Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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When patients with blunt chest trauma and suspected cardiac contusion are brought to the emergency department, focus on detecting subtle signs of myocardial dysfunction. Obtain the important first EKG, monitor for arrhythmia development, and assess for signs of failure of the right side of the heart.
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Recently it has been recognized that women are less likely than men to be diagnosed with a myocardial infarction (MI) or to receive early or aggressive treatment and are more likely than men to die of an MI. The purpose of this qualitative study was to examine the triage decisions made by ED nurses for persons with symptoms suggestive of MI. The theoretical framework for this investigation was Hammond's lens model for clinical inference and Evan's two-stage reasoning model. ⋯ The inability of ED nurses to associate middle-aged women's presenting symptoms with MI may contribute to the increased morbidity and mortality experienced by this population. The findings of this study have implications for nursing research, education, and practice.