International emergency nursing
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Severe sepsis and septic shock are syndromes resulting in a systemic inflammatory response and the dysfunction of one or more organs following infection. The Surviving Sepsis Campaign is an international effort to reduce mortality in severe sepsis and septic shock by 25% by 2009 using a care bundle approach. It comprises evidenced-based interventions to be carried out within 6h of onset of sepsis. ⋯ Administration of an antibiotic was also very slow. Local recommendations include improvements to the track and trigger scoring system in A&E to improve recognition of sick patients, ensuring the doctor responsible for prescribing the antibiotic will administer it, and increasing awareness of the surviving sepsis campaign via education and training of all A&E staff. Given current evidence greater compliance to the care bundle may well improve patient outcomes for this client group.
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Review
Increasing the profile of the care of the older person in the ED: a contemporary nursing challenge.
The numbers of frail older persons using emergency departments are already considerable and will continue to increase over time. There are a number of issues related to the assessment and care of older patients that are significantly different to other patient groups. The traditional emergency department (ED) model focusing on rapid triage, treatment and throughput does not meet the needs of many older patients, who have complex presentations, and require comprehensive assessment and referral. ⋯ Nurses have a crucial role in contributing to these approaches and in raising the profile of quality care of the older person. Some specific areas that ED nurses can focus on include a more comprehensive approach to assessment and discharge planning, improved communication with the patient and their personal carers, attention to basic nursing care, and making the physical environment safer and less stressful for the older patient. While developing collaborations with their aged care nursing colleagues is important, emergency nurses need to view care of the older person as a central part of their own core business.
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Although crowd medical services in English league football are common, there is little data examining the use of such services. The aim of this study was to provide detailed data by examining the usage of the Crowd Medical Service at a First Division Football Club (Millwall FC) over six Football League seasons. This usage has implications in terms of resources, provision of level of service and training needs of staff. ⋯ The principal focus of a crowd medical service is to manage a major incident and medically emergent spectators. The majority of presentations were minor injuries and pre-existing medical conditions. In addition staff make up a significant proportion of the users. Some re-focussing of guidance is therefore necessary if these results are typical of English League Football. In turn this reflects a need for more education in the management of minor injuries and chronic disease management and recognition in training and service provision.
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The concept of children and their families receiving family-centred care when the child is unwell is not new. Family-centred care has been examined extensively within children's nursing curricula. ⋯ The skills for working with children are also examined in turn for all ED nurses. Whilst many ideas may not initially appear to be new or therefore innovative, a careful evaluation encourages individuals to rethink the services that they currently offer to children and their families.