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Emergency Nursing

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432 papers 1000+ followers
By Craig Button Clinical Nurse Educator and current grad student
https://www.readbyqxmd.com/read/28085685/ce-improving-outcomes-for-patients-with-chronic-kidney-disease-part-1
#1
Jenna M Norton, Eileen P Newman, Gayle Romancito, Stephanie Mahooty, Theresa Kuracina, Andrew S Narva
: The burden of chronic kidney disease (CKD) is rising both in this country and worldwide. An estimated 10% to 15% of U.S. adults are currently living with CKD. Reducing the CKD burden requires a systematic, interdisciplinary approach to care. The greatest opportunities to reduce the impact of CKD arise early, when most patients are being followed in primary care; yet many clinicians are inadequately educated on this disease. Nurses are well positioned to facilitate the implementation of collaborative care...
February 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28029394/non-anion-gap-metabolic-acidosis-a-clinical-approach%C3%A2-to%C3%A2-evaluation
#2
Mandana Rastegar, Glenn T Nagami
Acid-base disturbances can result from kidney or nonkidney disorders. We present a case of high-volume ileostomy output causing large bicarbonate losses and resulting in a non-anion gap metabolic acidosis. Non-anion gap metabolic acidosis can present as a form of either acute or chronic metabolic acidosis. A complete clinical history and physical examination are critical initial steps to begin the evaluation process, followed by measuring serum electrolytes with a focus on potassium level, blood gas, urine pH, and either direct or indirect urine ammonium concentration...
October 28, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28006967/remaining-in-the-nursing-profession
#3
Margareth Kristoffersen, Febe Friberg
BACKGROUND: Why nurses remain in the profession is a complex question. However, strong values can be grounds for their remaining, meaning nurses evaluate the qualitative worth of different desires and distinguish between senses of what is a good life. RESEARCH QUESTION: The overall aim is to explore and argue the relevance of strong evaluations for remaining in the nursing profession. RESEARCH DESIGN: This theoretical article based on a hermeneutical approach introduces the concept strong evaluations as described by the Canadian philosopher Charles Taylor and provides examples of nurses' experiences in everyday nursing care drawn from a Norwegian empirical study...
January 1, 2016: Nursing Ethics
https://www.readbyqxmd.com/read/27974285/increased-incidence-of-clinical-hypotension-with-etomidate-compared-to-ketamine-for-intubation-in-septic-patients-a-propensity-matched-analysis
#4
Megan A Van Berkel, Matthew C Exline, Kari M Cape, Lindsay P Ryder, Gary Phillips, Naeem A Ali, Bruce A Doepker
PURPOSE: This study compared the incidence of clinical hypotension between ketamine and etomidate within a 24 hour period following endotracheal intubation. MATERIALS AND METHODS: This single-center, retrospective propensity-matched cohort study included septic patients admitted to our medical intensive care unit who received either etomidate or ketamine for intubation. Clinical hypotension was defined as any one of the following: mean arterial pressure (MAP) decrease >40% compared to baseline and MAP <70 mmHg, MAP <60 mmHg, initiation of a vasopressor, or increase to >30% of the initial vasopressor dose...
November 15, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27921020/epidemiology-of-cervical-spine-fractures
#5
Mahnaz Yadollahi, Shahram Paydar, Haleh Ghaem, Mohammad Ghorbani, Seyed Mohsen Mousavi, Ali Taheri Akerdi, Eimen Jalili, Mohammad Hadi Niakan, Hossein Ali Khalili, Ali Haghnegahdar, Shahram Bolandparvaz
BACKGROUND: Epidemiology of cervical spine fractures (CSfx) in trauma patients of general population is not yet exclusively known. OBJECTIVES: The purpose of this study was to evaluate the epidemiology of CSfx in trauma patients. PATIENTS AND METHODS: Data from trauma patients admitted in the emergency room (ER) of Shiraz Shahid Rajaei hospital during the 3.5 years period from September 22, 2009 to March 21, 2013, were gathered. All trauma patients with CSfx and/or spinal cord injuries were included in the study...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27908956/ensuring-accurate-st-segment-monitoring
#6
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27726973/frequency-of-vital-sign-assessment-and-clinical-deterioration-in-an-australian-emergency-department
#7
Katherine Lambe, Judy Currey, Julie Considine
BACKGROUND: Understanding of clinical deterioration of emergency department patients is rapidly evolving. The aim of this study was to investigate the frequency and nature of vital sign collection and clinical deterioration in emergency care. METHODS: A descriptive exploratory approach was used. Data were collected from the records of 200 randomly selected adults with presenting complaints of abdominal pain, shortness of breath, chest pain and febrile illness from 1 January to 31 December 2014 at a 22 bed emergency department in Melbourne, Australia...
