Advanced Emergency Nursing Journal

Current Issue

July/September 2018 - Volume 40 - Issue 3

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

Editor's Remarks

The Advanced Emergency Nursing Journal (AENJ) received increased visibility at both the Wolters Kluwer and AAENP booths in June with over 6,000 attendees at the AANP 2018 National Conference in Denver, Colorado. AENJs flew off the shelf! AENJ continues to secure more manuscripts and reviewers. We currently have 20 manuscripts ready to go!

A Virtual Town Hall meeting held by AAENP on July 11, 2018 was also high success! A welcome address was given by Ken Stackhouse, AAENP President followed by an introduction to AAENP by Amanda Comber and Andrea Smith. Eric Roberts, AAENP Board Chair, then discussed upcoming events including “What’s Hot”-

ENP Practice Data-Elda Ramirez, Dian Evans, Jennifer Wilbeck

ENP Practice Standards-Elda Ramirez

Membership Committee Survey Results-Brittany Hines

Barriers to Practice-Dian Evans, Melissa King, Paula Fessler

The Virtual Town Hall Meeting ended with a call for AAENP applications (including the benefits of AENJ with membership. An audio recording of this event is available at https://aaenp-natl.org/

Have a great rest of the summer!

Sue

K. Sue Hoyt

Editor-in-Chief

Online Editor's Suggestions

SUGGESTIONS: 2018-15 {September 17, 2018}

McGonigal, Michael, MD. BEST OF AAST #1: THE PRICE OF BEING A TRAUMA CENTER. The Trauma Professional's Blog. September 10^TH, 2018.

McGonigal, Michael, MD. BEST OF AAST #2: CERVICAL SPINE CLEARANCE AND DISTRACTING INJURIES. The Trauma Professional's Blog. September 11^TH, 2018.

McGonigal, Michael, MD. BEST OF AAST #3: LEVEL I VS LEVEL II TRAUMA CENTERS. The Trauma Professional's Blog. September 12^TH, 2018.

McGonigal, Michael, MD. BEST OF AAST #4: BETTER TRIAGE FOR SCENE HELICOPTER TRANSPORT. The Trauma Professional's Blog. September 13^TH, 2018.

McGonigal, Michael, MD. BEST OF AAST #5: PNEUMOTHORAX – HOW BIG IS TOO BIG?
The Trauma Professional's Blog. September 14^TH, 2018.

McGonigal, Michael, MD. August 2018 Trauma MedED Newsletter. [Part 1 of 2 on Massive Transfusion Protocol] September 7^th, 2018. http://bit.ly/TME201808a. Subscribe to receive Part 2 ASAP. Subscribe: www.TraumaMedEd.com.

"juwo" . Lewis Derivative - Atria hate this trick! (Browser-translated from German-language "#DasFOAM.org" article "FOAM Link-Sammlung und Literatur". Use the Lewis Lead derivation to enhance low-amplitude atrial electrical activity. September 7^th, 2018.

Sean M. Fox, MD. Pediatric Difficult Airway. emDocs.net. (Originally published at Pediatric EM Morsels on June 23, 2017, updated on July 23, 2017. Reposted with permission.)

Skyler Lentz, MD. Looking for a Better Way to Treat Hypoxia in the Emergency Department? Reach for High-Flow Nasal Cannula. emDocs.net. May 28^th, 2018.

Warnecke, T., Tochtermann, F., Kerkhoff, S., Komorowski, M., Neuhaus, C., & Hinkelbein, J. Airway management in microgravity: A systematic review. Acta Anaesthesiologica Scandinavica. 10 September 2018. {Abstraqct & Paywall} https://doi.org/10.1111/aas.13251

Mary Ellen Lewis. 5 Historical fashions you didn't know had medical context. MDLinx. September 12^th, 2018.

Michele G. Sullivan. More than half of urine drug screens showed improper medication use. Internal Medicine News. Publish date: September 13^th, 2018.

FOAMEMSADMIN. FOAMEMS is a compendium site of FOAM literature important for EMS; this is their republication of A completely healthy 30-something woman with acute chest pain — this post is loaded with info !!! sourced from the original at Dr. Smith's ECG Blog, a well-known and expert source. Saturday, September 15^th, 2018 by Dr. Smith.

FOAMEMSADMIN. Prehospital OMI recognized immediately by a fantastic paramedic. Republication from original Dr. Smith's ECG Blog (Written by Pendell Meyers, edits by Steve Smith). Prehospital OMI recognized immediately by a fantastic paramedic. July 28^th, 2018.

