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Advanced Emergency Nursing Journal

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https://www.readbyqxmd.com/read/29095184/orbital-floor-fractures
#1
(no author information available yet)
No abstract text is available yet for this article.
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095183/the-effect-of-apneic-oxygenation-on-reducing-hypoxemia-during-rapid-sequence-induction-and-intubation-in-the-acutely-ill-or-injured
#2
Autumn Riddell
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...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095182/reducing-unnecessary-head-computed-tomography-in-mild-traumatic-brain-injury
#3
Nathaniel John Webster, Nathan Moore, Felicia Stewart
There is growing concern about the frequency of computed tomographic (CT) scans performed for evaluation of adults with suspected mild traumatic brain injury. The Canadian CT Head Rule and the New Orleans Criteria are the most studied head CT decision tools that aid providers in determining which patients do not require a CT scan. 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...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095181/intravenous-push-cephalosporin-antibiotics-in-the-emergency-department-a-practice-improvement-project
#4
Julie M McLaughlin, Robin A Scott, Stephanie L Koenig, Scott W Mueller
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...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095180/a-randomized-double-blind-trial-to-determine-if-vapocoolant-in-the-adult-population-improves-patient-perception-of-pain-with-peripheral-intravascular-access
#5
Courtney Edwards, Christina Noah
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)...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095179/barriers-to-research-recruitment-of-women-experiencing-a-pregnancy-loss-in-the-emergency-department
#6
Brittany E Punches, Kimberly D Johnson, Shauna P Acquavita, Dianne M Felblinger, Gordon L Gillespie
Women often come to the emergency department (ED) with signs and symptoms suggesting an early pregnancy loss; yet, little is known about their experience and how it relates to future outcomes. To improve patient outcomes and experiences of women seeking care for a pregnancy loss, research is required. However, recruitment of participants experiencing an event such as a pregnancy loss is challenging. The purpose of this article is to discuss the application of an electronic medical record (EMR)-based participant screening tool recruiting women seeking care for a pregnancy loss in the ED...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095178/changing-the-emergency-department-s-practice-of-rapid-sequence-intubation-to-reduce-the-incidence-of-hypoxia
#7
Michael D Gooch, Eric Roberts
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...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095177/postpartum-headache
#8
Kathleen J Richardson
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...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095176/sugammadex-for-neuromuscular-blockade-reversal
#9
Michelle R Papathanas, Alley Killian
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...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095175/orbital-floor-fractures
#10
Denise R Ramponi, Terri Astorino, Colleen R Bessetti-Barrett
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.
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095174/does-suprapubic-stimulation-in-infants-facilitate-collection-of-a-clean-catch-urine-specimen
#11
Shannon Hall-Million, Patricia Kunz Howard
Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Faster Clean Catch Urine Collection (Quick Wee Method) From Infants: Randomised Controlled Trial." This prospective study enrolled 344 infants between 1 and 12 months of age seeking care in an emergency department with a complaint that led to the ordering of a clean catch urine specimen. Use of the Quick Wee procedure yielded clean catch urine specimens without the use of an invasive procedure...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095173/the-specialty-of-emergency-nurse-practitioner-practice
#12
K Sue Hoyt, Dian Dowling Evans, Elda G Ramirez, Jennifer Wilbeck
No abstract text is available yet for this article.
