Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Licensed independent practitioners in emergency clinical practice are tasked with differentiating acute cardiac presentations. Despite its similarity in clinical presentation to acute coronary syndrome, Takotsubo cardiomyopathy is a unique cardiac disorder characterized by a stress-induced ballooning of the myocardium. ⋯ Takotsubo cardiomyopathy is similar in presentation to other cardiac disorders; therefore, clinicians in emergency settings must be efficient and effective in their diagnosis of this disorder on the basis of its distinct criteria. The current article uses most recent evidence to describe the etiology, pathophysiology, diagnosis, and recommended treatment for Takotsubo cardiomyopathy to support licensed independent practitioners in emergency departments in improving patient outcomes and reducing morbidity.
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Recent data indicate that patients treated in the emergency department for an ankle sprain receive multiple medications. However, research has not been able to accurately identify all the medications because of study limitations. The primary purpose of this study was to document the type of medication, number of doses, and number of encounters given a prescription at discharge or instructions to take over-the-counter medication. The secondary purpose was to determine if the proportion of encounters given each type of medication varied on the basis of age, sex, race, and year. ⋯ Patients are primarily given an opioid or nonsteroidal anti-inflammatory drug in the emergency department. Fewer patients receive a prescription at discharge but are regularly instructed to take over-the-counter medication.
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Kratom ingestion for its psychotropic effect or to self-treat opioid withdrawal symptoms has increased over the last 10 years in the United States. Although mild adverse effects have been observed in users, reports of respiratory failure and shock after kratom consumption remain rare. In this case, a 35-year-old man initially presented to the emergency department with profound circulatory shock, metabolic acidosis, hypoxia, and symptoms of autonomic nervous system dysfunction. ⋯ Within 72 hours, the patient's condition stabilized, and he was extubated. The patient reported regular consumption of large quantities of kratom as well as injection of heroin and cocaine. In this report, a rare clinical presentation after kratom ingestion is described.
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Climate change is an urgent public health problem that has looming implications and associated deleterious health consequences. The intersection of climate change and health has broad implications for health professionals in a variety of settings but especially for ED settings. Climate change is already affecting human health and health systems-which includes impacts on ED care. ⋯ Disaster preparedness, environmental emergency response, and health emergency management are important elements of emergency nursing and are explicated in Sheehy's Emergency Nursing Principles and Practices, 7th Edition. The purpose of this article is to present an overview of a clinical tool and mnemonic, A CLIMATE, developed by the authors with application to a case review. It is imperative that the nursing profession-particularly emergency clinicians-address the intersection of climate and health to engage in the assessment, intervention, management, evaluation, education, and referral of those who present to emergency departments with potential climate-related health impacts.