. As frontline clinicians, emergency nurse practitioners should be aware of these skin findings to recognize potentially infected and otherwise asymptomatic patients. Early recognition could potenti...
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: DERMATOLOGY DILEMMAS Source Type: research
An Unusual Presentation of Intussusception
This is the case of a 9-month-old female infant who presented to the emergency department with a history of several episodes of nonbilious and nonbloody emesis. The patient was found to be afebrile with normal vital signs and an otherwise normal physical examination. Initial plain film radiography was concern for possible obstruction. Imaging studies with ultrasonogram demonstrated intussusception. This was an unusual case of intussusception because children are typically more ill-appearing with vomiting, diarrhea, fevers, lethargy, and blood in stool. Management options included surgery, pneumatic enema reduction, and bar...
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: CASES OF NOTE Source Type: research
INSTRUCTIONS: Don't Be a Stiff: A Review Article on the Management of Tetanus
No abstract available (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: NCPD Tests Source Type: research
Don't Be a Stiff: A Review Article on the Management of Tetanus
This article briefly summarizes tetanus and the therapies considered to be first line in its management. (Source: Advanced Emergency Nursing Journal)
Source: Advanced Emergency Nursing Journal - January 1, 2021 Category: Emergency Medicine Tags: APPLIED PHARMACOLOGY Source Type: research
