Evidence-Based Practice
Transcutaneous Pacing: An Emergency Nurse’s Guide
Transcutaneous pacing is commonly performed in emergency departments to treat patients with cardiac dysrhythmias. Although emergency nurses are required to complete a standardized course that reviews components of transcutaneous pacing, such as Advanced Cardiac Life Support, performing transcutaneous pacing on patients may be done infrequently in some facilities and can lead to anxiety and fear for bedside emergency nurses, especially novice emergency nurses and nurses who infrequently care for patients requiring external pacing.Spontaneous Coronary Artery Dissection: A Comprehensive Overview
Spontaneous coronary artery dissection is an underdiagnosed cause of acute coronary syndrome that primarily impacts young women. Spontaneous coronary artery dissection as a cause of acute coronary syndrome is not rare and should not be overlooked. Spontaneous coronary artery dissection should be considered on the list of differential diagnosis of any chest pain occurring in young women with few typical risk factors. The purposes of this article are to broaden the understanding and increase awareness of spontaneous coronary artery dissection, specifically its diagnosis and clinical outcomes.Nursing of Patients Critically Ill With Coronavirus Disease Treated With Extracorporeal Membrane Oxygenation
Since the end of 2019, coronavirus disease (COVID-19) has spread rapidly from Wuhan to other parts of China.1,2 Approximately 17% of the patients with this disease became critically ill and had symptoms such as acute respiratory distress syndrome (ARDS), respiratory failure, and multiple organ dysfunction syndrome, which may ultimately lead to death.1 Medical experts in different fields have stated that it is difficult to treat severe or critically ill COVID-19 cases.2,3,4Drug Overdose, Loss of Consciousness, and Compartment Syndrome: A Life-Threatening Combination
Acute extremity compartment syndrome is considered an orthopedic emergency that has serious consequences if a correct diagnosis is not made rapidly. Patients who lose consciousness due to a drug overdose are known to collapse onto their extremities. The limbs are compressed for hours, placing them at an increased risk for acute extremity compartment syndrome and its sequelae. Compartment syndrome due to a compression of a limb from loss of consciousness secondary to drug overdose, presents unique issues to health care providers.Prehospital Medical Response to Active Shooter Incidents—The Rescue Task Force Concept
Acts of mass shooting violence plague our society. The Federal Bureau of Investigation (FBI) cites 27 active shootings in the United Stated in 2018.1 These incidents occurred in 16 states resulting in 213 casualties and 85 deaths.1 As this article is being written, Jersey City, New Jersey, is the latest community to fall victim to an active shooter situation. Characterized as an act of domestic terrorism, this December 9, 2019, incident resulted in the fatal shooting of Jersey City Police Detective Joseph Seals.Can Sudden Cardiac Death Risk in the Young be Identified in the Emergency Department?
Sudden cardiac death in the young is devastating for the family and the community. Although it has diverse etiologies, many are inherited. Discovering the disease in 1 patient offers the chance to save otherwise asymptomatic family members. Although some diseases can be discovered during autopsy, others require electrocardiograms for diagnosis, making it difficult to estimate the prevalence of disease and cause of death. Careful assessment of the history of present illness, family history, and electrocardiogram can guide clinical teams toward sometimes rare and difficult diagnoses.Tension Pneumothorax: What Is an Effective Treatment?
Many emergency nurses have memorized the phrase “needle decompression 2ICS MCL” (translation: second intercostal space, mid clavicular line) as the intervention for a tension pneumothorax. However, if you believe in using an evidence-based approach to emergency nursing practice and examine the effectiveness of this intervention, you may be surprised at the challenges related to site placement and needle length, along with failure rates. For example, consider the following cases that have been reported in the literature.Are You Using Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Noncompressible Hemorrhage?
EMS is bringing you a 32-year-old male victim of multiple stab wounds to the lower abdomen. The patient was unresponsive at the scene. His blood pressure is 88/50, his heart rate is 78, and his respiratory rate is slow and shallow. Because they were 2 minutes away, they just scooped up the patient and are at the front door. Is he hemorrhaging…in shock? How will you stop the bleeding?Traumatic Ruptured Diaphragm: A Frequently Missed or Delayed Diagnosis
A 67-year-old woman presented to the emergency department with a report of nausea and vomiting and abdominal pain after eating. Upon questioning, she revealed that she fell 3 months earlier and sustained 2 broken ribs on the left side.1
