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Pharmacotherapy Management of Beta-Blocker Toxicity in the Emergency Department. 急诊科β受体阻滞剂毒性的药物治疗管理。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI: 10.1097/TME.0000000000000603
Kyle A Weant
{"title":"Pharmacotherapy Management of Beta-Blocker Toxicity in the Emergency Department.","authors":"Kyle A Weant","doi":"10.1097/TME.0000000000000603","DOIUrl":"10.1097/TME.0000000000000603","url":null,"abstract":"<p><p>Beta-blocker (BB) overdose presentations to the emergency department represent a significant contributor to cardiovascular toxic exposures and associated morbidity and mortality. Overdose is characterized primarily by bradycardia, hypotension, atrioventricular blockade, and cardiogenic shock, alongside potential central nervous system depression. The severity of clinical manifestations is influenced by agent-specific pharmacologic properties, formulation (e.g., extended-release), and dose. Specific therapies discussed include atropine, glucagon, hyperinsulinemic euglycemia therapy, intravenous lipid emulsion, methylene blue, and extracorporeal treatments such as hemodialysis and extracorporeal membrane oxygenation. BB overdose requires prompt recognition in the emergency department and a tiered therapeutic approach tailored to the severity of presentation and specific agent involved. While foundational interventions remain vital, adjunctive therapies such as hyperinsulinemic euglycemia therapy and methylene blue offer mechanistically distinct options that may improve outcomes in refractory cases. Further studies are warranted to clarify optimal treatment sequencing, comparative efficacy, and long-term outcomes in BB toxicity.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"6-10"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670214","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
Negative D -Dimer With Single-Subsegmental Pulmonary Embolism. d-二聚体阴性伴单亚节段性肺栓塞。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI: 10.1097/TME.0000000000000606
Caitlin Burnett, Michael Koehler
{"title":"Negative D -Dimer With Single-Subsegmental Pulmonary Embolism.","authors":"Caitlin Burnett, Michael Koehler","doi":"10.1097/TME.0000000000000606","DOIUrl":"10.1097/TME.0000000000000606","url":null,"abstract":"<p><p>Pulmonary embolism (PE) is a potentially fatal condition that often presents with nonspecific symptoms, making diagnosis challenging in the emergency department (ED). This case study details the presentation of a 37-year-old woman with a history of PE, who presented to the ED with pleuritic chest pain and a history of a recent cesarean section. Despite a negative d -dimer, which generally suggests a low likelihood of PE, her clinical presentation raised suspicion, prompting further evaluation. A CT pulmonary angiography revealed a single-subsegmental PE, underscoring that negative d -dimer results should not rule out PE, particularly in high-risk patients or those with a prior thromboembolic history. This case emphasizes the importance of clinical judgment in the ED setting, where rapid diagnosis is critical. While a negative d -dimer is valuable in excluding PE in low-risk patients, imaging remains the gold standard for diagnosing high-risk cases. The patient's management included outpatient anticoagulation with Eliquis, reinforcing the need for personalized treatment based on risk stratification in the ED. This case highlights the importance of clinicians in the ED being cautious when interpreting negative d -dimer results and considering imaging when clinical suspicion remains high.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"11-15"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946447","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
Lyme Disease: More Than a Bullseye Rash. 莱姆病不仅仅是靶心疹
IF 1
Advanced Emergency Nursing Journal Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI: 10.1097/TME.0000000000000607
Teresa Dodge
{"title":"Lyme Disease: More Than a Bullseye Rash.","authors":"Teresa Dodge","doi":"10.1097/TME.0000000000000607","DOIUrl":"10.1097/TME.0000000000000607","url":null,"abstract":"<p><p>Lyme disease, much like the nymphs and adult ticks that transmit the disease, can be tricky and at times hard to identify. When the disease presents with hallmark symptoms, such as the erythema migrans rash with central clearing, diagnosis and treatment are often straightforward. However, especially when practicing in an endemic area, health care providers can be presented with a wide range of clinical presentations and symptoms, which can lead to variable testing and treatment recommendations based on the stage of the disease the patient presents in. Therefore, a thorough understanding of Lyme disease is necessary when managing patients with this complex disease.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"16-21"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946449","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
Traumatic Diaphragmatic Injuries. 创伤性横膈膜损伤。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI: 10.1097/TME.0000000000000608
John Ramos
