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Emergency Nursing

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474 papers 1000+ followers
By Craig Button Clinical Nurse Educator and current grad student
https://www.readbyqxmd.com/read/30147067/understanding-the-characteristics-of-frequent-users-of-emergency-departments-what-role-do-medical-conditions-play
#1
Jens Rauch, Jens Hüsers, Birgit Babitsch, Ursula Hübner
Frequent users of emergency departments (ED) pose a significant challenge to hospital emergency services. Despite a wealth of studies in this field, it is hardly understood, what medical conditions lead to frequent attendance. We examine (1) what ambulatory care sensitive conditions (ACSC) are linked to frequent use, (2) how frequent users can be clustered into subgroups with respect to their diagnoses, acuity and admittance, and (3) whether frequent use is related to higher acuity or admission rate. We identified several ACSC that highly increase the risk for heavy ED use, extracted four major diagnose subgroups and found no significant effect neither for acuity nor admission rate...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/30158174/cervical-spine-can-be-assessed-effectively-by-emergency-department-triage-nurses
#2
Mike Parker
No abstract text is available yet for this article.
August 29, 2018: Evidence-based Nursing
https://www.readbyqxmd.com/read/30142399/capnography-during-cardiac-arrest
#3
REVIEW
Claudio Sandroni, Paolo De Santis, Sonia D'Arrigo
Successful resuscitation from cardiac arrest depends on provision of adequate blood flow to vital organs generated by cardiopulmonary resuscitation (CPR). Measurement of end-tidal expiratory pressure of carbon dioxide (ETCO2 ) using capnography provides a noninvasive estimate of cardiac output and organ perfusion during cardiac arrest and can therefore be used to monitor the quality of CPR and predict return of spontaneous circulation (ROSC). In clinical observational studies, mean ETCO2 levels in patients with ROSC are higher than those in patients with no ROSC...
August 22, 2018: Resuscitation
https://www.readbyqxmd.com/read/30116685/academic-life-in-emergency-medicine-blog-and-podcast-watch-respiratory-emergencies
#4
REVIEW
Alice A Min, Eric J Morley, Salim R Rezaie, Sean M Fox, Andrew Grock
The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) Series and Approved Instruction Resources Professional (AIR-Pro) Series were created in 2014 and 2015, respectively, to address the need for curation of online educational content as well as a nationally available curriculum that meets individualized interactive instruction criteria. These two programs identify high-quality educational blog and podcast content using an expert-based approach. We summarize the accredited posts on respiratory emergencies that met our a priori determined quality criteria per evaluation by eight experienced faculty educators in emergency medicine...
June 14, 2018: Curēus
https://www.readbyqxmd.com/read/30096510/smartphones-and-mobile-applications-apps-in-clinical-nursing-education-a-student-perspective
#5
Siobhan O'Connor, Tom Andrews
BACKGROUND: Nurse educators are exploring how mobile technology can support students in clinical practice. However, the view of nursing students on the use of smartphones and mobile applications (apps) to enhance clinical education has not been explored. Their opinions are vital to capture if the right technology is to be designed, evaluated, implemented and used. METHOD: A self-reported questionnaire, based on a review of the literature, was used to understand the opinions of undergraduate nursing students towards the use of smartphones and mobile apps to support learning in clinical environments...
October 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29485926/balanced-crystalloids-versus-saline-in-noncritically-ill-adults
#6
RANDOMIZED CONTROLLED TRIAL
Wesley H Self, Matthew W Semler, Jonathan P Wanderer, Li Wang, Daniel W Byrne, Sean P Collins, Corey M Slovis, Christopher J Lindsell, Jesse M Ehrenfeld, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Comparative clinical effects of balanced crystalloids and saline are uncertain, particularly in noncritically ill patients cared for outside an intensive care unit (ICU). METHODS: We conducted a single-center, pragmatic, multiple-crossover trial comparing balanced crystalloids (lactated Ringer's solution or Plasma-Lyte A) with saline among adults who were treated with intravenous crystalloids in the emergency department and were subsequently hospitalized outside an ICU...
