Editor-in-Chief: K. Sue Hoyt, PhD, RN, FNP-BC, CEN, FAEN, FAANP, FAAN
Jean A. Proehl, RN, MN, CEN, CPEN, FAEN
ISSN: 1931-4485
Online ISSN: 1931-4493
Frequency: 4 issues / year

Editors' Remarks

  Editor Karen Sue Hoyt


 Editor Jean A. Proehl

 Editor Karen Sue Hoyt


Editor Jean A. Proehl 

Editors' Remarks


Dear Colleague,

Welcome to the American Academy of Emergency Nurse Practitioners!


The newly formed American Academy of Nurse Practitioners (AAENP) has adopted the AENJ as their official journal. Both AENJ and the AAENP seek to promote high quality, evidence-based care so this relationship is a natural fit. There are many opportunities for collaboration and mutual gain which will translate into improved resources for ENPs and improved care for patients.

Members will have free on-line access to AENJ as a benefit of membership and may also subscribe the print journal at a deeply discounted rate.  AAENP Founder, Elda Ramirez, is a long-time AENJ board member and AENJ Editor, K. Sue Hoyt, is now an AAENP board member so our collegial relationship is well established.

If you're an ENP who doesn't already belong to AAENP, you can see what you're missing at www.aaenp-natl.org.

Sue and Jean

Online Editor's Suggestions

A closer look . . .


Following upon the last entry's list of top-tier emergency blogs; these are largely from the top-tier emDocs, for a closer look of current useful content. Two are borrowed from http://pemplaybook.org/. An abstract from a forensic journal reminds us of additional injury possibilities.


Lex, Joe, MD. EM Mindset – Joe Lex – Thinking Like An Emergency Physician. July 11, 2016.  emDocs.

**This is a "Don't pass this up!" must-read.
Five decades of distilled experience and wisdom from one of the finest USA academic emergency medicine thinkers and teachers, who has just retired. Patient relations, medical decision making, avoiding errors and bias in thinking, work-load, and much more.


Troubleshooting G-tubes & J-tubes: Common scenarios / Tips & Tricks. emDocs.
**How to handle this common recurring problem.


Dr. Tim Horeczko. PEM Playbook – Multisystem Trauma in Children Part I: Airway, Chest Tubes, and Resuscitative Thoracotomy from PEM Playbook [02/01/2016]; reposted on emDocs. [07/15/2016].


Dr. Tim Horeczko. PEM Playbook – Multisystem Trauma in Children Part II: Massive Transfusion, Trauma Imaging, and Resuscitative Pearls. from PEM Playbook [03/01/2016]; reposted on emDocs. [[07/01/2016].


Bucher, Joshua, MD & Joseph, Joslyn, DO. Cervical Collars for C-Spine Trauma: The Facts. July 12, 2016. emDocs.


Kroll, M. W., Adamec, J., Wetli, C. V., & Williams, H. E. (2016). Fatal traumatic brain injury with electrical weapon falls. Journal of Forensic and Legal Medicine. {abstract & paywall).



                   Tom Trimble, RN
                        All opinions are solely those of the author.
                        Users are responsible for the validity to their own practice.


Advanced Emergency Nursing Journal is always looking for authors, articles, and suggestions for topics that inform the work of our specialty and excite the readers. If you have an article or concept to propose, or suggestions and opinions that would help us meet your needs, please use our "Feedback" form to contact the Editors. It's a direct line of communication, and the free registration of your email allows us to respond to your suggestions, and makes the entire website and all other LWW Journals more useable and functional for you.

Current Issue Highlights


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Official Journal of the American Academy of Nurse Practitioners


Advanced Emergency Nursing Blog

Go to the
Advanced Emergency Nursing ​Blog

Why is there a firehose of information from which to drink?




Clinical Tips from AENJ

# 165 Respect the trajectory

Should you find yourself and family in a place where imminent violence may occur, have a "no-questions-asked" code word for "we are leaving right now. This may happen when young men, perhaps similarly dressed or having gang colors, seem to be either moving or milling purposely towards you or another objective. Backpacks and inappropriate clothing are particularly of concern.


As with X-Rays and other ionizing radiation, your protective modalities are Time, Distance, and Shielding. If you are about to be "in the wrong place at the wrong time," rapidly put Distance/Time and Shielding between you and the threat. You may not see the person who launches a projectile towards you, nor will you be able to "dance" around it, as in a John Wu movie. Bullets will hit whatever is in their path regardless of your good character and intentions. Don't ask "Why?" Just leave. Do not spectate at a riot.


The best shielding, if you are within range, is "Cover." Cover is an intervening object of substantial mass that will protect you from most missiles fired at it. "Concealment" merely obscures you from view of your assailant, but will not withstand fire against it; bullets or explosives penetrating through it and wounding you without the direct vision of your assailant. Think of a cardboard box versus a reinforced concrete wall. Behind which, should you hide?


Having cover, do not forsake leaving - as soon as possible, - as quickly as is safe. Do not linger, or retrieve personal items. If there may be explosives, do not slow down until you have ~400 meters or more behind you; unlike the movies, you cannot outrun an explosive. Within 15-20 meters, death is virtually certain; beyond that your chances of survival increase with every additional meter. If an explosion occurs, drop to the ground facing away and cover your head; shelter behind sturdy cover helps if available; but some cover will be blown over by the pressure wave.


You, and the people that you care about, should have codewords; communications (although cell phones may be jammed by either terrorists or authorities); and a plan for reunion if separated. Beware of potential accomplices and possible secondary explosions or targeting.


You are on your own. The perpetrators will not likely attack when police are present, or they will immediately kill police or security first, so as to have a free hand and maximum body count for their propaganda. They probably do not care about surviving. You must be your own First Responder. "Help" is later than you can afford. Be able to give trauma care to yourself or your loved ones.


When in public places, always be aware of activities around you; the nearest exits (including the less obvious one through the kitchen or the back); sit near a wall near that exit with each adult taking a field of view to "keep watch." When you must fight back, do so with "no holds barred" vigorously with all your strength so as to immobilize the assailant and break free to better safety; this is no time to be nice, or to prevent injury. It's  not a patient; it's a terrorist or violent criminal actor.


CDC. Explosions and Blast Injuries A Primer for Clinicians.

American Red Cross. Terrorism Preparedness.

Blast Injuries: Practice Essentials, Background, Pathophysiology. Medscape.

Ellifritz, Greg. Articles tagged "terrorism." Active Response Training.

 All Tips: 2013  2014  2015  2016  

Upcoming Conferences

EM Day of Service

Your Community
TBA September 2016

ENA Emergency Nursing 2016
Los Angeles, CA
September 14th - 17th, 2016

ACEP 16 Scientific Assembly
Las Vegas, NV
October 19 th - 21st, 2016

Contact us with information upon conferences of interest to the readership.

Author Alert!

Advanced Emergency Nursing Journal is seeking authors, articles, and topics. If you are interested in writing for publication, please check our current (2015)  "Topics of Interest" for your project. Please contact our Editors if you have an additional proposal or suggestion.