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All the Better to Taste You With, My Dear: ED Management of Mammalian Bites. 更适合品尝你的味道，亲爱的：哺乳动物咬伤的 ED 管理。
IF 0.5
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000513
Ryan Holley-Mallo
{"title":"All the Better to Taste You With, My Dear: ED Management of Mammalian Bites.","authors":"Ryan Holley-Mallo","doi":"10.1097/TME.0000000000000513","DOIUrl":"10.1097/TME.0000000000000513","url":null,"abstract":"<p><p>Mammal bites account for over 5 million visits to Emergency Departments (EDs) annually. Nurse Practitioners (NPs) need to stay abreast of current guidelines, changes to antibiotic regimens that are now most effective, and understand in what circumstances collaboration with other specialists is indicated. It is not enough to care for the wound, itself, but rather understand in what presentations additional care may be needed despite the fact that there is no clear evidence at the time of evaluation of the need for advanced care. Additionally, NPs should understand what resources are available within their community for wound care that may exceed the scope and ability of the facility in which they practice. Health departments may need to be utilized in the care of ED patients who present with wounds that are suspicious for rabies. Finally understanding what constitutes a high, medium, and low risk bite will aide NPs in delivering optimal care within the communities they serve while also minimizing patient morbidity.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"118-125"},"PeriodicalIF":0.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912821","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
Lumbar Puncture. 腰椎穿刺
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000511
Margaret J Carman
{"title":"Lumbar Puncture.","authors":"Margaret J Carman","doi":"10.1097/TME.0000000000000511","DOIUrl":"10.1097/TME.0000000000000511","url":null,"abstract":"<p><p>Lumbar puncture (LP) is a procedural skill that is required for practice in the emergency care setting, most often for diagnostic purposes. Rarely, it can also be used therapeutically, to alleviate the pain of patients presenting to the emergency department with acute headache from idiopathic intracranial hypertension. In either case, LP constitutes an invasive procedure in which the subarachnoid space is entered in order to obtain a sample of cerebrospinal fluid from one of the most vulnerable areas of the human anatomy. It is essential for the emergency clinician to carefully weigh the risks and benefits of LP, to ensure informed consent when possible, and to proceed in a manner that ensures optimal patient safety and effectiveness. This article reviews current recommendations and considerations around performing LP, in addition to the process for performing the procedure.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"141-148"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912834","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
Pharmacological Approach for Symptomatic Nonsustained Ventricular Tachycardia. 治疗症状性非持续性室性心动过速的药物疗法。
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000509
Ida Obeso-Martinez, Farshad Raissi
{"title":"Pharmacological Approach for Symptomatic Nonsustained Ventricular Tachycardia.","authors":"Ida Obeso-Martinez, Farshad Raissi","doi":"10.1097/TME.0000000000000509","DOIUrl":"10.1097/TME.0000000000000509","url":null,"abstract":"<p><p>Nonsustained ventricular tachycardia (NSVT) is a common arrhythmia associated with heart failure, cardiomyopathy, coronary artery disease, electrolyte imbalances, and congenital heart disorders (Foth et al., 2023). NSVT is often asymptomatic depending on its burden percentage. However, typical NSVT presentation in the emergency department (ED) includes palpitations, near-syncope, dizziness, skipped beats, chest pain, and/or dyspnea (Katritsis et al., 2012). In some instances, NSVT can present with elevated or slightly elevated troponin from demand ischemia. A definite diagnosis of NSVT is not of high complexity; nevertheless, it is not always identified on electrocardiogram (ECG) by the time the patient arrives to the ED. Identification of NSVT usually requires prolonged cardiac monitoring, mobile cardiac telemetry (MCT), and in some instances internal loop recorder placement. The purpose of this case is to discuss the typical presentation and pharmacological approach of patients with stable NSVT.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"149-157"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912840","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
Can Artificial Intelligence Be Utilized to Predict Real-Time Adverse Outcomes in Individuals Arriving at the Emergency Department With Hyperglycemic Crises?: Implications for APRN Practice. 人工智能能否用于预测急诊科高血糖危象患者的实时不良后果？对全科护士实践的意义。
IF 0.5
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000508
Alisha Amin Bhimani, Tova Safier Frenkel, Adam Kaizer Hasham
