Accident and emergency nursing
-
Review
The advantages and disadvantages of Bier's blocks and haematoma blocks for Colles' fractures in A&E.
In the author's current area of practice the use of either the Bier's block or haematoma block for manipulating distal radial fractures seems to have been based mostly on the A&E consultant's preference. The purpose of this literature review was to determine if there was sufficient evidence on the advantages and disadvantages of each method of regional anaesthesia to advocate the general use of one and the exclusion of the other. When reviewing the literature the author specifically looked in to three key areas to answer this question: 1) the patient's perception of pain experienced during and after the manipulation; 2) patient safety i.e. the documented risks of the anaesthetic type used; and 3) the success of the manipulation as determined by repeat radiographs immediately after the application of a plaster of Paris cast.
-
Comparative Study Clinical Trial
Wound glue: a comparative study of tissue adhesives.
The purpose of this study was to determine which single-use wound adhesive is the most appropriate in terms of ease of use, minimal pain on application, adequate bonding time and wound closure. The three wound adhesives audited were Indermil (n-butyl cynoacrylate), Liquiband (n-butyl cynoacrylate) and Dermabond (octylcyanoacrylate). ⋯ All of the tissue adhesives examined produced satisfactory results in terms of wound closure and ease of use. However, the Liquiband tissue adhesive produced the most consistent results, scoring higher in most of the categories when compared with the other tissue adhesives.
-
The Manchester triage methodology and the practice of analgesic transcribing were introduced to the Accident & Emergency Department of the Wrexham Maelor Hospital in April 1998. The concept of nurse led transcribing is relatively new and its introduction was not without an element of administrative caution. ⋯ This paper describes the steps of implementation of this transcribing project and its successful completion through a prospective audit. Although there is a paucity of published literature in this topic, the Wrexham Pain Triage Group wishes to extend this implementation methodology into other areas of innovative nursing practice.
-
Within a 'whole system' approach to the management of acute medical referrals, many hospitals have introduced Medical Assessment Units (MAUs) to improve the care of acutely ill patients by assessing their need for hospital admission or discharge. This paper gives details of a research study designed to investigate the extent of MAU provision in the West Midlands Region, how these Units are organized and the nature of nursing roles within them. Results indicate that MAUs are organized and managed in different ways according to the likely length of patient stay. Likewise, nursing roles vary depending upon the context in which the nurses are working.
-
The initiation of emergency care primarily depends on the decisions made by the triage nurse. Triage decisions can therefore have a profound effect on the health outcomes of patients who present for emergency care. ⋯ This study examines triage nurses' level of agreement in their allocation of triage categories to patients with specific presenting problems using the NTS. Relationships between demographic characteristics of participants and triage decisions are examined and implications of any variation for triage practice and patient outcomes are explored.