March 1, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/30037788/expanding-opportunities-for-professional-development-utilization-of-twitter-by-early-career-women-in-academic-medicine-and-science
#7
Jaime D Lewis, Kathleen E Fane, Angela M Ingraham, Ayesha Khan, Anne M Mills, Susan C Pitt, Danielle Ramo, Roseann I Wu, Susan M Pollart
The number of women entering medical school and careers in science is increasing; however, women remain the minority of those in senior faculty and leadership positions. Barriers contributing to the shortage of women in academics and academic leadership are numerous, including a shortage of role models and mentors. Thus, achieving equity in a timelier manner will require more than encouraging women to pursue these fields of study or waiting long enough for those in the pipelines to be promoted. Social media provides new ways to connect and augments traditional forms of communication...
July 23, 2018: JMIR Medical Education
https://www.readbyqxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#8
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/30020259/adults-and-children-with-anaphylaxis-in-the-emergency-room-why-it-is-not-recognized
#9
Marcelo V Aun, Jorge Kalil, Pedro Giavina-Bianchi
PURPOSE OF REVIEW: Despite many international guidelines have been published in the last 10 years, anaphylaxis continues to be underdiagnosed, undernotified, and undertreated. Anaphylactic reactions in adults and children in emergency departments are frequently not recognized, leading to underutilization of epinephrine, and a higher risk of death. RECENT FINDINGS: A few studies have been recently published showing that educational intervention for both physicians and other healthcare professionals improve diagnosis and treatment of anaphylaxis...
October 2018: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29731287/controversies-in-management-of-hyperkalemia
#10
Brit Long, Justin R Warix, Alex Koyfman
BACKGROUND: Hyperkalemia is a common electrolyte disorder that can result in morbidity and mortality if not managed appropriately. OBJECTIVES: This review evaluates the classic treatments of hyperkalemia and discusses controversies and new medications for management. DISCUSSION: Potassium (K+) plays a key role in determining the transmembrane potentials of "excitable membranes" present in nerve and muscle cells. K+ is the predominant intracellular cation, and clinical deterioration typically ensues when patients develop sufficiently marked elevation in extracellular fluid concentrations of K+ (hyperkalemia)...
August 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29472039/safety-of-bolus-dose-phenylephrine-for-hypotensive-emergency-department-patients
#11
Kjirsten Swenson, Shannon Rankin, Leticia Daconti, Tomas Villarreal, Jens Langsjoen, Darren Braude
INTRODUCTION: Bolus-dose phenylephrine (BDPE) is routinely used to treat hypotension in the operating room. BDPE's fast onset of action and ability to be administered peripherally have prompted calls for its use in the Emergency Department (ED). There are few published data on the safety of BDPE use in the ED. Primary concerns include BDPE's potential to cause dangerous hypertension or reflex bradycardia. We hypothesize that BDPE is a safe short-term vasopressor choice for hypotensive ED patients...
February 19, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29624770/hot-off-the-press-topical-tranexamic-acid-compared-with-anterior-nasal-packing-for-treatment-of-epistaxis-in-patients-taking-antiplatelet-drugs
#12
Justin Morgenstern, Sahaana Rangarajan, Corey Heitz, Chris Bond, William K Milne
No abstract text is available yet for this article.
September 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29548372/balanced-versus-unbalanced-crystalloids-in-initial-sepsis-fluid-resuscitation
#13
Kerry Kerr Fellows
No abstract text is available yet for this article.
March 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29548376/change-the-channel-of-a-negative-attitude-and-promote-employee-and-patient-satisfaction
#14
Deborah Serrone, Jalma Mesnick Marcus, Sharon Lisman Longmore
No abstract text is available yet for this article.