{"title":"Can Artificial Intelligence Be Utilized to Predict Real-Time Adverse Outcomes in Individuals Arriving at the Emergency Department With Hyperglycemic Crises?: Implications for APRN Practice.","authors":"Alisha Amin Bhimani, Tova Safier Frenkel, Adam Kaizer Hasham","doi":"10.1097/TME.0000000000000508","DOIUrl":"10.1097/TME.0000000000000508","url":null,"abstract":"<p><p>This column on translating research into practice is crafted to offer advanced practice registered nurses an analysis of current research topics that hold practical relevance for emergency care settings. The article titled \"Using Artificial Intelligence to Predict Adverse Outcomes in Emergency Department Patients With Hyperglycemic Crises in Real Time,\" authored by C. Hsu et al. (2023), investigates through a randomized control trial, the effectiveness of artificial intelligence as a practical tool compared with the traditional predicting hyperglycemic crisis death score to clinically predict adverse outcomes in individuals presenting to the emergency department with hyperglycemic crises. The results are discussed in the context of averting adverse outcomes associated with sepsis/septic shock, intensive care unit admission, and all-cause mortality within a 1-month time frame.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"93-100"},"PeriodicalIF":0.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912853","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
Fast-Track Training in Emergency Department During the COVID-19 Pandemic: Evaluation of a Hybrid Education Model. COVID-19 大流行期间急诊科的快速培训：混合教育模式评估。
IF 0.5
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000516
Hui Grace Xu, Amy N B Johnston, Gillian Ray-Barruel
{"title":"Fast-Track Training in Emergency Department During the COVID-19 Pandemic: Evaluation of a Hybrid Education Model.","authors":"Hui Grace Xu, Amy N B Johnston, Gillian Ray-Barruel","doi":"10.1097/TME.0000000000000516","DOIUrl":"10.1097/TME.0000000000000516","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department (ED) fast track (FT) for the ambulatory, minor injury patient cohort requires rapid patient assessment, treatment, and turnover, yet specific nursing education is limited. The study aimed to test the feasibility and staff satisfaction of an education program to expand nursing skills and knowledge of managing FT patients during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This quasi-experimental study, including self-rating surveys and interviews, assessed the pre- and postimplementation of an education program for nurses working in FT in a metropolitan hospital ED in Australia. Hybrid (face-to-face and Teams) education sessions on 10 topics of staff-perceived limited knowledge were delivered over 8 months.</p><p><strong>Results: </strong>Participants demonstrated higher knowledge scores after the implementation of short online education sessions to cover the core facets of minor injury management. Overall staff satisfaction with the program was high. Interview discussions involved three key themes, including \"benefits to staff learning,\" \"positive impact on patient care and flow,\" and \"preferred mode of delivery.\"</p><p><strong>Conclusiions: </strong>Recorded education sessions on minor injury topics for nurses working in FT have proved effective, and this program has now become a core facet of ED education in our hospital.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"169-181"},"PeriodicalIF":0.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912856","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
Spontaneous Pneumothorax: Controversies in Treatment: Erratum. 自发性气胸：治疗中的争议：勘误。
IF 0.5
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000493
{"title":"Spontaneous Pneumothorax: Controversies in Treatment: Erratum.","authors":"","doi":"10.1097/TME.0000000000000493","DOIUrl":"10.1097/TME.0000000000000493","url":null,"abstract":"","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"182"},"PeriodicalIF":0.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912884","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
A Near Miss in the Emergency Department: Atypical Presentation of Acute Coronary Syndrome. 急诊科的一次险情：急性冠状动脉综合征的非典型表现。
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000510
Kimberly P Toole, Catherine Frank
{"title":"A Near Miss in the Emergency Department: Atypical Presentation of Acute Coronary Syndrome.","authors":"Kimberly P Toole, Catherine Frank","doi":"10.1097/TME.0000000000000510","DOIUrl":"10.1097/TME.0000000000000510","url":null,"abstract":"<p><p>Acute coronary syndrome is an umbrella term encompassing three types of coronary artery disease that affect millions worldwide annually. Despite the availability of diagnostic tests (blood analysis, imaging, electrocardiogram, and screening tools), the diagnosis of myocardial infarction (MI) is still sometimes missed. According to the Centers for Disease Control and Prevention, the reported prevalence of heart disease is higher among males than females, with adults over the age of 75 having the highest prevalence. Typical \"heart attack\" features include chest pain that feels like pressure or squeezing, pain or discomfort in one or both arms that can radiate to the neck or jaw, shortness of breath, diaphoresis, nausea, vomiting, and lightheadedness. However, there are three subgroups where the typical warning signs do not always present: the elderly, individuals with diabetes, and females. The following is an atypical case presentation of unstable angina and non-ST-elevation MI.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"108-117"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912817","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
