Advanced emergency nursing journal
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The aim of this study was to investigate the practice profile of emergency nurse practitioners across Australia. Nurse practitioners have been providing health service in the emergency setting internationally for more than 30 years, and evidence supports the value of this role in terms of patient satisfaction, effectiveness in improving service indicators, and acceptability of the role. The introduction of this service model has been instrumental in reducing waiting times for low-acuity patients and impacting positively on emergency department service delivery. ⋯ The study participants worked in a range of service models and managed patient presentations across all levels of acuity and complexity. The findings show that although there is no single definable model of the emergency nurse practitioner role in Australia, there are practice features that are common across all service models; these have been conceptualized as "modes of practice." This study has produced new knowledge about the practice profile of emergency nurse practitioners. The findings will inform development of practice standards for education and continuing professional development for emergency nurse practitioners and facilitate standardized operational definitions for ongoing research into this growing service model.
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Bioterrorism presents a real and omnipresent risk to public health throughout the world. More than 30 biological agents have been identified as possessing the potential to be deployed in a bioterrorist attack. ⋯ Part I of this two-part review will focus on the clinical presentation and treatment of anthrax, plague, and tularemia. The subsequent Part II of this review will discuss smallpox, viral hemorrhagic fevers, botulism toxin, and the provision of mass prophylaxis.
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Case Reports Randomized Controlled Trial
Rehydration of children with gastroenteritis.
Review of recent evidence with translation to practice for the advanced practice nurse role is presented using a case study module for "Intravenous Dextrose for Children With Gastroenteritis and Dehydration: A Double-Blind Randomized Controlled Trial." The study results showed that 35% of the children who received dextrose in normal saline (D5NS) were hospitalized as compared with 44% who received normal saline. The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting best evidence.
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Trauma-related deaths represent a leading cause of mortality among persons younger than 45 years. A significant percentage of these are secondary to hemorrhage. In trauma, massive and rapid loss of blood creates an imbalance in hemostasis. ⋯ Tranexamic acid has been prospectively proven to reduce mortality in trauma-related hemorrhage. Its use will likely expand into such areas as resuscitation and massive transfusion protocols and the prehospital setting. Therefore, it is critical for emergency medicine providers to be familiar with appropriate use of tranexamic acid in order to maximize efficacy and decrease the potential adverse events.
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Case Reports
Intravenous magnesium sulfate reduces rates of mechanical ventilation in pediatric asthma.
In this column, we examine an original research article by S. Torres et al. (2012) on the subject of magnesium sulfate use in pediatric patients with acute asthma. ⋯ We review and critique this article and use a case study to illustrate the clinical implications of this research. We also examine some of the research and guidelines pertaining to the use of magnesium sulfate in acute asthma.