Emergency Nursing 2019: Interactive Learning and Today’s Health Crises

The medical transport helicopter was at the ready. Meanwhile, the trauma team was in the midst of resuscitating a man. The crowd of onlookers remarked on the extreme pallor of the patient and were ready to jump in to help as needed. Fortunately, this was not a real life trauma but a scene in the exhibit hall of the sold-out Emergency Nurses Association (ENA) meeting in Austin, Texas, last week.

Four thousand ED nurses spent four days at Emergency Nursing 2019 attending educational sessions, skills labs (including a mock ED and a cadaver lab), and CE classes; viewing exhibit hall products; and relaxing in ‘Awesome Austin,’ celebrating themselves and the important work they do.

Documentary film producer Carolyn Jones (The American Nurse; Defining Hope) opened the meeting by presenting previews from her current documentary on emergency nurses, In Case of Emergency, a project in collaboration with the ENA for its 50th anniversary, to be released in May 2020. Jones and her film team traveled to seven EDs around the country, from an urban ED to rural farm country, to document ER nurses at work. […]

2019-10-07T10:13:54-04:00October 7th, 2019|Conference reports, Nursing|1 Comment
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‘I Sorted, I Triaged’: Notes of an Emergency Nurse

Trauma and triage in the ED.

Ralph Hogaboom / Flickr

Today, I was assigned to be one of just two triage nurses in the emergency department (ED) waiting room. With a limited staff and nearly full department, our next wave of patients arrived. I collected health information from the patients, screened for domestic violence and suicidality, made a triage decision regarding acuity level, and assigned an ED destination based on bed availability and estimation of resources.

Then, a man was wheeled in, with a woman close behind screaming “a car ran over his legs!” I saw an open bleeding wound on his right lower leg. I brought him to the trauma room.

The woman said to me, “I don’t think I can walk anymore.” I asked her if the car hit her too, and she replied, “yes, the car hit me too.”

As a trauma nurse, I stayed to help the trauma staff with the simultaneous trauma cases. Then I went back to the waiting room.

I prioritized.

More patients arrived, seeking assistance for many different needs. Then my charge nurse came out and informed me that I was needed back in the trauma room to receive an incoming patient who had fallen down a 15-foot ravine. Nursing resources were reallocated as needed to […]

2019-02-14T10:53:42-05:00February 14th, 2019|Nursing|2 Comments
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In Colorado EDs, ‘Alternative to Opioids’ Pilot Project Exceeds Goals

Ashley Copeland talks to her mother in the Swedish Medical Center ED. Copeland was treated for a severe headache with a nerve-blocking anesthetic, but no opioids. (John Daley/CPR News)

Last year, in an effort to address the state’s acute opioid abuse problem, several Colorado health care organizations—including the Colorado Emergency Nurses Association—worked together on an intervention to target patients admitted to the ED with pain. The plan? Implement a pain management program to promote alternative strategies, with a goal of decreasing opioid usage by 15% in the participating EDs.

As discussed in a June news article, the program, which was piloted in 10 hospitals and involved heavy involvement from nurses, surpassed its goal: opioid usage during the intervention period (as measured in morphine equivalent units) was 36% less than in the previous year.

The pilot […]

2018-06-14T09:29:35-04:00June 14th, 2018|Nursing, patient experience|1 Comment
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How Should We Measure Temperature in Young Children?

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Photo courtesy of Exergen Corporation. Photo courtesy of Exergen Corporation.

Do you dread taking rectal temperatures in pediatric patients, knowing that your action will leave you with a screaming, distrustful child as well as a distressed parent? Rectal temperature measurements have long been considered the “gold standard” for accuracy. But are they essential in very young children, especially when infection is not suspected?

“Improving Pediatric Temperature Measurement in the ED” in our September issue relates how a group of ED nurses explored possible alternatives to routine rectal temperature measurements during triage. Their ED protocol had been to use this method in all children under the age of five. However, this practice extended the time needed for triage, was often upsetting to parents, and seemed potentially unnecessary when the reason for the ED visit did not suggest infection (where there would be a need for more careful fever assessment).

An existing emergency services committee made up of ED staff nurses from the hospital’s two campuses set out to explore their options. The committee’s first move was to clearly define the practice problem:

Using PICOT format (Patient population, Intervention of interest, Comparison intervention, Outcome, Time frame), the committee initially formulated the following clinical question: For pediatric patients younger than five years of age (P) who require […]

2016-11-21T13:02:01-05:00September 10th, 2015|Nursing, Patients|0 Comments
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Drilling into Bone: A Nurse’s Guide to Intraosseous Vascular Access

By Sylvia Foley, AJN senior editor

An example of a pediatric manual intraosseous needle insertion. Used by permission. An example of a manual pediatric intraosseous needle insertion. Reprinted with permission from King C, et al. Textbook of Pediatric Emergency Procedures. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2007.

In this month’s CE Emergency feature, “Intraosseous Vascular Access for Alert Patients,” authors Stacy Hunsaker and Darren Hillis  describe this scenario: a three-year-old girl arrives in the ED after three days of fever, vomiting, and diarrhea. She needs fluids urgently, but efforts to establish IV access have been unsuccessful. Now she’s on the verge of decompensated shock. The team is about to try an alternative route—intraosseous (IO) vascular access—but there are concerns: “Could such access be attempted on a patient who wasn’t unconscious? Would the parents understand why a hole was going to be drilled into the bone of their child’s leg?” The team must decide whether and how to proceed.

If this child were your patient, would you know what to do? If you aren’t sure, you are not alone. In this article, Hunsaker and Hillis provide some answers. Here’s a short summary. […]

2017-07-27T14:49:36-04:00October 31st, 2013|Nursing|4 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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