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Just because a child with mental health issues is connected with an outpatient provider doesnt mean he or she wont come to the ED frequently for care, according to research from Johns Hopkins Childrens Center.
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ED nurses at Mount Desert Island Hospital in Bar Harbor, ME, have dramatically shortened door-to-CT and door-to-drug times with a Code Stroke program, reports Sean Hall, RN, one of the hospitals ED nurses.
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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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The medical literature is rife with information on the trends of various infectious diseases. Much of this begins with the diagnosis made and helps us connect the diagnosis to a preferred regimen of antimicrobials or antivirals. The real detective work starts before this. Our tools are constant vigilance for subtle clues in the history and physical examination, some nonspecific laboratory tests (for example white blood cell [WBC] count or lactate), and a high level of suspicion for infection.
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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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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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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.
