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Emergency Nursing

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465 papers 1000+ followers
By Craig Button Clinical Nurse Educator and current grad student
https://www.readbyqxmd.com/read/29731287/controversies-in-management-of-hyperkalemia
#1
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)...
May 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29472039/safety-of-bolus-dose-phenylephrine-for-hypotensive-emergency-department-patients
#2
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
#3
Justin Morgenstern, Sahaana Rangarajan, Corey Heitz, Chris Bond, William K Milne
No abstract text is available yet for this article.
April 6, 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
#4
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
#5
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
#6
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
#7
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...
April 13, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29384586/emergency-patient-handoffs-identifying-essential-elements-and-developing-an-evidence-based-training-tool
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28924481/euglycemic-diabetic-ketoacidosis-a-diagnostic-and-therapeutic-dilemma
#12
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#13
REVIEW
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension due to depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoids fluid overload...
August 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29356176/tools-of-the-trade-improving-nurses-ability-to-access-and-evaluate-research
#14
Martha R Sleutel, John W Bullion, Ronnie Sullivan
AIM: To evaluate the effect of a manager-required RN competency on staff nurses' perceived knowledge, ability and frequency of information-seeking activities. BACKGROUND: Basing clinical practice on research and standards of care is essential to delivering appropriate care with optimal outcomes. Nurses' information-seeking abilities are critical for acquiring evidence-based answers to aid clinical decision-making, yet nurses under-utilize library resources and report barriers...
March 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29254821/is-adenosine-or-an-intravenous-calcium-channel-blocker-more-effective-for-treating-supraventricular-tachycardia
#15
EDITORIAL
Michael Gottlieb, Katarzyna Gore, Stephen R Gore
No abstract text is available yet for this article.
December 15, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29306421/clinical-practice-guideline-intranasal-medication-administration
#16
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29306428/neostigmine-not-only-for-the-operating-room
#17
Dante Gravino, Afton McNierney-Moore
No abstract text is available yet for this article.
January 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28912083/nasogastric-decompression-not-associated-with-a-reduction-in-surgery-or-bowel-ischemia-for-acute-small-bowel-obstruction
#18
Daniel J Berman, Hamza Ijaz, Mohammad Alkhunaizi, Paige E Kulie, Khashayar Vaziri, Lorna M Richards, Andrew C Meltzer
OBJECTIVES: Small bowel obstructions (SBOs) occur 300,000 times annually leading to $1.3 billion in cost. Approximately 20% of patients require a laparotomy to manage the obstruction and either prevent or treat intestinal ischemia. Early management may play a role in reducing these complications. Nasogastric decompression is commonly used for early management. Our primary objective was to determine if NGD was associated with lower rates of surgery, bowel ischemia or length of stay. METHODS: We retrospectively enrolled 181 ED patients with SBO from 9/2013 to 9/2015 in order to determine if nasogastric decompression was associated with a reduction in rates of surgery, bowel ischemia or hospital length of stay...
December 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28405953/angioedema-in-the-emergency-department-a-practical-guide-to-differential-diagnosis-and-management
#19
REVIEW
Jonathan A Bernstein, Paolo Cremonesi, Thomas K Hoffmann, John Hollingsworth
BACKGROUND: Angioedema is a common presentation in the emergency department (ED). Airway angioedema can be fatal; therefore, prompt diagnosis and correct treatment are vital. OBJECTIVE OF THE REVIEW: Based on the findings of two expert panels attended by international experts in angioedema and emergency medicine, this review aims to provide practical guidance on the diagnosis, differentiation, and management of histamine- and bradykinin-mediated angioedema in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28484958/markers-of-diuretic-resistance-in-emergency-department-patients-with-acute-heart-failure
#20
Andrew Doering, Cathy A Jenkins, Alan B Storrow, JoAnn Lindenfeld, Gregory J Fermann, Karen F Miller, Matthew Sperling, Sean P Collins
BACKGROUND: Loop diuretics are common therapy for emergency department (ED) patients with acute heart failure (AHF). Diuretic resistance (DR) is a term used to describe blunted natriuretic response to loop diuretics. It would be important to detect DR prior to it becoming clinically apparent, so early interventions can be initiated. However, several definitions have been proposed, and it is not clear if they identify similar patients. We compared these definitions and described the clinical characteristics of patients who fulfilled them...
December 2017: International Journal of Emergency Medicine
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