Critical Care / Emergency / Trauma

Astute assessment prevents paralysis

What seems like a simple pulled muscle to a shipping clerk turns out to be cauda equina syndrome, a potentially paralyzing injury that warrants immediate surgery.

Battlefield nursing at the Boston Marathon

Three yellow balloons danced through the air, hovering over the finish line after being released by the bomb blast that brought the 2013 Boston Marathon to a catastrophic…

Calming a thyroid storm

Saving a patient’s life may rest on recognizing which findings are red herrings and which hold the key to the crisis.

Care during crisis

ANA brings nurses, experts together to shape practice policy during disasters

Care, not chaos

A new document created by ANA and other groups delineates emergency care principles for psychiatric patients.

Case Study: How much is enough?

Three-year-old Christy* has been in the hospital’s pediatric intensive care unit (PICU) since birth, when she was diagnosed with McCune-Albright syndrome and multiple other conditions that left her…

Challenging nursing’s sacred cows

Do you routinely instill normal saline solution into endotracheal tubes before suctioning? Use only the Glasgow Coma Scale for neurologic assessment? Evidence on these and other sacred cows…

Coffee drinking and arrhythmias

Coffee drinkers are less likely to be hospitalized for cardiac arrhythmias, according to a report presented at the American Heart Association’s 50th Annual Conference on Cardiovascular Disease Epidemiology…

Dealing with the dangers of dog bites

Dog bites can cause serious or even fatal injuries. Find out how to assess and intervene when your patient has been bitten. This content is for Digital Access…

Derailing potentially deadly dehydration

When a dehydrated patient falls into a stupor and her vital signs head south, a rapid response team can help unit nurses stabilize her quickly – and avoid…

Dodging a trach tragedy

When a patient’s O2 Sat falls and subcutaneous neck edema arises, adroit troubleshooting identifies the cause.

During an emergency: Be safe!

Thousands of accidental chemical spills and leaks take place in this country each year. Providing nurses with adequate first-receiver training can help ensure that we can care for…

Family initiated rapid response team

Rapid response isn’t just for staff. More hospitals are allowing, even encouraging, patients and their families to make the call for help.

Halting postpartum hemorrhage

When excessive blood loss during delivery threatens a mother’s life, quick assessment, effective interventions, and expert aid from the rapid response team maneuver her postpartum course back onto…

Letters to the Editor – July 2007

Oversight not needed As a recent graduate of a nurse practitioner (NP) program, I appreciated your article “Retail-based clinics: New option for nurses” in the March issue. You…

Managing acute decompensated heart failure

Patients with stable chronic heart failure may suddenly start decompensating. Do you know how to recognize this condition and help avert organ failure?
emergency department nurse

My First Day in the ED

Note: This article was written before Kenneth graduated from nursing school. My first experience in an emergency department (ED) setting happened last week at Frankfort Regional Medical Center…

Ogilvie’s syndrome: No ordinary constipation

A patient complains of bloating, abdominal tenderness, and constipation. Nothing unusual? Maybe. But if you’re too quick to dismiss these symptoms, you could be overlooking a serious condition called…

PA catheter controversy

Standard of care in the ICU – or object of overuse, abuse, and misuse? The authors explain why they believe PA catheter use may harm more critically ill…

Putting the breaks on pulmonary edema

I.V. fluids should help a dehydrated patient, but for one with a history of atrial fibrillation and coronary artery disease, they could contribute to pulmonary edema. For Grace…

Quiz time

Which of the following does not help address issues related to post-intensive care syndrome? a. Diaries kept jointly by family, ICU staff, and physicians b. Post-ICU clinics for…

Recovery lessons from the Sandy Hook trauma

Children are people with small hearts and big emotions that often come from the people around them, particularly family members. As a pediatric nurse and mother of two…
Hypertensive

Responding to a hypertensive crisis

Clifton Jones, an African-American male aged 59, comes to the emergency department (ED) complaining of headache and blurred vision. After the triage nurse measures his blood pressure (BP)…

Saving a snakebite victim

While hiking, Paul Sawyer, age 31, is bitten twice on the right hand by a rattlesnake. When he arrives at the emergency department (ED), the team obtains STAT…

Sepsis signposts: Can you spot them?

Sepsis can show up in any setting. So even if you don’t work in a critical care unit, you need to know how to detect it. This article…

Shhhhhh! Quiet zone

Nurses play a significant role in helping patients to get the sleep they need.

Stemming a lethal immunologic response

When a patient shows signs of systemic inflammatory response syndrome, her survival hinges on the nurse’s expert assessment skills and the clinical team’s swift interventions.

Stopping a downward spiral

For a patient with chronic heart failure, failure to take prescribed diuretics triggers a perilous chain of events

Stroke in a child with sickle cell anemia

Adrienne Johnson, age 5, is admitted to the general pediatric unit. She has sickle cell anemia (hemoglobin SS subtype) and recently was discharged after being hospitalized for acute…

Study: Distracted driving more lethal

According to a recent study, from 2005 to 2010, the national number of pedestrians struck and killed by distracted drivers increased from 344 to 500, an almost 50%…

Study: ICU transfer timing affects mortality

A study in the American Journal of Critical Care found that transferring patients out of the ICU before or later an optimal time window increased mortality. Read more.

Suppressing a COPD flare-up

Nursing vigilance helps a patient with chronic obstructive oulmonary disease stave off respiratory failure.
SWAT nursing specialty

SWAT nursing: A unique specialty

What does SWAT stand for? So Where Are They? Smart, Witty, and Talented? Smiling, Willing, Able, Technical? (more…)
ibuprofen medication meds pills pill

Take Note – December 2006

CDC recommends HIV screening for everyone New recommendations from the Centers for Disease Control and Prevention (CDC) call for routine human immunodeficiency virus (HIV) screening for all patients…
colonoscopy cancer note nurse healthcare

Take Note – December 2007

Previous pneumonia vaccination reduces ICU admissions Among adults hospitalized for pneumonia, those who’ve been vaccinated against the disease are less likely than unvaccinated patients to require admission to…
type 2 diabetes

Take Note – July 2007

On-line video-based course on emergency preparedness   The need for better coordination between governmental agencies and hospitals became apparent after 9/11 and again after Hurricane Katrina. To fill this…

Taking the ICU to the Patient

How one rapid response team prevents cardiac arrest and provides other life-saving benefits outside the ICU.

Thwarting a pneumothorax

As a patient deteriorates, assessment and history findings guide clinicians to the right diagnosis and interventions.

To sleep, perchance to heal

Sleep doesn’t come easily for ICU patients. Many suffer chronic sleep deprivation, which can raise stress levels, depress immune responses, and impair wound healing. To help them sleep, some…

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Which of the following is correct about the stages of sleep?