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Advanced Emergency Nursing Journal最新文献

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Early Recognition of Sepsis in Prehospital Settings: A Review of Screening Tools and Practices.
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-04-01 DOI: 10.1097/TME.0000000000000561
William C Tirado
{"title":"Early Recognition of Sepsis in Prehospital Settings: A Review of Screening Tools and Practices.","authors":"William C Tirado","doi":"10.1097/TME.0000000000000561","DOIUrl":"https://doi.org/10.1097/TME.0000000000000561","url":null,"abstract":"<p><p>Sepsis remains a global health challenge, with millions affected and high mortality rates. Early recognition is critical for improving outcomes, particularly in prehospital settings where timely interventions can significantly impact patient survival. This literature review examines screening tools used in prehospital environments, focusing on their predictive abilities, ease of use, and limitations in detecting sepsis. Tools such as the quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS), National Early Warning Score 2 (NEWS2), Systemic Inflammatory Response Syndrome, and Monocyte Distribution Width offer varied strengths and applications in identifying sepsis. Research shows that NEWS and NEWS2 demonstrate higher sensitivity for predicting mortality, while qSOFA offers simplicity but may lack sensitivity outside of acute care settings. Differential diagnoses, such as pulmonary embolism and adrenal crisis, can mimic sepsis, making accurate assessment essential. The review highlights the role of Emergency Medical Services (EMS) and Family Nurse Practitioners in early detection and emphasizes the importance of evidence-based practices and clear protocols. This review aims to provide EMS and Nurse Practitioners with the knowledge and tools to recognize sepsis early, ensuring appropriate referrals and improving patient outcomes.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From History Books to Headlines: Plague in Modern Times.
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-04-01 DOI: 10.1097/TME.0000000000000568
Mindy Johnson, Michael D Gooch
{"title":"From History Books to Headlines: Plague in Modern Times.","authors":"Mindy Johnson, Michael D Gooch","doi":"10.1097/TME.0000000000000568","DOIUrl":"https://doi.org/10.1097/TME.0000000000000568","url":null,"abstract":"<p><p>Although often considered a historical disease, plague remains a modern-day public health concern with global relevance. Caused by the bacterium Yersinia pestis and transmitted to humans primarily through infected flea bites or contact with infected animals, plague persists worldwide, including parts of the southwestern United States. The disease presents in three main forms: bubonic, septicemic, and pneumonic. Bubonic plague, the most common form, is characterized by painful swollen lymph nodes known as buboes. Septicemic plague occurs when the infection enters the blood stream, while pneumonic plague, the most virulent and transmissible form, poses a serious bioterrorism threat due to its ability to spread via respiratory droplets and high fatality rate. Though rare today, with an average of seven cases annually in the U.S., plague still demands awareness and preparedness by emergency nurse practitioners and other clinicians. Early diagnosis, timely antibiotic treatment, and vigilant public health measures are critical to reducing its morbidity and mortality.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leprosy, Ancient, and Modern: A Review for Emergency Medicine Providers.
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-03-13 DOI: 10.1097/TME.0000000000000563
Teresa Dodge
{"title":"Leprosy, Ancient, and Modern: A Review for Emergency Medicine Providers.","authors":"Teresa Dodge","doi":"10.1097/TME.0000000000000563","DOIUrl":"https://doi.org/10.1097/TME.0000000000000563","url":null,"abstract":"<p><p>Leprosy is a complex and interesting bacterial infection affecting individuals across the world. This is not just an ancient disease from antiquity, but one that is still present today. The diagnosis and treatment of leprosy is complex, and often there is a significant delay in diagnosis from the onset of the disease. Understanding the varied clinical presentations of leprosy and how to treat it can improve clinical outcomes. Healthcare practitioners need to be knowledgeable about all diseases, not just the most common ones.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fluid Resuscitation in the Treatment of Acute Pancreatitis: Rate and Volume Controversies.
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-03-07 DOI: 10.1097/TME.0000000000000569
Philip Davis, Dian Evans
{"title":"Fluid Resuscitation in the Treatment of Acute Pancreatitis: Rate and Volume Controversies.","authors":"Philip Davis, Dian Evans","doi":"10.1097/TME.0000000000000569","DOIUrl":"https://doi.org/10.1097/TME.0000000000000569","url":null,"abstract":"<p><p>The aim of the Research to Practice column is to enhance the research critique abilities of both advanced practice registered nurses and emergency nurses, while also aiding in the translation of research findings into clinical practice. Each column focuses on a specific topic and research study. In this article, we used a scenario of left upper quadrant pain to explore the study by de-Madaria et al., titled \"Aggressive or moderate fluid resuscitation in acute pancreatitis\".</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Button Battery Ingestion: A Tiny Object with the Potential for a Catastrophic Outcome.
