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Advanced Emergency Nursing Journal

Brian W Gilbert, Lanae Faires, Amber Meister, Joel Huffman, Rebecca K Faber
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...
April 2018: Advanced Emergency Nursing Journal
Marianne K Pop, Katelyn R Dervay, Mary Dansby, Carolina Jones
The purpose of this study was to assess Richmond Agitation Sedation Scale (RASS) goal implementation in mechanically ventilated patients sedated in the emergency department (ED), compliance with RASS, and goal achievement. 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...
April 2018: Advanced Emergency Nursing Journal
Kumhee Ro, Christy Weiland, Mo-Kyung Sin
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 provide an opportunity to enhance the clinical education of the APRN students in the ED...
April 2018: Advanced Emergency Nursing Journal
Flavio G Gaudio, Rosa Borensztein
Growing numbers of nurse practitioners (NPs) are entering emergency medicine at a time when emergency departments are experiencing an increasing practice intensity and acuity. In this context, to further prepare NPs for a career in emergency medicine, postgraduate educational programs have emerged in the United States: from post-master's programs with 300-400 clinical hours in emergency medicine to intense residency or fellowship tracks with 2,000-3,000 clinical hours of training. 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...
April 2018: Advanced Emergency Nursing Journal
Tracie Gadler, Nicole Martinez, Jill Ogg-Gress
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...
April 2018: Advanced Emergency Nursing Journal
Yvonne McCague
Chemical burns to the eye represent a true ocular emergency, requiring immediate and proficient attention to preserve visual function. Although there have been very few reports of serious ocular burns secondary to the accidental administration of electronic cigarette liquid, this case report discusses the risk of same because of product confusion between electronic cigarette liquid and ocular preparations. This article presents a patient's case including patient history and management in the emergency department...
April 2018: Advanced Emergency Nursing Journal
RaeAnn Hirschy, Ethan Sterk, Rachel Dobersztyn, Megan A Rech
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...
April 2018: Advanced Emergency Nursing Journal
Denise R Ramponi
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...
April 2018: Advanced Emergency Nursing Journal
Sarah Steffens, Paula Tucker, Dian Dowling Evans
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 hemorrhage (SAH), the complaint of neck stiffness can increase the likelihood of SAH...
April 2018: Advanced Emergency Nursing Journal
K Sue Hoyt, Elda G Ramirez
No abstract text is available yet for this article.
April 2018: Advanced Emergency Nursing Journal
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Advanced Emergency Nursing Journal
Anna Marie Joyner Blair, Bernita K Hamilton, Amy Spurlock
The timely management of diabetic ketoacidosis (DKA) is essential to avoid lengthy hospitalizations and poor clinical outcomes. There is often an absence of ownership for glycemic management in hospitalized patients, most notably in those with a diagnosis other than diabetes. Evidence supports the use of evidence-based DKA protocols. The purpose of this project was to determine whether utilization of an evidence-based order set versus an individualized provider approach for the treatment and management of DKA decreases resolution time and occurrences of hypoglycemia and improves clinical outcomes...
January 2018: Advanced Emergency Nursing Journal
Eric Roberts, Barbara Velsor-Friedrich, Vicki Keough
Patients often present to emergency departments (EDs) for the management of chronic asthma. Because of the nature of ED care, national guideline recommendations for asthma education are generally not initiated in the ED. There is evidence that asthma education can have a positive effect on patient outcomes (; ). This study examines the feasibility of implementing an asthma self-management guideline in a tertiary care center ED. Despite protocol utilization by physicians (87%), nurse practitioners and physician assistants (66...
January 2018: Advanced Emergency Nursing Journal
Darlie Simerson
Despite the decline in traditional tobacco use among teens and young adults, the rapid increase in electronic cigarette (EC) use has filled the gap, raising concern that this will usher in a new generation of tobacco users. Although long-term effects have not been clearly established, EC use is not without risks or hazards that may be encountered by the advanced practice nurse in the emergency department (ED). The ED presents an opportune moment for health promotion and risk reduction education for patients and families, but there are also dangers to EC use that the practitioner should be aware of and prepared to manage...
January 2018: Advanced Emergency Nursing Journal
Brian G Cornelius, Karen McCarty, Kristi Hylan, Angela Cornelius, Keith Carter, Kenneth W G Smith, Srdan Ristic, Daniel Vining, Urska Cvek, Marjan Trutschl
The MATTERs and CRASH-2 studies demonstrate that tranexamic acid (TXA) reduces mortality in patients with traumatic hemorrhage. However, their results, conducted in foreign countries and with U.S. military soldiers, provoke concerns over generalizability to civilian trauma patients in the United States was reported. The evaluation of patient outcomes following treatment with TXA by a civilian air medical program. A retrospective chart review of trauma patients transported by air service to a Level 1 trauma center was conducted...
January 2018: Advanced Emergency Nursing Journal
Valerie J Reap
Spontaneous vertebral artery dissection (SVAD) is an extremely rare, yet life-threatening, event that can potentially result in ischemic stroke or subarachnoid hemorrhage, depending on the origin and extension of the dissection. Vertebral artery dissection is more commonly associated with traumatic injury to the neck, resulting in compromised structural integrity of the vertebral artery wall. This case study discusses the clinical presentation, physical examination, diagnosis, clinical course, and outcome for a young, otherwise healthy, female patient who presented to the emergency department with a SVAD...
January 2018: Advanced Emergency Nursing Journal
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Advanced Emergency Nursing Journal
Joshua Villarreal, David Townes, Michael Vrablik, Kumhee Ro
The purpose of this article is to present a discussion of immune checkpoint inhibitors (ICIs) that are relatively new, yet growing, form of cancer therapy. Immune checkpoint inhibitors increase host immune response against neoplastic cells. Strengthened immunological response increases the potential for adverse events such as life-threatening endocrinopathies. The case of a 66-year-old man with metastatic melanoma treated with nivolumab and ipilimumab presented to the emergency department with marked hyperglycemia and elevated anion gap 19 days after receiving both agents is discussed...
January 2018: Advanced Emergency Nursing Journal
Denise R Ramponi, Judith Kaufmann, Gwendolen Drahnak
Hip fractures are associated with significant morbidity and mortality and a major health problem in the United States (). Eighty percent of hip fractures are experienced by 80-year-old women. Plain radiographs usually confirm the diagnosis, but if there is a high level of suspicion of an occult hip fracture, magnetic resonance imaging or bone scan is the next step to confirm the diagnosis. Areas of the hip bone have varied bone strength and blood supply, making the femoral neck one of the most vulnerable areas for fracture...
January 2018: Advanced Emergency Nursing Journal
Brittany M Newberry, Dian Dowling Evans
The Research to Practice Column is designed to improve translational research critique skills of advanced practice nurses. In this issue, the article "Risk of Acute Kidney Injury After Intravenous Contrast Media Administration" () is discussed in the context of a patient presenting to the emergency department with acute abdominal pain. The study was designed to assess the risk of acute kidney injury and adverse clinical outcomes in patients receiving intravenous contrast for computed tomography. Advanced practice nurses need to be aware of advances in types of intravenous contrast and current recommendations for administration of intravenous contrast for diagnostic purposes in patients at risk for acute kidney injury to facilitate making timely and accurate diagnoses...
January 2018: Advanced Emergency Nursing Journal
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