Advanced emergency nursing journal
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The ability to safely manage birth in the emergency department is a competency for emergency nurse practitioner practice. However, it is difficult to ensure that students receive enough practice with this low-frequency event. ⋯ The realistic nature of the simulations, use of recently graduated nurse-midwives as the simulated patients, and group interactions during the births were keys to this successful simulation experience. When paired with appropriate preparation, simulation of an unexpected birth in the emergency department promotes confidence and safe practice among advanced practice nursing students.
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Crowding is extremely problematic in Canada, as the emergency department (ED) utilization is considerably higher than in any other country. Consequently, an increase has been noted in waiting times for patients who present with injuries of lesser acuity such as wrist injuries. Wrist fractures are the most common broken bone in patients younger than 65 years. ⋯ The triage nurse algorithm includes the clinical decision-making process. Providing triage nurses with up-to-date evidence-based educational material not only allowed triage nurses to independently assess and request wrist radiographs for patients with potential wrist fractures but also strengthening the link between competent nursing care and better patient outcomes. A review of the literature also found that such initiatives increase patient and staff satisfaction as well as promoting efficient use of right staff at the right time.
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Child maltreatment is a leading cause of pediatric morbidity and mortality, described as one of the greatest threats facing the health, welfare, and social well-being of children in the United States (U. S. ⋯ The purpose of this project was to implement a series of strategies in a pediatric emergency department to identify children who are at risk of maltreatment and initiate interventions to ensure their safety and protection before a devastating outcome occurs. The results of this project support the implementation of nursing education, a screening program for risk of child maltreatment, and collaboration with interdisciplinary stakeholders to achieve best practice in emergency medicine.
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Case Reports
Pyogenic flexor tenosynovitis: assessment and management in the emergency department setting.
Emergency departments are frequently confronted with had infections. Significant morbidity can result from hand infections when they are not appropriately diagnosed or treated. ⋯ A case report is presented of a patient with worsening pain of a digit after a penetrating injury. The diagnosis was made on the basis of clinical findings and plain radiography.
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Implantation of left ventricular assist devices (LVADs) is becoming more common with the advancement of mechanical circulatory support technology and the continued insufficient number of organ donors available for heart transplantation. Modern LVADs provide a mechanically induced, nonpulsatile, continuous blood flow that drastically alters the hemodynamic and coagulation profile of patients using these devices. ⋯ Although LVAD therapy can prolong life, the majority of patients will experience an adverse event following implantation and many of these complications can result in emergency department visits. By understanding the pathophysiology and management of LVAD complications, emergency nurses will be able to provide prompt and quality care for this unique patient population.