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October 1, 2011

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  • Are a child's symptoms psychiatric, or something else? Rule out medical causes

    A young girl experiencing hallucinations presents to an ED after being evaluated at another hospital, and twice referred for psychiatric care. "Her diagnosis was, in fact, a potentially life-threatening underlying cardiac disorder. Unfortunately, that missed diagnosis is not uncommon," says Deena Brecher, MSN, RN, ACNS-BC, CEN, CPEN, a clinical nurse specialist in the ED at Alfred I. duPont Hospital for Children in Wilmington, DE.
  • Are patient's symptoms due to their home meds?

    Heel and ankle pain was the only complaint of a patient being triaged by ED nurses at Edward Hospital in Naperville, IL, with no history of injury and no obvious signs of trauma or infection, when they learned an additional piece of information.
  • Your patient may understand very little about ED instructions

    ED patients often don't understand important information in their discharge instructions, according to a new study, which can result in bad outcomes and needless repeat visits.
  • Confirm accurate placement of gastric tubes in ED patient

    Although gastric tube placement is commonly performed at the bedside by ED nurses, it can result in serious complications such as misplacement of the gastric tube into the pulmonary system, resulting in respiratory distress or death, according to a December 2010 Emergency Nursing Resource (ENR) on Gastric Tube Placement Verification, developed by the Emergency Nurses Association (ENA).
  • Shortness of breath? ID rapid deterioration

    Patients with shortness of breath are "one of the highest priority patients" for ED nurses because of their tendency to rapidly deteriorate, says Alexandra Penzias, RN, MEd, MSN, CEN, an ED educator at Tufts Medical Center in Boston, MA. "We perform a complete set of vital signs, oxygen saturation, and peak flow measurements at triage," she says.
  • Are women still getting delayed ECGs in EDs?

    Women may wait longer for ECGs than men, according to a new study. Jessica Zègre Hemsey, RN, PhD, the study's lead author, says she found the findings surprising because the American College of Cardiology/American Heart Association gives acquiring an initial ECG within 10 minutes of arrival to the ED a Class I recommendation.