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Have you just placed a urinary catheter in an ED patient? If so, possible complications include urosepsis, septicemia, trauma to the urethra or bladder, and urethral perforation, warns Mark Goldstein, RN, MSN, EMT-P I/C, clinical nurse specialist at the Emergency Center at Beaumont Hospital in Grosse Pointe, MI.
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Dog-bite injuries resulting in hospital admissions have increased drastically in recent years, from 5100 cases in 1993 to 9500 in 2008, according to a recent report from the Agency for Healthcare Research and Quality (AHRQ).
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If a patient presents visibly intoxicated and announces his or her intent to harm others, it's easy to make the decision to involve security. However, any ED patient or visitor has the potential to become physically violent, warns Gordon Lee Gillespie, PhD, RN, PHCNS-BC, CEN, CCRN, CPEN, FAEN, assistant professor and director of population-focused care at University of Cincinnati (OH) College of Nursing.
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When a man with a known history of seizures came to the ED at the University of California San Diego Medical Center very agitated, diaphoretic, and yelling, ED nurses first thought he was having a schizophrenic breakdown, says Tia Valentine, RN, CEN, ED clinical nurse educator.
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David M. Solomon, RN, BSN, CEN, EMT-P, patient care coordinator in the ED at Catawba Valley Medical Center in Hickory, NC, says that usually, medications for boarded patients have to be ordered from the pharmacy.
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Do you treat elderly patients waiting in the ED as you would expect your own family member to be treated as if they were the only ones there?
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Before ED nurses at Ridgeview Medical Center in Waconia, MN, administered tissue plasminogen activator (tPA) to a man in his 80s with obvious stroke symptoms, the neurologist was consulted and also the patient's family members, says Kathie Pulchinski, RN, ED nurse manager.
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Editor's Note: This is a two-part series on medication safety for inpatients being held in the ED. This month, we give strategies to reduce errors with inpatient medications. Last month, we gave strategies to avoid missed dosages.
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Is a cardiac-arrest patient failing to wake up and follow commands? "Therapeutic hypothermia is one of the few therapies we can offer," says Marion Leary, BSN, RN, assistant director of clinical research at the Hospital of the University of Pennsylvania's Center for Resuscitation Science in Philadelphia.
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If ED nurses believe a patient poses a risk of harm to themselves or others, a patient safety checklist is used for "closed-loop" communication with security, says Alexandra Penzias, RN, MEd, MSN, CEN, clinical nurse educator in the department of emergency medicine at Tufts Medical Center in Boston, MA. "This ensures that all members of the ED team are aware of the patient's status and plan of care," she explains.