Guest Editorial: The Time Is Now: A Call for Research in Emergency Care. 特邀社论：时不我待：呼吁开展急救护理研究
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000507
Nicole Martinez
{"title":"Guest Editorial: The Time Is Now: A Call for Research in Emergency Care.","authors":"Nicole Martinez","doi":"10.1097/TME.0000000000000507","DOIUrl":"10.1097/TME.0000000000000507","url":null,"abstract":"","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"91-92"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912860","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
Bleeding Reversal With Antifibrinolytics or Cryoprecipitate Following Thrombolysis for Acute Ischemic Stroke: A Case Series. 急性缺血性脑卒中溶栓治疗后使用抗纤维蛋白溶解剂或低温沉淀逆转出血：病例系列。
IF 0.5
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000512
Abby M Bailey, Regan Baum, Melissa Nestor, Thomas Platt
{"title":"Bleeding Reversal With Antifibrinolytics or Cryoprecipitate Following Thrombolysis for Acute Ischemic Stroke: A Case Series.","authors":"Abby M Bailey, Regan Baum, Melissa Nestor, Thomas Platt","doi":"10.1097/TME.0000000000000512","DOIUrl":"10.1097/TME.0000000000000512","url":null,"abstract":"<p><p>Patients who develop an intracerebral hemorrhage (ICH) following thrombolysis in acute ischemic stroke (AIS) have a mortality rate as high as 50%. Treatment options include blood products, such as cryoprecipitate, or antifibrinolytics, such as tranexamic acid (TXA) or ε-aminocaproic acid (EACA). Current guidelines recommend cryoprecipitate first-line despite limited data to support one agent over another. In addition, compared to antifibrinolytics, cryoprecipitate is higher in cost and requires thawing before use. This case series seeks to characterize the management of thrombolytic reversal at a single institution as well as provide additional evidence for antifibrinolytics in this setting. Patients were included for a retrospective review if they met the following criteria: presented between January 2011-January 2017, were >18 years of age, were admitted for AIS, received a thrombolytic, and received TXA EACA, or cryoprecipitate. Twelve patients met the inclusion criteria. Ten (83.3%) developed an ICH, one (8.3%) experienced gastrointestinal bleeding, and one (8.3%) had bleeding at the site of knee arthroscopy. Eleven patients received cryoprecipitate (median dose: 10 units), three received TXA (median dose: 1,000 mg), and one patient received EACA (13 g). TXA was administered faster than the first blood product at a mean time of 19 min and 137 min, respectively. Hemorrhagic expansion (N = 8, 66.67%) and inhospital mortality (N = 7, 58.3%) were high. While limited by its small sample size, this case series demonstrates significant variability in reversal strategies for thrombolysis-associated bleeding. It also provides additional evidence for the role of antifibrinolytics in this setting.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"101-107"},"PeriodicalIF":0.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912827","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
Point-of-Care Ultrasonography to Confirm Endotracheal Tube Placement: A Review for the Emergency Nurse Practitioner. 用于确认气管插管位置的护理点超声波检查：急诊科执业护士回顾。
IF 0.8
Advanced Emergency Nursing Journal Pub Date : 2024-04-01 Epub Date: 2024-05-09 DOI: 10.1097/TME.0000000000000514
Juan M Gonzalez, Johis Ortega, Juan E Gonzalez, Nichole Crenshaw, Stephen McGhee, Jeffrey Groom
{"title":"Point-of-Care Ultrasonography to Confirm Endotracheal Tube Placement: A Review for the Emergency Nurse Practitioner.","authors":"Juan M Gonzalez, Johis Ortega, Juan E Gonzalez, Nichole Crenshaw, Stephen McGhee, Jeffrey Groom","doi":"10.1097/TME.0000000000000514","DOIUrl":"10.1097/TME.0000000000000514","url":null,"abstract":"<p><p>Ensuring correct placement of the endotracheal tube (ETT) during intubation is an important step to avoid complications. Appropriate placement of the ETT can be challenging and, if done incorrectly, can lead to complications such as hypoxemia, atelectasis, hyperinflation, barotrauma, cardiovascular instability, end organ damage, and even death. Although several procedures exist to help assess ETT confirmation, all have limitations, are not always reliable, and vary in their degree of accuracy. Point-of-care ultrasound (POCUS) has emerged as a useful tool in the emergency department for quick diagnosis and treatment of many emergency conditions (Gonzalez et al., 2020). The purpose of this paper is to describe a systematic approach for the emergency nurse practitioner to use POCUS to assess proper endotracheal placement and the positioning within the trachea based on prior studies that compare this modality to traditional ones.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"46 2","pages":"126-140"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912867","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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