Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of administered crystalloid fluid temperature on aural temperature of moderately and severely injured children.
Warm intravenous fluid (W-IVF) administration is the standard of care to prevent hypothermia in injured adults. It is argued that such administration may not be helpful for treating injured children, because children often do not require as much intravenous fluid (i.v.f.) as adults. The purpose of this study was to compare the effects of W-i.v.f. to room temperature intravenous fluid (RT-i.v.f.) administration on aural temperature (Ta) in injured children during the first hour of trauma resuscitation. ⋯ When comparing the changes between baseline and final Ta for the W-i.v.f. and RT-i.v.f. groups, the standardized difference in temperature change was 0.62. Although results of the repeated measures analysis of covariance were not statistically significant, the standardized difference in temperature changes was large enough to warrant administration of W-i.v.f., even at slow flow rates, to prevent hypothermia in injured children.
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Although they are not totally without controversy, proxy consent and prospective consent are generally condoned as being legally and ethically acceptable alternatives to traditional informed consent by the majority of IRBs and researchers. Deferred consent, on the other hand, continues to fuel a heated debate in the emergency research community. Detractors believe that deferred consent is nothing more than unauthorized experimentation on a vulnerable population. ⋯ Nurses in emergency settings, whether researchers or associates, must understand the informed consent process to ensure that adequate steps have been taken to safeguard the patient and his or her rights. Yet they must also appreciate the precautions that have been taken, and the difficult decisions that have been made, by an IRB before an emergency research study is approved. By understanding the consent process, emergency nurses can become more fully informed research participants, ensuring that the rights of the patients have been protected, while working to advance medical science through legally sound, ethically proper, clinical investigation.
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About one fourth of physicians report having received training on domestic violence. The purpose of this study was to determine the response of the ED house staff to an educational program on domestic violence against women. The research questions in this study were as follows: (1) What training topics did the house staff rate as most important and relevant to their practice? (2) What topics did the house staff rate as most useful to their day-to-day practice? (3) What were the house staff's attitudes and beliefs before training? (4) Did the method of training on domestic violence influence the house staff's attitudes and beliefs? (5) What were the house staff's perceptions in terms of sociodemographic variables? ⋯ The major conclusion of the study was that the house staff had a positive response to training on violence against women. Sixty-five percent of the house staff had no previous training on domestic violence. Implications for practice include continuing education and research on domestic violence training in the emergency department.
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Randomized Controlled Trial Clinical Trial
A comparison of hemolysis rates using intravenous catheters versus venipuncture tubes for obtaining blood samples.
The primary purpose of this study was to compare the rate of hemolysis in blood samples obtained by an i.v. catheter versus the rate in samples obtained by venipuncture (Vacutainer tubes and needles; Becton Dickinson Vacutainer Systems, Franklin Lakes, N.J.). Subsequently, variance in i.v. catheter diameter was reviewed to determine its influence on hemolysis rate of i.v. catheter aspirate. ⋯ Hemolysis of blood samples obtained by an i.v. catheter was significantly higher than when blood was obtained through Vacutainer venipuncture. There is an inverse correlation between i.v. catheter diameter and the rate of hemolysis.
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The purposes of this descriptive survey were to determine the treatments for minor burns in rural Alabama emergency departments, to assess how closely those treatments correspond with recommendations for burn therapy noted in the literature, and to identify specific deficits in the burn research literature. ⋯ Seven categories of burn care are common to all respondent facilities, with wide variation in the details. Most practices proceed logically from the treatments recommended for major burn care, with a few notable and potentially dangerous exceptions, but there is no definitive research available to guide the clinician in the care of outpatient burns. Research questions were generated that can provide direction for measurement of outcomes in the care of minor burns treated on an outpatient basis.