Advanced emergency nursing journal
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Necrotizing fasciitis is a rapidly progressing soft tissue infection associated with a high rate of mortality. Vibrio vulnificus, a gram-negative bacillus found in warm seawater, is a rare but serious cause of necrotizing fasciitis. Definitive treatment is often delayed because of the vague clinical manifestations associated with the early stages of the disease. ⋯ Health care providers in northern and inland areas must be aware of patients who have recently traveled to regions where V. vulnificus is more common, such as warm coastal regions. Early fasciotomy, debridement, and culture-directed antimicrobial therapy are essential to improve survival. The case presented in this report highlights the importance of early diagnosis of V. vulnificus-associated necrotizing fasciitis.
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Nursemaid's elbow, also known as radial head subluxation, is a common childhood orthopedic injury that can easily be diagnosed and reduced by the advanced practice nurse. It is most common in children 1-4 years of age and typically occurs as the result of a pulling mechanism on an outstretched arm. ⋯ The child subsequently refuses to use the affected arm, leading the caregiver to present for evaluation. This article explores epidemiology, pathophysiology, clinical presentation, reduction techniques, and parent education.