{"title":"Traumatic Diaphragmatic Injuries.","authors":"John Ramos","doi":"10.1097/TME.0000000000000608","DOIUrl":"10.1097/TME.0000000000000608","url":null,"abstract":"<p><p>Diaphragmatic injuries are uncommon but are associated with high mortality rates in acute and chronic presentations. Mortality increases with complications of diaphragmatic hernia, which include strangulated bowel, perforation, and peritonitis. Traumatic diaphragmatic injury (TDI) is notoriously underdiagnosed and delayed presentations are common. Firearm injuries and stab wounds account for the majority of TDI. Blunt TDI is frequently associated with severe injuries including pneumothorax and hemorrhaging shock. Contrast enhanced computed tomography imaging is the gold standard for diagnosis in both blunt and penetrating mechanisms of injury. Laparoscopy is a useful nonoperative tool for diagnosing TDI. Small lacerations may not warrant further investigation or repair at the index admission. Patients with clinical instability and/or evidence of TDI with blunt trauma warrant emergent operative intervention. Recognition of TDI is essential for nurse practitioners and physician assistants, given disease mortality, frequency of delayed presentations, and the lack of guidance on surveillance for initially nonoperative injuries.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"22-31"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726508","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
Balloon Blowing Facilitates the Termination of Paroxysmal Supraventricular Tachycardia: Comparing the Practicality and Efficacy of Balloon With Syringe-Based Valsalva Maneuver. 吹球囊有助于终止阵发性室上性心动过速：球囊与注射器式Valsalva手法的实用性和有效性比较。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI: 10.1097/TME.0000000000000613
Xiaoyin Huang, Feiyan Chen, Yadong Wu, Liang Cheng, Lu Yu, Daoyang Zhou
{"title":"Balloon Blowing Facilitates the Termination of Paroxysmal Supraventricular Tachycardia: Comparing the Practicality and Efficacy of Balloon With Syringe-Based Valsalva Maneuver.","authors":"Xiaoyin Huang, Feiyan Chen, Yadong Wu, Liang Cheng, Lu Yu, Daoyang Zhou","doi":"10.1097/TME.0000000000000613","DOIUrl":"10.1097/TME.0000000000000613","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to assess the practicality and efficacy of balloon insufflation versus syringe-based modified Valsava maneuver (VM) for terminating paroxysmal supraventricular tachycardia (PSVT).</p><p><strong>Methods: </strong>Pressure generation tests compared latex balloons (uninflated diameters: 5.7-6 cm) and 10-ml syringes. A total of 103 hemodynamically stable PSVT patients presenting in the emergency department (ED) were random assigned to perform the modified VM using either a balloon ( n = 58) or a syringe ( n = 45). Primary outcome was a cardioversion of sinus rhythm.</p><p><strong>Results: </strong>We found that when blowing air into a balloon, we were able to reach the target intrathoracic pressure (40-60 mmHg; mean 47.8 mmHg for 5.8-cm balloon) required for VM. A total of 103 patients were randomized to perform the modified VM. Among them, cardioversion success was 50% (29/58) in the balloon group versus 55.6% (25/45) in the syringe group ( p = .575). Balloon insufflation was visibly effective in 100% of patients versus 36.4% with syringes ( p < .001).</p><p><strong>Conclusion: </strong>In this study, the patients in the ED showed that the modified VM using a balloon was effective in terminating PSVT with which the balloon allowed for visible insufflation. Its simplicity and visibility make it preferable in emergency and community settings, reducing reliance on invasive interventions.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"48-53"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946475","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
Pharmacotherapy Management of Beta Blocker Toxicity in the Emergency Department. 急诊科β受体阻滞剂毒性的药物治疗管理
IF 1
Advanced Emergency Nursing Journal Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI: 10.1097/TME.0000000000000616
{"title":"Pharmacotherapy Management of Beta Blocker Toxicity in the Emergency Department.","authors":"","doi":"10.1097/TME.0000000000000616","DOIUrl":"https://doi.org/10.1097/TME.0000000000000616","url":null,"abstract":"","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"48 1","pages":"E1"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114586","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
POCUS-Assisted Therapeutic Thoracentesis. pocus辅助治疗性胸穿刺。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2025-10-01 Epub Date: 2025-11-04 DOI: 10.1097/TME.0000000000000595
Major William C Moreo, Kelly Ball
{"title":"POCUS-Assisted Therapeutic Thoracentesis.","authors":"Major William C Moreo, Kelly Ball","doi":"10.1097/TME.0000000000000595","DOIUrl":"10.1097/TME.0000000000000595","url":null,"abstract":"<p><p>Therapeutic thoracentesis is an invasive procedure performed to relieve symptoms in patients with large pleural effusions identified on diagnostic imaging. Untreated effusions can lead to respiratory compromise or hemodynamic instability. Factors such as poor patient compliance, worsening disease progression, or limited outpatient follow-up availability may increase the need for therapeutic thoracentesis in the emergency department (ED). This article provides a comprehensive overview of the procedure with point-of-care ultrasound (POCUS) guidance and discusses indications, contraindications, and post-procedure care in the ED setting. Competence in thoracentesis and POCUS enables the emergency nurse practitioner to optimize procedural utilization and deliver safe, high-quality care for patients with significant pleural effusions.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"299-308"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126353","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