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-03-07 DOI: 10.1097/TME.0000000000000565
Kathleen S Jordan, Cody Carpenter, Sara H Steelman
{"title":"Button Battery Ingestion: A Tiny Object with the Potential for a Catastrophic Outcome.","authors":"Kathleen S Jordan, Cody Carpenter, Sara H Steelman","doi":"10.1097/TME.0000000000000565","DOIUrl":"https://doi.org/10.1097/TME.0000000000000565","url":null,"abstract":"<p><p>Foreign body ingestion is a common complaint encountered in the emergency department among both adults and children. Children under the age of 6 years are at especially high risk of foreign body ingestion, including coins, toys, jewelry and batteries. The button battery is the most common battery ingested and has the highest potential for serious and fatal injuries in infants and children. Over the past decade there has been a dramatic increase in the incidence of button battery ingestions directly related to the widespread expansion and availability of common consumer electronics powered by button batteries. Most ingested foreign bodies pass through the gastrointestinal system spontaneously and without complications. However a button battery that becomes lodged in the nasopharynx, oropharynx, trachea, esophagus, or any part of the gastrointestinal tract is associated with an exceptionally high rate of complications, including death. Button batteries lodged in the esophagus are especially dangerous and require immediate removal as serious tissue damage may occur in as little as 2 hours. Emergency care providers must maintain a high index of suspicion and be fully aware of the dangers of button battery ingestion. Initial symptoms may be variable nonspecific symptoms including fussiness, decreased appetite or refusal to eat or drink, drooling, difficulty swallowing, hematemesis or abdominal pain. Obtaining plain radiographs for foreign body ingestion should not be delayed. In addition, emergency care providers can be advocates for the safety and protection of button battery ingestions through knowledge dissemination and public advocacy.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Updates on the Use of Osmotherapy in the Emergency Department.
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-03-05 DOI: 10.1097/TME.0000000000000559
Kyle A Weant, Haili Gregory
{"title":"Updates on the Use of Osmotherapy in the Emergency Department.","authors":"Kyle A Weant, Haili Gregory","doi":"10.1097/TME.0000000000000559","DOIUrl":"https://doi.org/10.1097/TME.0000000000000559","url":null,"abstract":"<p><p>Elevated intracranial pressure (ICP) is a critical condition associated with significant morbidity and mortality, requiring prompt and effective management. Mannitol and hypertonic saline (HTS) are the two most widely used hyperosmolar agents in clinical practice for ICP reduction, each with distinct pharmacologic properties, efficacy profiles, and safety considerations. This review aims to provide a comprehensive assessment of the mechanisms, clinical efficacy, safety, practical considerations, and guideline recommendations associated with the use of mannitol and HTS for the management of elevated ICP. Current available data does not clearly support one hyperosmolar agent over another and both agents are considered equivalent. Consensus recommendations vary, but the most recent recommendations seem to support the use of HTS over mannitol, mostly due to potential pharmacodynamic advantages that have been shown in smaller investigations. Further research is warranted to refine dosing strategies, clarify administration concerns, and address knowledge gaps in comparative efficacy and safety.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
It's Probably Just Heart Burn! A Case of Pregnancy-Associated Spontaneous Coronary Artery Dissection. 可能只是烧心！一例与妊娠相关的自发性冠状动脉夹层。
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-01-01 Epub Date: 2024-11-25 DOI: 10.1097/TME.0000000000000550
Catherine Nadeau, Juan M Gonzalez, Christina Cardy, Mary A Cain, Daniela Crousillat
{"title":"It's Probably Just Heart Burn! A Case of Pregnancy-Associated Spontaneous Coronary Artery Dissection.","authors":"Catherine Nadeau, Juan M Gonzalez, Christina Cardy, Mary A Cain, Daniela Crousillat","doi":"10.1097/TME.0000000000000550","DOIUrl":"10.1097/TME.0000000000000550","url":null,"abstract":"<p><p>Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) poses a rare yet critical concern among postpartum individuals, increasingly recognized as a significant trigger for acute myocardial infarction. Timely identification, accurate diagnosis, and prompt treatment are paramount for clinicians confronted with this condition. Patients with P-SCAD commonly manifest signs and symptoms akin to acute coronary syndrome but have different etiology and treatment. SCAD is defined as a non-traumatic, non-iatrogenic separation of the coronary artery wall, not associated with atherosclerosis. The predominant mechanism of myocardial injury is coronary artery obstruction caused by an intramural hematoma or intimal disruption compromising the lumen at the site of dissection. Diagnosis is made with a comprehensive history and physical examination, cardiac biomarkers, a 12-lead ECG, transthoracic echocardiogram, and confirmed with coronary angiography. Stable patients are managed medically, while more severe cases may require additional intervention.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"55-63"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ED Nurse-Led Code Sepsis to Reduce Time to Antibiotics. 急诊室护士主导的败血症代码，缩短使用抗生素的时间。
