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All patients should be asked about any medication, prescribed or over-the-counter, that they are taking, including transdermal patches, says Cindy Vanek, MS, RN, director of emergency and critical care services at Indian River Medical Center in Vero Beach, FL.
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If panicked parents bring in a seizing infant, the underlying cause could be life-threatening, but it also could have resulted from something as simple as drinking too much water.
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Recently, ED nurses at University of Virginia Health System in Charlottesville were given a two-hour in-service on the Prime ECG (manufactured by Columbia, MD-based Heartscape Technologies), reports William Brady, MD, a professor in the Department of Emergency Medicine at University of Virginia Health System in Charlottesville.
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Here are some examples of suspicious injuries in children, according to Thomas Tryon, RN, an ED nurse at Thomas Jefferson University Hospital in Philadelphia:
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If a woman came to your ED with a black eye and swollen lip, you would suspect abuse or assault.
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Young gymnasts may be more stoic than other kids you treat. "So you really have to use all your clinical tools: History, physical exam and X-rays to determine whether it's something more significant or not," says Robert Frederick, MD, sports medicine specialist at the Rothman Institute at Thomas Jefferson University Hospital in Philadelphia.
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Because a woman with chronic pain failed to tell ED nurses about the fentanyl patch she was wearing, she was given a second fentanyl patch and intravenous morphine for breakthrough pain.
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Patients may be hesitant to admit cocaine use, either because they fear legal consequences or because they don't want family members to know, says Pamela Tokarski, RN, an ED nurse at Henry Ford Hospital in Detroit. Do the following to obtain a truthful response:
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Always ask about recent cocaine use when a younger individual presents to the ED with possible cardiac symptoms, says Pamela Tokarski, RN, an ED nurse at Henry Ford Hospital in Detroit.
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Young people with a history of Type I diabetes, juvenile obesity, hypertension, sickle cell anemia, smoking, or recreational drug use are at considerable risk for myocardial infarction (MI), even in their 20s, says James Hardecki, RN, ED nurse at Henry Ford Hospital in Detroit.