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April 1, 2011

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  • Warning: Your boarded patients may be missing life-saving medication dosages

    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 avoid missed dosages; next month, we'll cover how ED nurses can reduce errors with inpatient medications.
  • Do this immediately for heat-injured ED patients

    Exertional heat-related injuries are on the rise in EDs, with an estimated 54,000 patients treated over a 10-year period a 133% increase that was not linked to increased seasonal temperatures, according to a new study.
  • Be ready for sudden change in asthma patients' status

    "Normal-looking" asthma patients, whose condition is poorly controlled with treatment, or patients who are not compliant with treatment, may show up in your ED after weeks of deteriorating gradually, warns Anissa Washington, RN, BSN, ED nurse at St. John's Mercy Medical Center in St. Louis, MO.
  • Reduce restraint use for mental-health patients

    Adrienne Jones, RN, an ED nurse at Providence St. Vincent Medical Center in Portland, OR, says that ED nurses used to see about five to 10 mental-health patients a day, but are now seeing twice as many.
  • Do rapid HIV test without any delays

    A 63-year-old construction worker came to the ED at Jacobi Medical Center in Bronx, NY, with difficulty swallowing, and reported losing 40 pounds in the previous six months.
  • You may overlook these pneumonia symptoms

    Smoking, lung diseases, and chest X-ray abnormalities may result in your ED patient being diagnosed with bronchitis, flu, pleurisy, costochondritis, and upper respiratory infection, when he or she actually has pneumonia, says Carrie April, RN, BSN, an ED nurse at St. John's Mercy Medical Center in St. Louis, MO.
  • Never assume ED patient is "just intoxicated again"

    Paramedics arrive with a man you recognize instantly from his many previous visits to your ED, always intoxicated. You learn that his vital signs are stable, and he was found on the ground by bystanders, says Tia Valentine, RN, CEN, clinical nurse educator for the ED at University of California-San Diego Medical Center.
  • Avoid multiple IV sticks; Reduce risk of infection

    With intraosseous (IO) vascular access, patients are subjected to a minimum number of sticks, so there is less chance of creating a portal for infection, says Sean Hall, an ED nurse at Desert Island Hospital in Bar Harbor, ME. "The time which can be saved by using these devices can be lifesaving in a critical patient," he says.
  • Pediatric Corner: Give life-saving meds faster with new e-Broselow system

    Dosages based on the color-coded Broselow Pediatric Emergency tape will soon be displayed on a large LCD monitor for all ED staff to see, says Andre A. Muelenaer Jr., part of the product's developmental team and an associate professor of pediatrics at the Virginia Tech Carilion School of Medicine in Roanoke.