ED Nursing 2005-03-01

Are elderly patients undertriaged? Don’t miss life-threatening conditions

If a 78-year-old woman came to your ED with lower abdominal pain and bloating, but had normal vital signs without chest pain, would you suspect a myocardial infarction (MI)? When this patient was placed on a monitor, ED nurses at Carondelet St. Marys Hospital in Tucson, AZ, saw large ST-elevation in most leads, and point-of-care testing revealed positive myoglobin, creatine kinase, and troponin levels.

Heart attack! Don’t delay ED care for women

This is the second article in a two-part series on chest pain in the ED. Last month, we gave strategies to speed door-to-needle time. This month, we cover treatment delays due to atypical presentation.

Be creative teaching nurses to do neuro assessments

Your head trauma patient bounces back and seems fine after an epidural bleed and temporary loss of consciousness, but lapses into a profound coma all in a matter of minutes. Your elderly Alzheimers patient has gone from confused to aphasic, and suddenly cant move her left side. Both these scenarios illustrate the importance of performing a quick neurological assessment in the ED, says Teri Howick, RN, nurse educator for the ED at McKay Dee Hospital in Ogden, UT.

Tips to teach nurses to do neuro assessments

You should perform a neurological assessment for any patient whose history or mechanism of injury indicates a possible neurological problem, says Cynthia Bautista, PhD, RN, CNRN, neuroscience clinical nurse specialist at Yale-New Haven (CT) Hospital.

Do on-call physicians put patients at risk? Act now

Its been more than 30 minutes, and youre still waiting for the on-call surgeon to evaluate an elderly trauma patient for internal bleeding. When you page him again, he says curtly, Ill get there when I get there. What do you do next?

Are nurses still using ‘do-not-use’ abbreviations?

A recent report from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) revealed that hospitals were almost 100% in compliance with all the National Patient Safety Goals, with one exception: the requirement to avoid use of unauthorized abbreviations, which fell to 85% compliance.

Dramatic rise in CA-MRSA: What it means for your ED

There is an alarming increase in community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) cases in ED patients seeking treatment for skin and soft tissue infections, according to a new study. Researchers found 51% of skin and soft tissue infections in Alamedas ED were caused by CA-MRSA.

Journal Reviews

Marek M, Lindsell CJ, Jauch EC, et al. Effect of education and guidelines for treatment of uncomplicated dental pain on patient and provider behavior. Ann Emerg Med 2004; 44:323-329. Gorelick MH, Yen K, Yun HJ. The effect of in-room registration on emergency department length of stay. Ann Emerg Med 2005; 45:128-133.

ED Nursing Archives – March 1, 2005

March 1, 2005