Aydin, G. (2018). Hyperbaric oxygen treatment resistant carbon monoxide poisoning. Journal of Clinical Anesthesia, 50, 24-25. {Abstract & Paywall} PMID: 29940471
DOI: 10.1016/j.jclinane.2018.06.035 [Ed. Note: Multifocal cerebral edema suggests resistance to hyperbaric O₂ may have other causes.]

Sincerely,

Tom Trimble, RN

All opinions are solely those of the author.
Users are responsible for the validity to their own practice.
Suggestion does not equal endorsement.

Current Issue Highlights

From the Editor

Building Bridges to Advance Specialty Practice: Updates and Accomplishments by the American Academy of Emergency Nurse Practitioners

Evans, Dian Dowling

Advanced Emergency Nursing Journal. 40(3):145-147, July/September 2018.

Research to Practice

Emergency Department Use of Intravenous Prochlorperazine for Acute Migraine

Cook, Calli; Newberry, Brittany

Advanced Emergency Nursing Journal. 40(3):148-154, July/September 2018.

Imaging

Tibial Plateau Fractures

Ramponi, Denise R.; McSwigan, Tara

Advanced Emergency Nursing Journal. 40(3):155-161, July/September 2018.

Applied Pharmacology

Outpatient Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department

Schutz, Douglas; Watson, Simon C.; Hayden, Geoffrey; More

Advanced Emergency Nursing Journal. 40(3):162-170, July/September 2018.

Cases of Note

A 20-Year-Old-Trauma Patient With Suspected Malignant Hyperthermia Following Induction With Succinylcholine: A Case Study

Luckey-Smith, Kaitlyn; High, Kevin

Advanced Emergency Nursing Journal. 40(3):171-175, July/September 2018.

Dermatology Dilemmas

Stevens–Johnson Syndrome: A Challenging Diagnosis

Davis, Wesley D.; Schafer, Phillip A.

Advanced Emergency Nursing Journal. 40(3):176-182, July/September 2018.

Procedural Column

Maximizing Success With Rapid Sequence Intubations

Smith, Tony L.; Van Meter, Jessica

Advanced Emergency Nursing Journal. 40(3):183-193, July/September 2018.

CE Test

Outpatient Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department

Advanced Emergency Nursing Journal. 40(3):E1-E2, July/September 2018.

Clinical Tips from AENJ

# 275 Horrendous in the Grass

It's one of those nights when the department is packed overcrowded and patient flow is obstipated. You're at Triage, trying to hasten assessments and begin initial measures without being tied up with direct patient care: yeah, right!

A very uncomfortable 35-year-old man complains of left ear pain since romping with his dog and rolling in dried grass. The "foxtail" that he thinks he has in his ear can be readily seen. He agrees to letting you remove it.

You fetch a wide metal ear speculum, Hartman's (Alligator) Forceps, and some 10% topical lidocaine spray. Warning him of the sensation of warmth, you gently spritz the anesthetic into the canal (tympanic membrane is intact). In seconds, he is delighted to be free of pain. There's no ENT chair, so he agrees to steady his head with his hand and that elbow with the other hand. Although the widest parts of the foxtail face you and are likely to dig in, you're able to carefully remove the foxtail and verify no scratches to the irritation.

You give him some cautions: don't dig at it with his finger; return if worse, any change in hearing, or ear discharge; don't immerse ear until well; avoid foxtails in future. You sign him out with essential documentation. Having spared the treatment area from a "minor" patient and long wait, you feel internal satisfaction and move onto the next arriving patient.

Dance, D., & Ludemann, J. P. (2009). Removal of ear canal foreign bodies in children: What can go wrong and when to refer. BCMJ, 51(1), 20-24. [PDF]

Davies, P. H., & Benger, J. R. (2000). Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department. Emergency Medicine Journal, 17(2), 91-94. [PDF]

Michelle Lin, MD. Trick of the Trade: A mini-suction device. ALiEM: Academic Life in Emergency Medicine. June 29^th, 2011.

Mitchell Li, MD. Trick of the Trade: Insect removal from the ear. ALiEM: Academic Life in Emergency Medicine. October 2^nd, 2014.

Adedeji, T. O., Sogebi, O. A., & Bande, S. (2016). Clinical spectrum of ear, nose and throat foreign bodies in North Western Nigeria. African health sciences, 16(1), 292-297. [PDF]
doi: 10.4314/ahs.v16i1.38 PMID: 27358644 PMCID: PMC4915433