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A very anxious-looking man told triage nurses At St. Johns Mercy Medical Center in St. Louis, MO, that he had a history of psychiatric disorders. Right away, he was placed in an appropriate room, asked to change into paper scrubs, and all his belongings were placed in a plastic bag.
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A chronic alcoholic with high blood pressure came to an inner city ED sometimes several times a day, always with the complaint of chest pain. After an initial assessment at triage, a quick check by the physician, a dose of his blood pressure medication and a box lunch, he would typically be on his way.
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A 40-year-old man landed in a small stream after a motor vehicle accident and arrives fully dressed and bleeding from the head. Emergency medical services (EMS) tells you the patient was lying on the ground when they found him. Would you ask the question, "How can this patient lose heat?"
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At Tufts Medical Center in Boston, the ED's protocol encourages any member of the ED staff a technician, nurse, or physician to perform an EKG whenever they find a patient presenting with angina or anginal equivalents.
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Young children are at greater risk for dosage mistakes, as they often receive medications available in multiple formulations and concentrations, warns Jennifer McNamara, RN, an ED nurse at Children's Hospital Boston.
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If you noticed increased lethargy and confusion in your patient, would you suspect an airway problem?
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(Editor's Note: This is the second of a two-part series on geriatrics. This issue, we cover elder stroke patients and ways to make long waits safer. Last month, we covered care of elders with seizures, traumatic brain injuries and psychiatric complaints, and we gave strategies to reduce risks of medication interactions and handoffs.)
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In October 2009, the Food and Drug administration (FDA) licensed the bivalent human papillomavirus vaccine (HPV2; Cervarix, GlaxoSmithKline) for use in females aged 10 through 25 years.
