ED Nursing Archives – March 1, 2005
March 1, 2005
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Are elderly patients undertriaged? Don’t miss life-threatening conditions
If a 78-year-old woman came to your ED with lower abdominal pain and bloating, but had normal vital signs without chest pain, would you suspect a myocardial infarction (MI)? When this patient was placed on a monitor, ED nurses at Carondelet St. Marys Hospital in Tucson, AZ, saw large ST-elevation in most leads, and point-of-care testing revealed positive myoglobin, creatine kinase, and troponin levels. -
Heart attack! Don’t delay ED care for women
This is the second article in a two-part series on chest pain in the ED. Last month, we gave strategies to speed door-to-needle time. This month, we cover treatment delays due to atypical presentation. -
Be creative teaching nurses to do neuro assessments
Your head trauma patient bounces back and seems fine after an epidural bleed and temporary loss of consciousness, but lapses into a profound coma all in a matter of minutes. Your elderly Alzheimers patient has gone from confused to aphasic, and suddenly cant move her left side. Both these scenarios illustrate the importance of performing a quick neurological assessment in the ED, says Teri Howick, RN, nurse educator for the ED at McKay Dee Hospital in Ogden, UT. -
Tips to teach nurses to do neuro assessments
You should perform a neurological assessment for any patient whose history or mechanism of injury indicates a possible neurological problem, says Cynthia Bautista, PhD, RN, CNRN, neuroscience clinical nurse specialist at Yale-New Haven (CT) Hospital. -
Do on-call physicians put patients at risk? Act now
Its been more than 30 minutes, and youre still waiting for the on-call surgeon to evaluate an elderly trauma patient for internal bleeding. When you page him again, he says curtly, Ill get there when I get there. What do you do next? -
Are nurses still using ‘do-not-use’ abbreviations?
A recent report from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) revealed that hospitals were almost 100% in compliance with all the National Patient Safety Goals, with one exception: the requirement to avoid use of unauthorized abbreviations, which fell to 85% compliance. -
Dramatic rise in CA-MRSA: What it means for your ED
There is an alarming increase in community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) cases in ED patients seeking treatment for skin and soft tissue infections, according to a new study. Researchers found 51% of skin and soft tissue infections in Alamedas ED were caused by CA-MRSA. -
Journal Reviews
Marek M, Lindsell CJ, Jauch EC, et al. Effect of education and guidelines for treatment of uncomplicated dental pain on patient and provider behavior. Ann Emerg Med 2004; 44:323-329. Gorelick MH, Yen K, Yun HJ. The effect of in-room registration on emergency department length of stay. Ann Emerg Med 2005; 45:128-133. -
ED nurses must prepare for a strange flu season