ED Nursing Archives – August 1, 2008
August 1, 2008
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Take these steps if your trauma patient was assaulted or abused
If a woman came to your ED with a black eye and swollen lip, you would suspect abuse or assault. -
When you suspect abuse, ask the right questions
A simple fall in a healthy person shouldn't result in multiple facial injuries, except if the patient was intoxicated, says Regina Curry, RN, an ED nurse at Thomas Jefferson University Hospital in Philadelphia. Instead, patients might break their wrist or skin their knees and hands from trying to break the fall, she says. -
Will your patient be safe after the ED visit?
Once a patient with violence-related traumatic injuries is stable and about to be discharged, you have to consider something equally important: Will he or she be safe after they leave your ED? -
Suspect child abuse if you see these injuries
Here are some examples of suspicious injuries in children, according to Thomas Tryon, RN, an ED nurse at Thomas Jefferson University Hospital in Philadelphia: -
You'll soon be using new 80-lead EKG to ID MIs
If a patient complains of chest pain, you probably suspect a myocardial infarction (MI) and obtain an immediate electrocardiogram (EKG). But it doesn't show any signs of a heart attack. What do you do next? -
New 80-lead EKG is easy to interpret
Recently, ED nurses at University of Virginia Health System in Charlottesville were given a two-hour in-service on the Prime ECG (manufactured by Columbia, MD-based Heartscape Technologies), reports William Brady, MD, a professor in the Department of Emergency Medicine at University of Virginia Health System in Charlottesville. -
What to do immediately for infants with seizures
If panicked parents bring in a seizing infant, the underlying cause could be life-threatening, but it also could have resulted from something as simple as drinking too much water. -
Ask these questions if an infant is seizing
"Undiagnosed or new-onset seizure in infants is always a critical emergency, mostly because we need to figure out the underlying cause and treat it before it worsens," says Jennifer Anders, MD, an ED physician at Johns Hopkins Children's Center in Baltimore. -
Are heart attack symptoms due to cocaine use?
Has your patient used cocaine? Not knowing the answer to this question could be life-threatening for your patient because the wrong medications might be given, says a new report on management of cocaine-associated chest pain and myocardial infarction. -
Know risk factors for youngest MI patients
Young people with a history of Type I diabetes, juvenile obesity, hypertension, sickle cell anemia, smoking, or recreational drug use are at considerable risk for myocardial infarction (MI), even in their 20s, says James Hardecki, RN, ED nurse at Henry Ford Hospital in Detroit. -
When should you ask about cocaine use?
Always ask about recent cocaine use when a younger individual presents to the ED with possible cardiac symptoms, says Pamela Tokarski, RN, an ED nurse at Henry Ford Hospital in Detroit. -
How to get an honest answer on cocaine use
Patients may be hesitant to admit cocaine use, either because they fear legal consequences or because they don't want family members to know, says Pamela Tokarski, RN, an ED nurse at Henry Ford Hospital in Detroit. Do the following to obtain a truthful response: -
Is there a fentanyl patch hidden on your patient?
Because a woman with chronic pain failed to tell ED nurses about the fentanyl patch she was wearing, she was given a second fentanyl patch and intravenous morphine for breakthrough pain. -
Always ask patients about transdermal patches
All patients should be asked about any medication, prescribed or over-the-counter, that they are taking, including transdermal patches, says Cindy Vanek, MS, RN, director of emergency and critical care services at Indian River Medical Center in Vero Beach, FL. -
EDs seeing an increase in gymnastics injuries
Nearly 27,000 gymnastics-related injuries are treated in EDs each year for children 6 to 17 years old, says a new study based on data obtained from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission. -
These 3 trauma injuries are easy for you to miss
Young gymnasts may be more stoic than other kids you treat. "So you really have to use all your clinical tools: History, physical exam and X-rays to determine whether it's something more significant or not," says Robert Frederick, MD, sports medicine specialist at the Rothman Institute at Thomas Jefferson University Hospital in Philadelphia. -
Don't forget to prepare kids for ED procedures
EDs often fail to manage pain of children undergoing painful procedures, which might mean the procedure can't be performed or the child might suffer needless discomfort, says Steven J. Weisman, MD, an ED physician at Children's Hospital of Wisconsin, Milwaukee.