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” (more […]

2021-09-14T14:36:42-04:00September 14th, 2021|COVID-19, infectious diseases, Nursing|1 Comment
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A Plea for Help in Making Nursing Sustainable

by Casey Horner/via Unsplash

My hairdresser made a comment that I hear from a lot of people who are not in health care.

“I don’t know how you do a full 12-hour shift when it’s life-and-death work. I mean, I have long days working too, but cutting and styling hair isn’t life and death. I just can’t understand how you do it.”

I smiled and shrugged, as I usually do.

“Thanks for recognizing that. I don’t know. We get used to it, and we have a certain flow at work, even when it gets crazy. Plus it cuts down on the number of days I have to commute to work since I get so many hours in in one day.”

I had so much more to say, but that wasn’t the place for it. This is.

It’s true that at our core, we nurses are just wired to do this kind of work and we can push through it beyond a standard eight-hour work day. It also works well for consistency in ICU patient care to only have one changeover of the patient’s nurse from one 12-hour day shift to the incoming 12-hour night shift. We have generally found ways to ride the waves of an especially high census mixed with especially sick patients, typically followed by […]

2021-08-19T16:46:41-04:00July 29th, 2021|health care policy, Nursing, nursing career, Public health, safe staffing|5 Comments
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What to Know About the ACA After Third Failed SCOTUS Challenge

As trusted sources of information related to health and health care, nurses should be informed about health care laws that govern access to care.

The issue.

On June 17, 2021, the Supreme Court of the United States (SCOTUS) rejected the latest constitutional challenge to the Affordable Care Act (ACA). The ACA lawsuit was linked to the Tax Cuts and Jobs Act of late 2017, which “zeroed out” the penalties imposed by the ACA’s controversial individual mandate requiring people to have health insurance. Following this, in February 2018 a coalition of 18 states and two individuals filed a lawsuit challenging the legality of the ACA because the individual mandate was unenforceable.

While most pundits initially dismissed the seriousness of the threat of the lawsuit, this changed in June 2018 when the U.S. Department of Justice under President Trump expressed support for the suit, asking the court to strike down not the entire law but just the ACA’s prohibitions against insurers’ denying coverage to people with preexisting conditions and against charging higher premiums because of health status (the Justice Department later expanded its support of the lawsuit to include repeal of the entire ACA). Historically, it is unusual for the Justice Department to oppose current […]

2021-07-07T10:30:18-04:00June 28th, 2021|health care policy, Nursing, Public health|0 Comments
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Pregnancy and COVID: What We Now Know

Meagan Garibay, RN, BSN, CIC, an infection preventionist at Comanche County Memorial Hospital in Lawton, Oklahoma, received the COVID vaccine in December 2020, when she was 35 weeks pregnant. Photo courtesy of WAVE 3 News.

Few aspects of pregnancy and birth have been unaffected by the COVID pandemic. In the past year, pregnant people and their health care providers have had to alter everything from the way they assess risk to the manner in which care is accessed.

Although little information about pregnancy and COVID was available early in the pandemic, emerging evidence is providing a clearer picture. As a result, in the past year recommendations have shifted—sometimes radically so—for both women and their health care providers. Based on the latest available research, this month in AJN Reports we cover what we now know about COVID and maternal health, including guidance about risk and vaccination.

Higher risks for pregnant people with COVID.

As the articles explains, research suggests pregnant people who have COVID are at higher risk of severe […]

2021-06-03T08:43:24-04:00June 3rd, 2021|COVID-19, infectious diseases, Public health|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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