March 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29628184/the-two-bag-method-for-treatment-of-diabetic-ketoacidosis-in-adults
#15
Nathan L Haas, Roma Y Gianchandani, Kyle J Gunnerson, Benjamin S Bassin, Arun Ganti, Christopher Hapner, Caryn Boyd, James A Cranford, Sage P Whitmore
BACKGROUND: The "two-bag method" of management of diabetic ketoacidosis (DKA) allows for titration of dextrose delivery by adjusting the infusions of two i.v. fluid bags of varying dextrose concentrations while keeping fluid, electrolyte, and insulin infusion rates constant. OBJECTIVE: We aimed to evaluate the feasibility and potential benefits of this strategy in adult emergency department (ED) patients with DKA. METHODS: This is a before-and-after comparison of a protocol using the two-bag method operationalized in our adult ED in 2015...
May 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29661658/is-transcellular-potassium-shifting-with-insulin-albuterol-or-sodium-bicarbonate-in-emergency-department-patients-with-hyperkalemia-associated-with-recurrent-hyperkalemia-after-dialysis
#16
Brian E Driver, Lauren R Klein, Chaitanya Chittineni, Ellen K Cales, Nathaniel Scott
BACKGROUND: Emergency department (ED) treatment of hyperkalemia often involves shifting potassium into the intracellular space. There is uncertainty whether transcellular shifting causes insufficient potassium removal during hemodialysis, resulting in a subsequent need for further medical therapy or multiple sessions of hemodialysis. OBJECTIVE: We sought to determine whether transcellular potassium shifting in ED patients with hyperkalemia who undergo hemodialysis is associated with recurrent hyperkalemia with or without repeat hemodialysis within 24 h...
July 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29384586/emergency-patient-handoffs-identifying-essential-elements-and-developing-an-evidence-based-training-tool
#17
REVIEW
Andrew P Reimer, Celeste M Alfes, Amanda S Rowe, Bianca M Rodriguez-Fox
BACKGROUND: Patient handoffs between care teams have been recognized as a major patient safety risk due to inadequate exchange or loss of critical information, especially during emergent patient transfers. The purpose of this literature review was to identify the essential elements of effective patient handoffs in emergency situations to develop a standardized tool to support a structured patient handoff procedure capable of guiding education and training. METHOD: A literature search of handoff procedures and patient transfers was conducted using the Cumulative Index to Nursing and Allied Health Literature and PubMed between 2008 and 2015...
January 1, 2018: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/29498402/journal-clubs-engaging-clinical-nurses-and-midwives-in-research
#18
Alannah L Cooper, Janie A Brown
It is essential that nurses and midwives can understand and critically evaluate research to ensure the delivery of high-quality evidence-based care. Journal clubs are an educational method that helps to develop research capacity and assist with bridging the gap between research and clinical practice. To maintain competence and remain current with the latest evidence, a commitment to continuing professional education is required. This article describes how a successful journal club led to clinical nurses identifying a gap in their own practice, which resulted in a research project being conducted by the members of the journal club...
March 1, 2018: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/27908339/vasopressors-and-inotropes-in-sepsis
#19
REVIEW
Leeanne Stratton, David A Berlin, John E Arbo
Vasopressor and inotropes are beneficial in shock states. Norepinephrine is considered the first-line vasopressor for patients with sepsis-associated hypotension. Dobutamine is considered the first-line inotrope in sepsis, and should be considered for patients with evidence of myocardial dysfunction or ongoing signs of hypoperfusion. Vasopressor and inotrope therapy has complex effects that are often difficult to predict; emergency providers should consider the physiology and clinical trial data. It is essential to continually reevaluate the patient to determine if the selected treatment is having the intended result...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29413215/management-of-acute-gastrointestinal-bleed
#20
REVIEW
Francisca Cisneros Farrar
Acute gastrointestinal bleeding is a common problem found in critically ill patients that can range from self-limited bleeding to a hemorrhaging emergency. Patients can quickly develop shock and altered mental status when they develop hemodynamic instability. Therefore, it is essential that the frontline critical care nurse develop self-efficacy for management of these disorders. This article overviews standards of practice for the management of upper and lower acute gastrointestinal bleeding. Common bleeding disorders are reviewed with expanded focus on peptic ulcer, acute variceal hemorrhage, colonic diverticular bleeding, and angiodysplasias, which are commonly found in the critical care setting...
March 2018: Critical Care Nursing Clinics of North America
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