Advanced emergency nursing journal
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Out-of-hospital cardiac arrest continues to be associated with high morbidity and mortality as the mortality rate has been documented to be as high as 90% in patients who experience the insult at home. For those who survive, more than 50% will have some form of brain damage. ⋯ However, therapeutic hypothermia has been evaluated in 2 landmark randomized, controlled trials in patients who experienced an out-of-hospital cardiac arrest with the results showing an improvement in both neurologic outcomes and mortality. Providers must be familiar with the rationale behind the therapy, the physiological effects of the cooling and rewarming processes, and the pharmacologic management that aides in improved outcomes and minimizes complications.
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Violence against health care workers is a serious and growing problem. The objectives of this cross-sectional study were to (a) describe the frequency of workplace violence (WPV) against emergency department (ED) workers; (b) identify demographic and occupational characteristics related to WPV; and (c) identify demographic and occupational characteristics related to feelings of safety and level of confidence when dealing with WPV. Survey data were collected from 213 workers at 6 hospital EDs. ⋯ Feelings of safety are related to job satisfaction and turnover. Violence has serious consequences for the employers, employees, and patients. It is recommended that administration, managers, and employees collaborate to develop and implement prevention strategies to reduce and manage the violence.
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Skin and Soft Tissue Infections (SSTI's) with abscess are commonly seen in the Emergency Department (ED) setting. Given the increasing prevalence of methicillin-resistant Staphylococcus-aureus (MRSA)-related abscesses, appropriate evidence-based decisions are essential in assuring successful treatment. ⋯ Evidence indicates that the use of Clinical Decision Support (CDS) tools is valuable in improving provider awareness and adherence to clinical guidelines. This study was conducted to examine whether the development of a CDS tool to guide order entry for the treatment of MRSA-related SSTI's and embed it into the electronic medical record program would improve provider adherence to the North Carolina Consensus Guideline for Management of Suspected Commmunity-Acquired MRSA Skin and Soft Tissue.
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This case study describes a 72-year-old man who complained of epigastric abdominal pain, indigestion, fatigue, and shortness of breath for 2 days. He subsequently sustained a witnessed cardiac arrest with resuscitation and return of circulation. ⋯ This article discusses the pathophysiology, use of the hypothermia protocol and also inclusion and exclusion criteria. Educational information within the article provides guidelines for the advanced practice nurse regarding the use of therapeutic hypothermia in resuscitated patients.
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Nursemaid's elbow (subluxation of the radial head) is a common pediatric upper extremity injury encountered in the emergency and urgent care settings. Subluxation of the radial head accounts for more than 20% of upper extremity injuries in the pediatric population. A clinical case of a three-year old girl who presented to the emergency department with a nursemaids elbow requiring reduction is presented in this article. The purpose of this article is to discuss the identification and treatment of this injury and delineate the two methods of supination and pronation for reduction of the annular ligament.