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759515/importance-of-early-detection-and-cardiovascular-surgical-intervention-in-marfan-syndrome
#13
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759514/postgraduate-emergency-nurse-practitioner-fellowships-opportunities-for-specialty-education
#14
Susanna Rudy, Jennifer Wilbeck
Specialty trained emergency nurse practitioners (ENPs) can meet the demands of an unpredictable emergency care environment within an overburdened health care system. Although existing literature supports fellowship training as a method for bridging academic knowledge with clinical experiences for the novice nurse practitioner, the currently available emergency care postgraduate fellowship programs are inconsistent in approach. Building upon descriptive data provided by the existing 9 postgraduate ENP fellowship programs, a comparison and gap analysis of program content was conducted to identify perceived standards for ENP specialty education and the congruence with published ENP competencies...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759513/importance-of-early-detection-and-cardiovascular-surgical-intervention-in-marfan-syndrome
#15
Rita DelloStritto, Steve Branham, Christina Chemmachel, Jayna Patel, Dayna Skolkin, Salima Gilani, Klever Uleanya
Marfan syndrome is an autosomal dominant connective tissue disorder that affects multiple systems, including the skeletal, ligamentous, oculofacial, pulmonary, abdominal, neurological, and cardiovascular systems. Cardiovascular complications, which involve the aorta and aortic valve, contribute most significantly to patient morbidity and mortality. A literature review was conducted on pathophysiology of the disease and recommendations for early diagnosis and treatment. Diagnosis largely relies on clinical features and a thorough history...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759512/implementing-interprofessional-alcohol-screening-brief-intervention-and-referral-to-treatment-in-the-emergency-department-an-evidence-based-quality-improvement-initiative
#16
Vicki Bacidore, MariJo Letizia, Ann M Mitchel
Alcohol misuse is one of the leading causes of illness, disease, injury, and death in the Unites States. For many patients, the emergency department (ED) visit may provide the only therapeutic opportunity to influence problematic drinking behavior. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach that may reduce alcohol-related morbidity and mortality and improve health outcomes and quality of life. Developing and implementing an alcohol SBIRT educational module for ED nurses and social workers is an efficient and effective mechanism to provide education about alcohol SBIRT, and revising the electronic health record to include an alcohol SBIRT protocol provides a standard mechanism for documentation by the interprofessional team of ED nurses and social workers...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759511/chemical-burns-of-the-eye
#17
Denise R Ramponi
Chemical burns of the eye are one of the most common eye injuries. The extent of the ocular surface damage is influenced by the type, temperature, volume, and pH of the corrosive substance and duration of exposure. Limbal ischemia found on eye assessment is the primary determinant of eventual visual outcome. Eye irrigation must be instituted immediately at the scene of exposure and continued in the emergency department to reduce visual impairment. Traditionally lactated Ringer's and normal saline have been used as irrigation fluids, although one systematic review demonstrates similar outcomes with other irrigation fluids...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759510/cerebellar-stroke-a-missed-diagnosis
#18
Diane C Berry, Amber Rafferty, Kathleen Tiu, Timothy F Platt-Mills
Cerebellar strokes account for less than 10% of all strokes but lead to significantly poor outcomes. Cerebellar strokes that are initially missed have a mortality rate of 40%, and half of the patients who survive have long-term deficits. The patient's history may provide clues that point to a cerebellar stroke. Signs and symptoms include vertigo, headache, vomiting and ataxia. It is important to note the presence of stroke risk factors, such as a history of strokes or transient ischemic attacks, diabetes mellitus, hypertension, hypercholesterolemia, advanced age, atrial fibrillation, and cigarette smoking...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759509/update-on-sepsis-treatment-in-the-emergency-department
#19
Kyle A Weant, Abby M Bailey
Sepsis continues to be a devastating, costly, and challenging syndrome to manage in emergency departments (ED) across the nation, and its impact seems to be only increasing. Recently, consensus recommendations have made some profound changes in the way we approach, classify, and treat sepsis. The ED serves as an important initial screening and intervention point for sepsis, and ED care can have a profound impact on overall morbidity and mortality. The provision of early fluid resuscitation, antimicrobial therapy, and vasopressor therapy, if appropriate, is essential in early care...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28759508/metatarsal-stress-fractures
#20
Denise R Ramponi, Viki Hedderick, Susan C Maloney
Metatarsal stress fractures are also called "march fractures" or "marcher's foot." They most commonly occur in the distal second and third metatarsals. The second and third metatarsals receive the majority of stress during ambulation and are less mobile compared with the other metatarsals. The predominant risk factor is excessive overuse with repetitive motions with little recovery time such as marching activities in the military. Any element that has a detrimental effect on bone density can predispose an individual to stress fractures...
July 2017: Advanced Emergency Nursing Journal
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