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The medications your elder patient is taking can cause a worsened injury or misleading vital signs, warns Chris Hoag-Apel, RN, TNS, SANE, trauma service supervisor at Freeman Health Systems in Joplin, MO.
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If you fail to confirm that neurological deficits are a normal baseline for your elder patient, this may be a dangerous assumption. To avoid this mistake, ask others about the patient's baseline, advises Nadya Valdovinos, RN, TNCC, an ED nurse at Northwestern Memorial Hospital in Chicago, and read past medical notes and transfer records.
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You, and other ED nurses, may have been taking care of a patient for hours without realizing he or she has an infection that requires isolation. The fast-paced ED environment is an added challenge in preventing ED-acquired infections, according to Susan Gray, RN, BSN, CEN, an ED nurse at Greater Baltimore (MD) Medical Center. "Staff are in and out of rooms often," she adds.
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At St. Joseph Hospital in Nashua, NH, ED nurses do at least 90% of bedside dysphagia screens while the patient is still in the ED, says Susan L. Barnard, MS, APRN, CCRN, trauma coordinator.
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Would you think to tell a receiving nurse that your ED patient has a dog at home she's worried about? That may be the reason she's refusing admission, says Pat Clutter, RN, MEd, CEN, FAEN, an ED nurse at St. John's Lebanon (MO) Hospital.
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Is your patient telling you, "It's probably something I ate," "It's nothing," "There isn't any heart history in my family," or "I'm way too young to have a heart problem?"
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Nearly 8% of 355,088 children received a CT scan in a 3-year period, with 3.5% of the children receiving more than one, according to a recent study.
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If you're taking a verbal order from an emergency physician, remember that there is always a potential for miscommunication, warns René Borghese, RN, BAS, unit educator in the ED at Duke University Medical Center. "This is the primary reason we utilize them only when absolutely necessary," she says.
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If your patient is abusing narcotic pain medications, he or she isn't likely to come out and tell you this. However, ED visits involving misuse or abuse of pharmaceuticals nearly doubled during the past five years, according to a new report, totaling about 1.2 million visits in 2009, compared to 627,000 in 2004.
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ED nurses at St. Elizabeth Healthcare Florence (KY) have cared for several healthy patients under age 35 with no history or family history of heart disease, who were having a cardiac event, reports Ben Brooks, RN, BSN.
