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There is a way to recognize the potential for appendicitis before your patient even says a word.
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A patient's chart is unavailable. Verbal orders are not yet written in the patient's chart. The identification bracelet is not yet on your patient. These are three reasons that an ED nurse may fail to comply with one of The Joint Commission's National Patient Safety Goals (NPSGs): the requirement for use of at least two patient identifiers.
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A 3-year-old boy with gastroenteritis presents with dry mucous membranes, and his mother tells you he has been sick for several days. This child is at high risk for acidosis, according to a new study.
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Severely dehydrated children are "in imminent danger" due to cardiovascular collapse, increased acidosis, and metabolic abnormalities, all of which can lead to significant morbidity and in some cases mortality, warns P. Jamil Madati, MD, director of emergency medical services at Rady Children's Hospital in San Diego.
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Nearly half of older patients use prescription and over-the-counter (OTC) medications together, says a new study, and one in 25 is at risk for a major potential drug-drug interaction. The researchers also found that 29% of these patients use at least five prescription medications.
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When 103 ED patients, 34 ED physicians, and 44 ED nurses were surveyed, they all agreed on one thing: Treating chronic pain in the ED is a "low priority."
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[Editor's note: This is the second of a two-part series on medical screening examinations (MSEs) performed by emergency nurses. This month, we cover the potential liability risks of nurse-performed MSEs and how to avoid legal problems. Last month, we reported on benefits seen by two EDs that have implemented this practice.]
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Acute gastroenteritis in children is not a benign condition. Worldwide, millions of young children continue to die from this treatable condition every year. Fortunately, in developed countries like the United States, deaths are uncommon, but a substantial proportion of pediatric acute care visits and hospitalizations are directly related to the dehydration caused by this condition.
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On the next chart you pick up, the triage nurse has written, "Back pain, needs med refill." What is your honest reaction? Mine, too. But after evaluating the patient, sometimes I am embarrassed that my initial reaction was negative.