November 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/27846078/targeted-simulation-instructor-course-for-nursing-professional-development-specialists
#8
Cynthia M LaFond, Angela Blood
Practical training for nursing professional development specialists in the facilitation of clinical simulations was implemented using a six-step curriculum development framework. General and targeted needs assessments were conducted. Methods used to apply needs assessment findings into the course design and delivery and the participant's responses via program evaluations are described. The process used to develop this training may be applied by other nursing professional development departments to prepare educators in the delivery of simulated-based learning experiences...
November 2016: Journal for Nurses in Professional Development
https://www.readbyqxmd.com/read/27832978/current-practice-of-hypoglycemia-management-in-the-ed
#9
Matthew H Bilhimer, Cierra N Treu, Nicole M Acquisto
PURPOSE: To characterize hypoglycemia management and identify characteristics associated with refractory (need for additional treatment following initial management) and recurrent (adequate initial treatment followed by blood glucose [BG] ≤50 mg/dL) hypoglycemia. METHODS: Retrospective review of adult emergency department (ED) patients who presented to a large academic medical center with hypoglycemia (BG ≤ 50 mg/dL) between January 2011 and July 2015. Data collection focused on BG measurements and treatment practices...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#10
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
February 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/27846050/the-ptsd-toolkit-for-nurses-assessment-intervention-and-referral-of-veterans
#11
Nancy P Hanrahan, Kate Judge, Grace Olamijulo, Lisa Seng, Matthew Lee, Pamela Herbig Wall, Sandy C Leake, Elizabeth Czekanski, Suzanne Thorne-Odem, Erika E DeMartinis, Ursula A Kelly, Lucas Blair, Warren Longmire
Approximately 20% of veterans suffer from posttraumatic stress disorder (PTSD). NPs are well positioned to provide early detection and assist veterans with access to life-saving treatment. The PTSD Toolkit for Nurses helps nurses improve their skills in assessing PTSD and provides a specialized intervention and referral procedure that promotes help-seeking behavior among veterans.
March 7, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/27731855/use-of-social-media-for-professional-development-by-health-care-professionals-a-cross-sectional-web-based-survey
#12
Hana Alsobayel
BACKGROUND: Social media can be used in health care settings to enhance professional networking and education; patient communication, care, and education; public health programs; organizational promotion; and research. OBJECTIVE: The aim of this study was to explore the use of social media networks for the purpose of professional development among health care professionals in Saudi Arabia using a purpose-designed Web-based survey. METHODS: A cross-sectional web-based survey was undertaken...
September 12, 2016: JMIR Medical Education
https://www.readbyqxmd.com/read/27716346/fundamentals-of-aerosol-therapy-in-critical-care
#13
REVIEW
Jayesh Dhanani, John F Fraser, Hak-Kim Chan, Jordi Rello, Jeremy Cohen, Jason A Roberts
Drug dosing in critically ill patients is challenging due to the altered drug pharmacokinetics-pharmacodynamics associated with systemic therapies. For many drug therapies, there is potential to use the respiratory system as an alternative route for drug delivery. Aerosol drug delivery can provide many advantages over conventional therapy. Given that respiratory diseases are the commonest causes of critical illness, use of aerosol therapy to provide high local drug concentrations with minimal systemic side effects makes this route an attractive option...
October 7, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27560340/-flipping-the-classroom
#14
Diane M Billings
This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students and new graduates to apply knowledge in clinical settings. This article describes the benefits and challenges of using a "flipped" classroom to promote active engagement among learners and more meaningful interaction between learners and educators.
