Advanced Emergency Nursing Journal最新文献_第6页

An Obstetric and Psychiatric Emergency: Managing Acute Agitation Among Pregnant Patients in the Emergency Department. 产科和精神科急诊：急诊科孕妇急性躁动的处理。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000485

Mei Yan Woo, Raymund Gantioque

引用次数: 0

Improving the Management of Adults With Mild Traumatic Brain Injury: An Initiative to Reduce Unnecessary Computed Tomographic Scans in the Emergency Department. 改善成人轻度颅脑损伤的管理：减少急诊科不必要的计算机断层扫描的举措。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000489

Rachel Helms

{"title":"Improving the Management of Adults With Mild Traumatic Brain Injury: An Initiative to Reduce Unnecessary Computed Tomographic Scans in the Emergency Department.","authors":"Rachel Helms","doi":"10.1097/TME.0000000000000489","DOIUrl":"10.1097/TME.0000000000000489","url":null,"abstract":"The overuse of computed tomographic (CT) scans for patients who present to the emergency department (ED) after mild traumatic brain injury (mTBI) has been well-documented. The Canadian Computed Tomography Head Rule (CCHR) is a validated tool to guide ED providers in determining the need for emergent CT of mTBI patients. The purpose of this project was to reduce radiation exposure and ED length of stay by using the CCHR to decrease unnecessary CT scans in adults with TBI. Cost of care was also estimated. The CCHR implementation strategy included an education program for ED staff. The use of the CCHR was promoted throughout the intervention period. The outcomes measured were the number of CT scans ordered, ED length of stay, and the cost of avoidable CT scans. Data were collected through medical record reviews completed by the project leader and were evaluated using the independent samples t test. A total of 600 medical records were reviewed. There was a significant difference between adherence to the CCHR before (M = 64.6%) and after provider education (M = 74.3%). The percentage of CT scans that could have been avoided significantly decreased from baseline (M = 0.63) after provider education (M = 0.46). Length of stay for mTBI patients who were managed based on the CCHR (M = 184.9) was significantly less than the length of stay for those who were not (M = 260.1). The cost of avoidable scans was decreased by 37% over the course of the project. There were no incidents of missed diagnosis found. By increasing awareness of the CCHR and promoting its use, the number of head CT scans ordered, cost of care, and ED length of stay for patients who present after mTBI were significantly improved.","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231523","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

Put It in the Air? Nebulized Opioids in the Emergency Department. 把它放在空中？急诊科的雾化阿片类药物。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000480

Abby M Bailey, Kyle A Weant

{"title":"Put It in the Air? Nebulized Opioids in the Emergency Department.","authors":"Abby M Bailey, Kyle A Weant","doi":"10.1097/TME.0000000000000480","DOIUrl":"10.1097/TME.0000000000000480","url":null,"abstract":"The emergency department (ED) is a frequent utilizer of alternative routes of medication administration (e.g., intranasal) for a variety of indications. Over the last several years, investigations into the use of medications via the nebulization route have greatly increased, with varying degrees of efficacy identified. This route has multiple theoretical advantages. Medications affecting bronchopulmonary function or secretions can be administered directly to the site of action, possibly utilizing a lower dose and hence minimizing side effects. It is also possible to have a faster onset of action compared with other routes, given the enhanced surface area for absorption. One group of medications that has been explored via this route of administration, and is frequently administered in EDs across the nation, is opioids, most notably fentanyl, hydromorphone, and morphine. However multiple questions exist regarding the implementation of these therapies via this route, including efficacy, dosing, and the functional aspects of medication administration that are more complex than that of more traditional routes. The intent of this review is to explore the supporting literature behind the use of nebulized opioids, most specifically fentanyl, hydromorphone, and morphine, in the ED for the treatment of acute pain presentations and provide the most up-to-date guidance for practitioners.","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231540","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

Content Validation of an Emergency Department Skin Risk Assessment Instrument. 急诊科皮肤风险评估仪器的内容验证。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000486

