International emergency nursing
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Research has demonstrated that children are at particular risk for oligoanalgesia due to assessment difficulties when they are unable to self-report. We sought to evaluate the psychometric properties of the Modified Preverbal, Early Verbal Pediatric Pain Scale (M-PEPPS) when used in an emergency department pediatric population. ⋯ Findings indicate that the M-PEPPS instrument is reliable when used by emergency nurses to measure pediatric pain. The single-factor common factor solution provides support for the scale as measuring the single construct of pain. Additional research is necessary to establish the degree of change in score required for a clinically meaningful reduction in pain to be present.
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Fractures are a common emergency department (ED) diagnosis. Ultrasound is a useful tool to evaluate for the presence of long bone fractures and can be performed by minimally trained individuals. We examined the ability of ED nurses to sonographically detect long bone fractures using a recently described training model. ⋯ An overall sensitivity of 98% (95% confidence interval: 92-99%) and specificity of 93% (95% confidence interval: 76-99%) was observed for the detection of a fractured model. No difference in fracture detection accuracy (p>0.05) was revealed compared to an evaluation by 30 ED physicians. While the clinical impact of this ability remains uncertain, future utilization of nursing ability to detect fractures by ultrasound may improve patient care in ways such as more efficient triaging of radiographs and the mobilization of resources for fracture reduction.
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In recent years economic and political drivers have strongly influenced the development and introduction of new roles such as medical substitution roles within emergency care in the National Health Service (NHS) in the United Kingdom (UK). ⋯ There is general agreement that non-medical roles help to reduce waiting times in emergency departments, as well as attracting a high level of patient satisfaction, confidence and acceptance of these roles. Several issues were identified which warrant further study; including the current UK evidence surrounding the limited scope of practice of these roles.
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Editorial Comment
Climate change and the Emergency Nurse Practitioner role.
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In 2005, we presented a manuscript about the use of aspirin (ASA) in the setting of the Emergency Department (ED). We now write to report recent developments in our understanding about ASA and individual responses to the medication. The phenomenon of aspirin resistance is explored.