September 2016: American Journal of Nursing
https://www.readbyqxmd.com/read/27461886/the-efficacy-of-transcutaneous-cardiac-pacing-in-ed
#15
Firat Bektas, Secgin Soyuncu
INTRODUCTION: Transcutaneous cardiac pacing (TCP) is a rapid, time-saving, and noninvasive ventricular stimulation that is tolerated by conscious patients despite the painful intervention for treatment of symptomatic bradycardias. The goal of this study was to determine the efficacy of TCP in unstable bradycardia patients in emergency department (ED). METHODS: This single-central, observational clinical study was conducted on patients older than 18 years who presented with acute unstable bradycardia to the tertiary care university ED...
November 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27411704/the-neurological-and-cognitive-consequences-of-hyperthermia
#16
REVIEW
Edward James Walter, Mike Carraretto
An elevated temperature has many aetiologies, both infective and non-infective, and while the fever of sepsis probably confers benefit, there is increasing evidence that the central nervous system is particularly vulnerable to damage from hyperthermia. A single episode of hyperthermia may cause short-term neurological and cognitive dysfunction, which may be prolonged or become permanent. The cerebellum is particularly intolerant to the effects of heat. Hyperthermia in the presence of acute brain injury worsens outcome...
July 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27457359/patching-for-corneal-abrasion
#17
REVIEW
Chris H L Lim, Angus Turner, Blanche X Lim
BACKGROUND: Published audits have demonstrated that corneal abrasions are a common presenting eye complaint. Eye patches are often recommended for treating corneal abrasions despite the lack of evidence for their use. This systematic review was conducted to determine the effects of the eye patch when used to treat corneal abrasions. OBJECTIVES: The objective of this review was to assess the effects of patching for corneal abrasion on healing and pain relief. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2016), EMBASE (January 1980 to May 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to May 2016), System for Information on Grey Literature in Europe (OpenGrey) (January 1995 to May 2016), the ISRCTN registry (www...
July 26, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/23391635/prevention-of-hemolysis-in-blood-samples-collected-from-intravenous-catheters
#18
RANDOMIZED CONTROLLED TRIAL
Giuseppe Lippi, Paola Avanzini, Gianfranco Cervellin
OBJECTIVES: Samples drawn through intravenous catheters are frequently hemolyzed. We planned a prospective, randomized study to establish whether hemolysis in samples drawn from intravenous catheters may be reduced using S-Monovette® tubes collected by manual aspiration as compared with standard vacuum tubes. DESIGN AND METHODS: We studied 52 consecutive patients admitted to the ED. Blood was drawn through a 20-gauge intravenous catheter. A 5.0mL, Becton Dickinson Vacutainer® SST II Plus serum tube was collected and discarded...
May 2013: Clinical Biochemistry
https://www.readbyqxmd.com/read/22968086/effectiveness-of-practices-to-reduce-blood-sample-hemolysis-in-eds-a-laboratory-medicine-best-practices-systematic-review-and-meta-analysis
#19
REVIEW
Nicholas J Heyer, James H Derzon, Linda Winges, Colleen Shaw, Diana Mass, Susan R Snyder, Paul Epner, James H Nichols, Julie A Gayken, Dennis Ernst, Edward B Liebow
OBJECTIVE: To complete a systematic review of emergency department (ED) practices for reducing hemolysis in blood samples sent to the clinical laboratory for testing. RESULTS: A total of 16 studies met the review inclusion criteria (12 published and 4 unpublished). All 11 studies comparing new straight needle venipuncture with IV starts found a reduction in hemolysis rates, [average risk ratio of 0.16 (95% CI=0.11-0.24)]. Four studies on the effect of venipuncture location showed reduced hemolysis rates for the antecubital site [average risk ratio of 0...
September 2012: Clinical Biochemistry
https://www.readbyqxmd.com/read/26766429/generalizability-and-effectiveness-of-butterfly-phlebotomy-in-reducing-hemolysis
#20
Douglas P Barnaby, Andrew Wollowitz, Deborah White, Scott Pearlman, Michelle Davitt, Laura Holihan, Polly Bijur, E John Gallagher
OBJECTIVES: The objective was to test the hypothesis that exclusive use of butterfly needles for phlebotomy, compared with sample collection via intravenous (IV) catheter, will reduce rates of sample hemolysis. METHODS: This was an observational study of hemolysis rates before and after implementation of a "butterfly-only" phlebotomy protocol. Weekly hemolysis rates, generated by the central laboratory, were collected and the proportion of hemolyzed specimens before and after protocol implementation were compared...
February 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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