Can You ‘Stop the Bleed’?

Reconsidering tourniquets.

Bystanders apply pressure to woman’s leg to stop bleeding after explosion at 117th Boston Marathon. Photo by John Tlumacki / Boston Globe via Getty Images.

Have you ever used a windlass tourniquet? I had never even heard of one until recently. The only tourniquets I knew were fashioned from belts, scarves, or neckties, and we were always admonished to use these sparingly, because it was thought that they could cause severe damage to a limb.

In “Leading the Effort to Promote Bleeding Control in Our Communities” in this month’s AJN, James Reed and Margaret Carman dispel myths about tourniquets and share the growing evidence for their safety.

They also introduce us to the Stop the Bleed campaign. Hemorrhage is the second-leading cause of death (head injury, the first) after a traumatic injury, and when an extremity is the source of bleeding, rapid tourniquet application saves lives.

“More than 50,000 casualties sustained in the wars in Central and Southwest Asia have provided evidence that recognizing hemorrhage and controlling it should be the highest priority in caring for […]

2019-05-16T12:15:52-04:00May 16th, 2019|Nursing, Public health|0 Comments
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Measles Outbreaks, and an Unexpected Vulnerability

The second-greatest number of cases since ‘elimination.’

3D graphical representation of spherical-shaped, measles virus particle studded with glycoprotein tubercles. CDC/ Allison M. Maiuri, MPH, CHES

Last month, a state of emergency—which has now been halted by state court—was declared in nearby Rockland County, New York, barring children who hadn’t been vaccinated against measles from public places. The unprecedented step made worldwide news and highlights the public health measures being taken to stem the six currently ongoing measles outbreaks in the United States.

Measles was eliminated in the United States in 2000, but outbreaks have occurred since, increasingly so in recent years. The CDC reported this week that almost 400 cases of measles have been confirmed in 15 states during the first three months of this year alone. This is the second-greatest number of reported cases since eradication of the disease. The most—667 cases—occurred in 2014.

Public health authorities are clear about the cause of these outbreaks: people contract measles abroad and bring it back to the United States, where groups of people who are unvaccinated are particularly susceptible to developing and spreading this highly contagious disease. Up to 90% of unvaccinated people […]

2019-04-08T07:55:37-04:00April 8th, 2019|infectious diseases, Nursing, Public health|3 Comments
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Back to the Future of Nursing

A new hashtag: #FutureofNursing2030

In 2010, a committee of the Institute of Medicine (now the National Academy of Medicine), released a report to lay out a vision for nursing for the coming decade. That decade is now almost over. The Future of Nursing: Leading Change, Advancing Health is the most viewed and most downloaded report of the National Academies. On March 20 in Washington, D.C., Victor Dzau, president of the National Academy of Medicine, announced an impending follow-up report for the next ten years: The Future of Nursing: 2020-2030.

Outcomes, not page views, are what matters.

Noting that “success is measured by outcomes and impact, and not by downloads and page views,” Dzau cited a few of the accomplishments that arose from the 2010 report:

  • removing barriers that limited NP practice (21 states and the District of Columbia allow for full practice authority)
  • doubling the number of nurses with doctoral degrees
  • increasing the diversity of nursing students

But Dzau also noted that more needs to be done in these areas, and he emphasized the need for better data about the nursing workforce. The new report will be a consensus study that seeks to chart a new path for nursing “to help our nation create a culture of health, reduce health disparities, and improve the health and well-being […]

2019-03-27T07:35:17-04:00March 27th, 2019|health care policy, Nursing|0 Comments
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Hidden in Plain Sight: What Nurses Need to Know About Food Insecurity

Are any of the people you see in your office or clinic “food insecure?” How about the college friends of your children? Or perhaps your own coworker?

Food insecurity is all around us.

The United States Department of Agriculture describes food insecurity as the lack of “consistent, dependable access to adequate food for active, healthy living.” Recent data indicate that food insecurity affects about 13% of U.S. households. In some states, the rate approaches 20%. Certain populations are particularly vulnerable: 27% of veterans who served in Iraq or Afghanistan and as many as 37% of college students are food insecure.

Twice monthly, the Muslim Food Pantry in Flint, MI, distributes free food to anyone who needs it. The pantry is run by volunteers and offers food, bottled water, and hygiene products to those with limited or no food or clean water—the latter a result of the Flint water […]

2019-01-14T11:45:33-05:00January 14th, 2019|Nursing, Public health|0 Comments
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How Can Nurses Identify and Assist Human Trafficking Victims?

Wikimedia Commons/ AlvaroGzP

What do sex workers have in common with nannies, housekeepers, farmworkers, janitorial and restaurant staff, and factory and construction workers? They all work in settings where victims of human trafficking are commonly found.

Human trafficking is big business in the United States.

Our country is reported to be the second-largest market globally for women and children trafficked into sex work. Sex trafficking is the main form of trafficking among U.S. citizens, while forced labor trafficking is more common among foreign nationals living here.

Globally, human trafficking is second only to drug trafficking among criminal industries. Because nurses are “everywhere,” we are very likely to come into contact with human trafficking victims at some point. Would you know how to recognize one?

Possible indicators of human trafficking.

In a 2011 AJN article, Donna Sabella shares several possible indicators of human trafficking that warrant further investigation, including:

2018-12-13T08:10:08-05:00December 13th, 2018|Nursing, 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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