Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Review
Spinal trauma: new guidelines for assessment and management in the out-of-hospital environment.
The keys to appropriate management of patients with spinal trauma lie in attending to life-threatening injuries, avoiding unnecessary movement of the spinal column, and carefully documenting patient reliability, MOI, history, physical examination findings, interventions, and responses to interventions. Who should be immobilized? Any victim of trauma complaining of neck or back pain, any patient with neurologic symptoms compatible with a spinal cord injury, and any patient who has an altered mental status or distracting injury should be immobilized. ⋯ Despite the marvels of modern research, prevention is still the key, including public education relative to wearing seat belts, instructing parents in the use of child restraint devices, encouraging people to jump rather than to dive when testing the depth of water (first time, feet first), enforcing driving under the influence laws, and outlawing such practices as spear tackling in football. In the meantime, EMS and ED personnel have a phenomenal opportunity to truly act as patient advocates by becoming familiar with new immobilization guidelines, honing their assessment skills, and providing anticipatory, compassionate care to those with neurologic deficits.
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Herbal therapies are very safe, and side effects are uncommon. Side effects requiring ED treatment are rare and would most likely involve an allergic reaction or toxic effect from improper administration of the herb. However, a working knowledge of possible side effects of herbal therapies can be helpful in those rare instances. Simple treatment options with herbal teas are also suggested as an adjunct to medical therapies in certain instances.
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Because of its effectiveness in providing relief for a wide variety of disorders and symptoms, acupuncture treatment is becoming widely accepted as an alternative therapy. Indeed, 40% of Americans are reported to have sought some type of nonconventional therapy in the previous year. Although the theory and beliefs about the acupuncture process are complex and may require a different way of thinking about health and harmony, it is important that health care professionals increase their knowledge about such therapies so we can continue to provide support and information to our patients.