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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.
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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.
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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.
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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:
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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.
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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.
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If a woman came to your ED with a black eye and swollen lip, you would suspect abuse or assault.
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Here are some examples of suspicious injuries in children, according to Thomas Tryon, RN, an ED nurse at Thomas Jefferson University Hospital in Philadelphia:
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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.
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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.