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-01-01 Epub Date: 2024-12-20 DOI: 10.1097/TME.0000000000000551
Leslie Gomez, Kelli LeClair, Danisha Jenkins, Mary Ann David, Jillian Downing, Julie Graham
{"title":"ED Nurse-Led Code Sepsis to Reduce Time to Antibiotics.","authors":"Leslie Gomez, Kelli LeClair, Danisha Jenkins, Mary Ann David, Jillian Downing, Julie Graham","doi":"10.1097/TME.0000000000000551","DOIUrl":"10.1097/TME.0000000000000551","url":null,"abstract":"<p><strong>Background: </strong>Delays in sepsis recognition contribute to delays in antibiotic administration, which lead to increased morbidity and mortality in patients with sepsis. Our objective was to create an Emergency Department (ED) Code Sepsis Nurse-led team to reduce the time to antibiotics and mortality in patients with sepsis.</p><p><strong>Methods: </strong>This initiative was implemented at a community hospital in Southern California in response to previous undesirable sepsis outcomes. In fiscal year 2021, the ED Sepsis Nursing Team was launched with the goal of improving sepsis-related outcomes. The following interventions were implemented: First, a group of dedicated Sepsis Nurses with training specific to sepsis recognition was created, and an electronic ED-sepsis screening tool was developed and implemented. Next, the dedicated sepsis nurses designed and educated to a \"Code Sepsis\" activation process. The code triggered a multidisciplinary response and implementation of standing orders for blood cultures, lactate, complete blood count, complete metabolic panel, and chest x-ray or urinalysis if indicated. Finally, the Sepsis Team Registered Nurse (RN) Captain led house-wide monthly Sepsis Task Force meetings to improve unit-level engagement and to allow the team to have ownership over sharing wins and losses.</p><p><strong>Results: </strong>By Quarter 4 (Q4) of Fiscal Year 2021, door-to-antibiotic time for sepsis patients dropped from 196.7 min (Q1) to 144.7 (Q4). Additionally, mortality dropped below the health system average (10.4% vs. 13.5%), and Fiscal Year 2021 surpassed the readmissions benchmark of <1.0 at a rate of 0.5.</p><p><strong>Conclusion: </strong>An RN-led, interprofessional response to accepted sepsis identification criteria enhanced staff and physician engagement and improved sepsis outcomes for patient mortality and hospital reporting outcomes. The process was adopted with very few obstacles that were easily overcome as the understanding of the role and its significance was realized.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"64-74"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dream of the Endless: Special Considerations in Procedural Sedation.
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-01-01 Epub Date: 2025-01-29 DOI: 10.1097/TME.0000000000000558
{"title":"Dream of the Endless: Special Considerations in Procedural Sedation.","authors":"","doi":"10.1097/TME.0000000000000558","DOIUrl":"https://doi.org/10.1097/TME.0000000000000558","url":null,"abstract":"","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"47 1","pages":"E1"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dog Bites With Resultant Periorbital Cellulitis. 狗咬伤导致眼眶周围蜂窝织炎。
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2025-01-01 Epub Date: 2024-11-28 DOI: 10.1097/TME.0000000000000548
Julie-Kathryn Graham, Pedro A Colio
{"title":"Dog Bites With Resultant Periorbital Cellulitis.","authors":"Julie-Kathryn Graham, Pedro A Colio","doi":"10.1097/TME.0000000000000548","DOIUrl":"10.1097/TME.0000000000000548","url":null,"abstract":"<p><p>This case study examines the delayed presentation of a facial dog bite, an uncommon occurrence in the periorbital area. Initially perceived as a minor injury, the wound was disregarded in its early stages. However, as the infection progressed, prompting urgent evaluation in the emergency department (ED) as the severity became evident. The patient was diagnosed with an acute facial infection carrying the potential for periorbital cellulitis and abscess formation, necessitating immediate imaging. Prompt evaluation of penetrating animal bites, particularly dog bites, is crucial due to their high infection risk. As emphasized by Hamed-Assam et al., immediate attention and prophylactic antibiotics are advised for such cases, preferably broad-spectrum antibiotics with anaerobic coverage. The patient underwent treatment in the ED approximately a day after the incident, receiving antibiotics and subsequently discharged following advanced diagnostic imaging. This case underscores the importance of recognizing and promptly addressing delayed dog bites, emphasizing the significance of immediate medical intervention post-penetrating animal bites.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"31-36"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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