Pharmacotherapy Management of Acute Migraine in the Emergency Department. 急诊科急性偏头痛的药物治疗管理。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2025-10-01 Epub Date: 2025-11-04 DOI: 10.1097/TME.0000000000000588
Kyle A Weant, Haili Gregory
{"title":"Pharmacotherapy Management of Acute Migraine in the Emergency Department.","authors":"Kyle A Weant, Haili Gregory","doi":"10.1097/TME.0000000000000588","DOIUrl":"10.1097/TME.0000000000000588","url":null,"abstract":"<p><strong>Background: </strong>Migraine is an often-disabling condition and a common presentation to the Emergency Department (ED). Rapid and effective treatment are essential to reduce symptom burden, prevent recurrence, and improve patient outcomes. This review provides a comprehensive, evidence-based overview of the pharmacologic management of acute migraine in the ED, including first-line therapies, rescue medications, adjunctive care strategies, and considerations for special populations. First-line agents for acute migraine include dopamine antagonists, nonsteroidal anti-inflammatory drugs, and triptans, with treatment tailored to severity, comorbidities, and previous response. Rescue therapies such as dexamethasone, valproic acid, magnesium sulfate, and, in rare cases, dihydroergotamine and caffeine, are indicated for refractory or recurrent symptoms. Supportive interventions such as intravenous fluids and antiemetics can enhance treatment response. Special populations, including pregnant individuals, pediatric, and geriatric patients, as well as those with cardiovascular disease, require individualized management. It is critical for ED personnel to provide not only optimal pharmacotherapy but also safe medication administration, astute monitoring for adverse effects, and the provision of discharge education to prevent migraine recurrence and ensure outpatient follow-up.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"269-281"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034389","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
Foreign Body of the Knee. 膝关节异物。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2025-10-01 Epub Date: 2025-11-04 DOI: 10.1097/TME.0000000000000597
Anthony Good, Angela Ersher, Denise R Ramponi
{"title":"Foreign Body of the Knee.","authors":"Anthony Good, Angela Ersher, Denise R Ramponi","doi":"10.1097/TME.0000000000000597","DOIUrl":"10.1097/TME.0000000000000597","url":null,"abstract":"<p><p>Patients experiencing foreign bodies in the knee joints may attempt to manage the situation at home before seeking care from their primary care provider. The delay in care may result in infection or sepsis of the knee joint. This case depicts how the delay in care can lead to hospitalization and delayed recovery. Timely diagnosis of foreign bodies in the knee joint leads to efficient removal and control of infection. Patient rapport and proper diagnostic testing are key to the efficient delivery of care.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"47 4","pages":"296-298"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496722","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
Crosswalk Analysis of Existing Nurse Practitioner Populations and Emergency Nurse Practitioner Competencies: An Executive Summary. 现有执业护士人群与急诊执业护士能力的交叉分析：执行摘要。
IF 1
Advanced Emergency Nursing Journal Pub Date : 2025-10-01 Epub Date: 2025-11-04 DOI: 10.1097/TME.0000000000000585
Jennifer Wilbeck, Wesley D Davis, Pamela Cromer, Autumn Henson, Christina Hicks, Jennifer Kim, Rene Love, Julie Stanik-Hutt, Suzanne Staebler, Malinda Teague
{"title":"Crosswalk Analysis of Existing Nurse Practitioner Populations and Emergency Nurse Practitioner Competencies: An Executive Summary.","authors":"Jennifer Wilbeck, Wesley D Davis, Pamela Cromer, Autumn Henson, Christina Hicks, Jennifer Kim, Rene Love, Julie Stanik-Hutt, Suzanne Staebler, Malinda Teague","doi":"10.1097/TME.0000000000000585","DOIUrl":"10.1097/TME.0000000000000585","url":null,"abstract":"<p><p>As the number of nurse practitioners working in emergency care (ENP) has grown over the past decade, the alignment of ENP knowledge, skills, and abilities with those of the NP populations has not been fully explored. To identify overlapping themes among the emergency nurse practitioner (ENP) specialty and the eight nurse practitioner population foci's knowledge, skills, and abilities, national leaders and expert faculty collaborated on a crosswalk analysis of NP competencies, certification examination content and procedures. This project revealed that the ENP specialty competencies, certification exam blueprint items, and procedures are not entirely subsumed within an existing nurse practitioner population focus.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":" ","pages":"353-364"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800500","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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