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Is your intubated patient being transporte d for radiological studies? This increases the chance of disastrous consequences due to an unrecognized displaced or dislodged endotracheal (ET) tube, warns Catherine Payne, RN, MSN, CCRN, CEN, an ED nurse at the University of California Davis Medical Center in Sacramento.
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While assessing a 40-year-old male who complained of abdominal pain, nurses did a routine mental health screening, which included asking if he was currently suicidal. "He answered 'yes' to all of the questions," says MaryEllen Swanson, RN, a senior staff nurse in the ED at Hennepin County Medical Center in Minneapolis. "It would have been missed if the screening had not been done."
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If a tuberculosis patient just left your ED to go to a negative pressure room, housekeeping must come and disinfect the room wearing full contact precautions garb, leave the room unused for four hours, and remove all hanging curtains and replace these with clean ones.
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Every part of the process in stroke care from the time the patient begins to have symptoms to the time treatment is initiated is constantly examined for ways to cut minutes, reports Sharon Pulver, MSN, RN, CEN, network stroke coordinator for the SSM Neurosciences Institute in St. Louis, MO.
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Children are more susceptible to acute airway compromise due to the unique characteristics of a child's airway, according to Eileen Callahan, RN, BSN, an ED pediatric nurse educator at Tufts Medical Center and the Floating Hospital for Children in Boston, MA.
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If the patient standing in front of you appears jittery, unable to sit still, and is continually scratching at sores on his or her face and body, it's likely he or she is using methamphetamine. "It's unfortunate to say, but we can usually tell by looking at someone that he or she is a meth user," says Sue Williams, RN, a nurse with SSM Behavioral Health Services at St. Joseph Health Center-Wentzville in Wentzville, MO.
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If your ED patient is sedated, he or she may have an adverse reaction to medications used in the procedure, an allergic reaction, or become hypoxic from inadequate respiratory effort, warns Brad Guffin, BSN, RN-BC, CPEN, director of emergency services at Martin Memorial Medical Center in Stuart, FL.
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While observing an elderly woman rubbing her arm as though it was a muscle ache, which she said was from gardening work, the possibility of a heart attack didn't cross the mind of the ED nurse caring for the patient.
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If your ED patient is taking multiple medications, he or she may have no idea what they are for. "They may tell us they are taking them because they were prescribed, without knowing what the purpose is or if the dosage changed recently," says Jocelyn Cajanap, RN, ED educator at Glendale (CA) Adventist Medical Center.
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When an ED physician at Scripps Mercy San Diego (CA) decided to order lorazepam to help an elderly man sleep, the ED nurse caring for the patient got a very unexpected reaction.
