Heat Illnesses: Nursing Essentials from a NYC Emergency Department

As complex as health care may be in an emergency department (ED) setting, the weather and seasonality have added additional variables to that complexity. It is critical that registered nurses in the ED understand the health care trends associated with the weather and seasons. As in many other places, the summer here in New York City is a time when people are more active, spending time outdoors and traveling. This summer we have experienced several stretches with temperature in the high 90 degrees. July recently had a seven-day stretch with temperatures nearing and exceeding 100 degrees in New York. These heat waves can become physiologically unbearable.

Jonathan Nover, MBA, RN

Who is most vulnerable to heat illness?

During these heat waves, it is important to recognize the pockets of vulnerability among us. Older adults are often the most vulnerable because of decreased capacity to thermoregulate in response to changes in temperature. It is also important to consider the effects of heat on the homeless community and people without access to air-conditioned environments. Children are more susceptible to heat illness than adults. Some medications, such as diuretics, and consumption of alcohol and illicit drugs can increase a person’s risk of heat exhaustion. Additionally, individuals who perform strenuous exercise […]

2022-08-18T11:39:58-04:00August 18th, 2022|climate change, environmental health, Nursing, nursing perspective, Public health|0 Comments
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The Monkeypox Vaccine: What Nurses Need to Know

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell, cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

In the current monkeypox outbreak, the pandemic-strained U.S. public health system is once again faced with a major threat. This time, a vaccine is already available, but only in limited quantities. Here’s what nurses need to know. It will remain important to keep up with new developments as they occur.

The Jynneos vaccine

Jynneos is a live but nonreplicating vaccine for the prevention of both monkeypox and smallpox. It is made from vaccinia virus, a less virulent relative of these two viruses. The vaccine is given subcutaneously in two separate doses administered at least 28 days apart, and a person is considered fully vaccinated two weeks after the second dose.

The most common vaccine side effects are pain, redness, induration, swelling, or itching at the vaccination site. (People with HIV infection or atopic dermatitis do not seem to experience additional or more severe side effects.) […]

2022-08-17T06:34:29-04:00August 17th, 2022|infection control, infectious diseases, Nursing|0 Comments
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Monkeypox Update: As Knowledge Increases, More to Be Learned

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell (blue), cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

It seems impossible that we have to confront the rapid spread of a new virus when we’re still dealing with the effects of COVID-19. But for monkeypox, we didn’t have to respond “from scratch.” After decades of research and clinical work on smallpox, a related but considerably more lethal virus, testing protocols and vaccines were already available for use in monkeypox.

Nearly 20,000 cases of monkeypox have been reported around the world since May, with more than 5,000 infections reported in the U.S. There are probably many more undiagnosed and unreported cases.

Variations in presentation.

In New York City, where more than 1,000 cases of monkeypox have been reported, clinicians are seeing variations from “classic” presentations of monkeypox. The NYC Department of Health and Mental Hygiene reports that many people with monkeypox are not experiencing prodromal symptoms such […]

2022-08-01T14:17:20-04:00August 1st, 2022|infection control, infectious diseases, Nursing, Public health|0 Comments
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A Long History of Abortion

Looking to the past for context and perspective as the U.S. abortion care landscape changes dramatically.

The Supreme Court decision overturning Roe v. Wade ended women’s nationwide legal right to abortion after nearly 50 years.

Photo by Ian Hutchinson on Unsplash

Several states with so-called trigger laws banning abortion moved to implement these immediately. Although some of these laws have since been challenged in court, within a few months it’s expected that women living in about half the states will have very limited or no access to abortion care. Most of these laws—predominantly in the Midwest, South, and Plains states—make no exception for rape or to safeguard a woman’s health, until she is at risk of death.

Limiting health care access amid rising maternal mortality rates.

These restrictions on women’s health care occur while the U.S. continues to have a maternal mortality rate much higher than in other developed nations. According to the latest statistics from the CDC, this rate is rising, and health disparities persist: Black women are three times more likely to die from pregnancy-related causes compared with White women.

Women who have historically been most marginalized will be disproportionately affected by the Supreme Court’s decision, which is expected to affect […]

2022-07-11T06:31:54-04:00July 11th, 2022|Public health, women's health|0 Comments
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Monkeypox: The Basics for Nurses

In the past, cases of monkeypox only occasionally occurred outside of central and western Africa, where the disease is endemic, and it was virtually always related to travel or to the inappropriate relocation of wild animals. (In the US in 2003, 71 cases of monkeypox in six states were traced to pet prairie dogs that had been imported in the “exotic animals” trade.) What should we make of the outbreaks this year in 23 countries where the disease is rarely seen?

Current cases of monkeypox are occurring in people without a history of travel to endemic areas, and in some cases without obvious contact to known cases. Most of these people have had mild disease, though monkeypox can cause severe disease in young children, pregnant women, and immunosuppressed individuals. While monkeypox usually is not highly transmissible nor deadly, it has never spread to so many countries seemingly simultaneously.

A close relative of smallpox.

Monkeypox is a close relative of smallpox, and the smallpox vaccine also prevents monkeypox infection.  Many experts point to the end of mass smallpox vaccination campaigns as a factor in the emergence of cases at this time. Forty years ago, about 80% of the population was vaccinated against smallpox; today that figure is only about 30%. Monkeypox cases have been on the rise since smallpox was declared to be eradicated in 1980. In one monkeypox-endemic region, cases had increased twentyfold in recent decades. At the same […]

2022-06-02T10:14:45-04:00June 2nd, 2022|infectious diseases, Public health|1 Comment
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