The Essentials for Nurses About Recognition and Treatment of MIS-C

‘A massive systemic inflammatory response.’

While on the whole the United States is seeing a decline in COVID cases, this most recent wave of the Delta variant has seen an unprecedented number of children infected and hospitalized for COVID-19.

While children generally fare better than adults from the virus, infection may make them susceptible to a rare condition known as multisystem inflammatory syndrome in children (MIS-C).

This rare but serious condition was described by Shields and colleagues in our May issue as “a massive systemic inflammatory response that has physiologic correlations to Kawasaki disease, Kawasaki disease shock syndrome, toxic shock syndrome, macrophage activation syndrome, and cytokine release syndrome.”

The CDC reports that, as of October 4, the number of patients meeting the case definition for MIS-C was 5,217 (up from 4,000 reported in June) and the total number of deaths meeting the case definition was 46.

The CDC case definition includes the following:

2021-10-28T10:36:09-04:00October 20th, 2021|COVID-19, infectious diseases, Nursing|0 Comments
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Delta, Mu, and Others: What to Know About Covid Variants

Daily Trends in COVID-19 Cases in the U.S. Reported to CDC (9-21-21): red line shows 7-day moving average. Click image to enlarge.

According to the CDC, the delta variant now makes up more than 99% of COVID-19 cases across the U.S. Recently, though, the media has been drawing attention to the mu variant. Should we worry?

How serious are variants?

Viruses constantly change. Mutations might make a virus easier to spread or more virulent, change its clinical presentation, or alter its response to tests, vaccines, or treatment. Or there may be no observable change in its characteristics at all. Some variants simply fade away; others stick around, but can’t compete with more dominant variants and never really get a “foothold” in a particular population. At this time—and this is a pretty big caveat—the COVID-19 mu variant seems stuck in this last category, at least in the U.S.

What about mu?

Although the mu variant has been identified in more than 39 countries, including the U.S., there have been only about 2,000 cases here, mostly in California, Florida, Texas, and New York. The World Health Organization (WHO) calls mu a “variant of interest” […]

2021-09-14T14:36:42-04:00September 14th, 2021|COVID-19, infectious diseases, Nursing|1 Comment
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School Nurses During COVID-19: Still Holding the Line

Anything but the normal school year we’d hoped for.

The 2021-2022 school year is upon us and it is anything but the normal year many of us had hoped for. For some kids, it will be the first time going back into the classroom after 18 months at home. As a mom of two kids under 12 who cannot yet be vaccinated, it is a time of anxiety as I send my kids into school with a more contagious COVID-19 variant. Despite the mitigation efforts put in place, I wonder if it will be enough.

In parts of the country, cases are still skyrocketing and hundreds of kids have already had to quarantine or switch to remote learning. Some states have layers of mitigation in place in their schools, while in others, governors are fighting to keep schools from instituting mask mandates. And through this all, the person at the front line is the school nurse.

School nurses on the front lines as the rules keep changing.

In our August issue, AJN Reports highlights how school nursing has changed amid the current pandemic. Adding to the many other challenging tasks that school nurses already have is

2021-08-23T09:23:14-04:00August 23rd, 2021|COVID-19, school nurses|0 Comments
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A New Nurse Learns Focus and Grace Under Pressure

“I entered this new chapter in my life running at full speed. But at nearly the same time, the world seemed to be coming to a full stop.”

That’s from the August Reflections essay in AJN: “2020: What a Time to Become a Nurse.” Alicia Sgroi finished nursing school and started as an RN in a Florida ICU in February 2020, just as the pandemic was starting to get a foothold in the United States. By June, her unit had been converted to a COVID-positive step-down unit.

Much has been written about the pressures and trauma of being a nurse during the pandemic. We know that it’s been tough for all nurses, sometimes overwhelmingly so. In fact, the original research article in the August issue of AJN is a study that looks at personal and institutional factors affecting levels of well-being and resilience among nurses during the pandemic, from staffing to support networks to personal resilience.

Rising to the occasion.

As a new nurse, Sgroi was understandably worried about catching the virus and also about having the skills to care for such patients. But as she tells it, far from discouraging her from continuing as a nurse, the experience taught her […]

2021-08-06T10:41:37-04:00August 6th, 2021|COVID-19, Nursing, nursing stories|0 Comments
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Accepting Patients’ End-of-Life Decisions Can Be Hard

“The most important decision an individual can make may be how much treatment they want at the end of life.”

photo from pxhere

When it comes to end-of-life decisions, it may be hard for a nurse to accept to support only what the patient wants, but it’s also vitally important. In the Viewpoint column in our June issue (Viewpoints are free to read), Nadine Donahue, PhD, RN-BC, CNE, describes caring for an elderly patient in his home as he begins to lose the ability to breathe on his own because of COVID-19.

When she implores the normally spry, physically active retired executive to let her call an ambulance to take him to the ED, he refuses. Writes Donahue, an associate professor of nursing at York College, City University of New York:

“He’d always told me that he believed in a time to be born, a time to live, and a time to die. He was not going to be attached to a ventilator and in a hospital if he could help it.”

[…]

2021-06-09T09:31:31-04:00June 9th, 2021|COVID-19, end of life|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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