Kathleen Flarity, Wendy J Haylett, Melissa Childers

{"title":"Content Validation of an Emergency Department Skin Risk Assessment Instrument.","authors":"Kathleen Flarity, Wendy J Haylett, Melissa Childers","doi":"10.1097/TME.0000000000000486","DOIUrl":"10.1097/TME.0000000000000486","url":null,"abstract":"Pressure injuries (PIs) are an important quality and patient safety metric for health care organizations. PI monitoring and treatment are often overlooked in the emergency department (ED). Emergency care professionals must be proactive about PI early identification and prevention strategies. A team at a Level 1 trauma center recognized the need for ED-friendly documentation and a validated ED skin risk assessment instrument. The Bjorklund 25-item ED Skin/Risk Assessment Tool was selected. However, because the tool was not fully validated, permission to validate/use was obtained from the author. The purpose of this research study was to determine the content validity of the Bjorklund Tool. Using a prospective survey design, content experts were recruited from wound, quality, and ED and participated in two rounds of content validation. The experts reviewed the Tool for relevance, clarity, and appropriateness for the ED population. Item-level content validity index (I-CVI) and scale-level CVI (S-CVI) were calculated, with 0.78 and 0.90 as the lower limits of acceptability for individual items and the overall scale, respectively. Of the first round I-CVI ratings, 24 of 75 were below 0.78, including 14 for relevance, four for clarity, and six for appropriateness. S-CVI was 0.7574 for relevance, 0.8809 for clarity, 0.8592 for appropriateness, and 0.8325 overall. The Bjorklund Tool was determined to be invalid in its current form. A novel tool was thus created in the second round per content experts' recommendations. After redesign and simplifying items and images, all I-CVIs rated above 0.78. S-CVI was 0.923 for relevance, 0.9743 for clarity, 0.9615 for appropriateness, and 0.9529 overall. These CVIs indicate excellent content validity of the new UCHealth ED Skin Risk Assessment Instrument. This research contributes to establishment of content validity of a skin risk assessment instrument which can be used in the unique ED setting.","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231521","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

Ophthalmologic Emergencies: Assessment and Management. 眼科紧急情况：评估和管理。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000490

Dian Dowling Evans, Karen Sue Hoyt

引用次数: 0

Re-expansion Pulmonary Edema: A Rare Complication of Chest Drain Insertion in Spontaneous Pneumothorax. 再膨胀性肺水肿：自发性胸腔引流管置入术的罕见并发症。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000481

Mohammad Firdaus Bolong, Selvendra Shanmuga Ratnam, Raja Muhammad Burhanudeen Afiq Bin Raja Badrol Hisham, Nicholas Pang Tze Ping

{"title":"Re-expansion Pulmonary Edema: A Rare Complication of Chest Drain Insertion in Spontaneous Pneumothorax.","authors":"Mohammad Firdaus Bolong, Selvendra Shanmuga Ratnam, Raja Muhammad Burhanudeen Afiq Bin Raja Badrol Hisham, Nicholas Pang Tze Ping","doi":"10.1097/TME.0000000000000481","DOIUrl":"10.1097/TME.0000000000000481","url":null,"abstract":"Re-expansion pulmonary edema (RPE) after chest drain insertion is rare. The objective of this clinical case report is to highlight the importance of this chest drain insertion complication. A 35-year-old man presented to the emergency department with a chief complaint of shortness of breath and pleuritic chest pain. Further physical examination and radiographic investigations showed a left-sided hemipneumothorax. A chest drain was inserted, but subsequently the patient developed worsening shortness of breath, desaturation, and coughed out pink frothy sputum. Repeated chest radiographic and computed tomographic thorax findings suggested RPE. A nonrebreathable mask with high-flow oxygen was given to the patient to maintain his oxygen saturation. The patient was referred to the cardiothoracic team and was admitted to the hospital. Despite conservative management in the ward, the patient underwent lung decortication. Postdecortication, the left-sided lung re-expanded well, and the patient was discharged home. This case highlighted this rare, potentially fatal complication of chest drain insertion for spontaneous pneumothorax.","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231543","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

Cast Removal: Pearls and Methods. 铸件去除：珍珠和方法。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000483

Brianne N Miller, Marcy C Purnell

引用次数: 0

Incidental Finding of a Skene Gland Cyst in the Emergency Department. 急诊科偶然发现一个Skene腺囊肿。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000482

Susan Hellier

引用次数: 0

Low-Dose Electrocution and Atrial Fibrillation. 低剂量电击与心房颤动。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000484

Ida Obeso-Martinez

引用次数: 0

Using Battlefield Acupuncture (BFA or Auricular Acupuncture) to Treat Primary Headaches in the Emergency Department. 运用战地针（BFA或耳针）治疗急诊科原发性头痛。

IF 0.5

Advanced Emergency Nursing Journal Pub Date : 2023-10-01 DOI: 10.1097/TME.0000000000000487

Fadzai Chiwandamira

引用次数: 0