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Smoking, lung diseases, and chest X-ray abnormalities may result in your ED patient being diagnosed with bronchitis, flu, pleurisy, costochondritis, and upper respiratory infection, when he or she actually has pneumonia, says Carrie April, RN, BSN, an ED nurse at St. John's Mercy Medical Center in St. Louis, MO.
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Editor's Note: This is a two-part series on medication safety for inpatients being held in the ED. This month, we give strategies to avoid missed dosages; next month, we'll cover how ED nurses can reduce errors with inpatient medications.
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Adrienne Jones, RN, an ED nurse at Providence St. Vincent Medical Center in Portland, OR, says that ED nurses used to see about five to 10 mental-health patients a day, but are now seeing twice as many.
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A 63-year-old construction worker came to the ED at Jacobi Medical Center in Bronx, NY, with difficulty swallowing, and reported losing 40 pounds in the previous six months.
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Paramedics arrive with a man you recognize instantly from his many previous visits to your ED, always intoxicated. You learn that his vital signs are stable, and he was found on the ground by bystanders, says Tia Valentine, RN, CEN, clinical nurse educator for the ED at University of California-San Diego Medical Center.
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With intraosseous (IO) vascular access, patients are subjected to a minimum number of sticks, so there is less chance of creating a portal for infection, says Sean Hall, an ED nurse at Desert Island Hospital in Bar Harbor, ME. "The time which can be saved by using these devices can be lifesaving in a critical patient," he says.
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Our faces play a role in almost every part of our lives. The structure and components of the face are involved in our ability to eat, speak, and see, and often are the features first noticed when we meet someone.
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With volume on the increase and a leave-without-being-seen (LWBS) rate already at 5%, ED administrators at Methodist Hospital of Sacramento in Sacramento, CA, knew they needed to come up with a way to get patients moved through the ED more expeditiously at least until a planned expansion of the ED took place, but in early 2008, that was still more than a year away.
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Physical therapists (PTs) are carving a niche for themselves in a small but growing number of EDs. They're doing everything from splinting fractures and taking care of wounds to evaluating cases of low back pain to helping patients with musculoskeletal injuries learn how to use assistive devices.
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Analyze the types of patients who typically come through your doors. Most EDs see a significant percentage of patients with musculoskeletal issues, which is an area of expertise for PTs, but check what the patterns are in your department, and determine what hours of the day are optimal for PT coverage.
