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If procedural sedation is longer-term, or if your patient has pre-existing chronic obstructive pulmonary disorder, consider monitoring end tidal carbon dioxide (CO2), advises Leah M. Gehri, RN, MN, CCRN, director of emergency, trauma, and cardiac services at MultiCare Good Samaritan Hospital in Puyallup, WA.
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An elderly womans bruising and gastrointestinal bleeding turned out to be caused by taking more than triple the dose of her warfarin medication for several days, reports Jeannette Witzel, RN, CEN, an ED nurse at Ukiah (CA) Valley Medical Center.
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Obtaining an EKG in a timely manner is critical, says Brian W. Selig, MHA, BSN, RN, CEN, NE-BC, nurse manager of the ED at the University of Kansas Hospital in Kansas City, MO, especially with the recent emphasis on time-critical diagnosis by the Joint Commission and [the Centers for Medicare & Medicaid Services.]
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Regardless of hospital trauma level designation, every emergency department (ED) manages patients with traumatic injury and needs to address the pain and discomfort that accompanies it.
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Heel and ankle pain was the only complaint of a patient being triaged by ED nurses at Edward Hospital in Naperville, IL, with no history of injury and no obvious signs of trauma or infection, when they learned an additional piece of information.
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Although gastric tube placement is commonly performed at the bedside by ED nurses, it can result in serious complications such as misplacement of the gastric tube into the pulmonary system, resulting in respiratory distress or death, according to a December 2010 Emergency Nursing Resource (ENR) on Gastric Tube Placement Verification, developed by the Emergency Nurses Association (ENA).
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Women may wait longer for ECGs than men, according to a new study. Jessica Zègre Hemsey, RN, PhD, the study's lead author, says she found the findings surprising because the American College of Cardiology/American Heart Association gives acquiring an initial ECG within 10 minutes of arrival to the ED a Class I recommendation.
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A young girl experiencing hallucinations presents to an ED after being evaluated at another hospital, and twice referred for psychiatric care. "Her diagnosis was, in fact, a potentially life-threatening underlying cardiac disorder. Unfortunately, that missed diagnosis is not uncommon," says Deena Brecher, MSN, RN, ACNS-BC, CEN, CPEN, a clinical nurse specialist in the ED at Alfred I. duPont Hospital for Children in Wilmington, DE.
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Patients with shortness of breath are "one of the highest priority patients" for ED nurses because of their tendency to rapidly deteriorate, says Alexandra Penzias, RN, MEd, MSN, CEN, an ED educator at Tufts Medical Center in Boston, MA. "We perform a complete set of vital signs, oxygen saturation, and peak flow measurements at triage," she says.
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ED patients often don't understand important information in their discharge instructions, according to a new study, which can result in bad outcomes and needless repeat visits.
