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Would you like to start a fight? Just ask a colleague how he or she selected the level of positive end-expiratory pressure (PEEP) for a patient.
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My hospital has a contract to provide medical care to the county jail. At any one time, there are more than 10,000 inmates in the county jail facilities supervised by the sheriff's office. We often see patients who are in custody and have sustained trauma, sometimes from less than lethal weapons. In my humble opinion, these devices reduce the risk of injury to the law enforcement officer when attempting to arrest or control a violent individual, and they greatly reduce the risk of serious injury or even death to the violent individuals themselves. However, even these less than lethal force weapons can cause significant damage when used at close range or on individuals with underlying medical conditions that render them vulnerable to the effects of these weapons.
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My emergency department (ED) has had an electronic medical record for the past two years. Part of that record includes a medication list that is created from past encounters and updated by the triage nurse. Because it is electronic and prints out nicely in the triage summary, it has the appearance of truth. My experience with the list is likely similar to some of yours: Patients are often taking medications not on the list and are not currently taking those that are.
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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.
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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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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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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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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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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.
