Advanced Emergency Nursing Journal最新文献

Procedural sedation and analgesia (PSAA) is integral to facilitating painful and anxiety-inducing medical procedures in the emergency department (ED). Optimal PSAA enhances procedural success and improves both patient and provider satisfaction. The selection of appropriate sedative and analgesic agents, routes, and dosages, which depend on various patient- and procedure-specific factors is a complex process. Alternative routes of administration, such as intranasal, intramuscular, and oral, are all options, each with their own inherent benefits and limitations. It is important for providers to take into account patient-specific considerations, including age, medical history, body weight composition, and pregnancy, which can significantly impact PSAA effectiveness and safety. Implementation strategies targeted to minimize medication errors and optimize workflow are also important considerations in PSAA. By adopting a comprehensive and evidence-based approach, health care providers can navigate the intricacies of PSAA and ensure the best possible care for patients in the ED.

Mass gathering events can greatly impact overburdened emergency medical service systems and emergency departments, which frequently experience staffing shortages and overcrowding. Nurse practitioners (NPs) were introduced into an event medicine team at mass gatherings to reduce emergency transports to local emergency departments as well as offering a "treat and release" disposition for patients presenting to medical tents. This study aimed to examine the impact of NPs at mass gathering events; 147 chart reviews were performed from 05/01/2023 to 09/30/2023 for all patients assessed by an NP at events staffed by an event medicine team; 60% of patients assessed by an NP were treated and released from the event, potentially reducing the number of patient transports and emergency department visits considerably. NPs can provide higher levels of care at events, treating common complaints such as heat-related illness, nausea, vomiting, minor trauma, and laceration repairs. Although this study did not compare data from events where NPs were not present versus when they were utilized to grasp the statistical impact their presence has had since their introduction to the team model, the study clearly shows the benefits NPs bring to mass gathering medical care. This is significant for emergency NPs as this research validates the need to include these providers in this new setting and role in which they can practice. More research is needed to compare patient outcomes with and without NPs present.

In the United States and the United Kingdom, where the author resides, many Emergency Departments utilize nerve blocks for fractures waiting to be seen by orthopedic surgery. As emergency nurses, be it advance practice nurse or staff nurse, it is our professional responsibility to be aware of emergencies that can result from these nerve blocks, namely local anesthetic toxicity (LAT). In the United Kingdom, there are protocols and guidelines for the treatment of this adverse event, which are shared in this article as a knowledge base for identifying and treating LAT. This paper also discusses the similarities in symptoms of LAT and anaphylaxis.

This manuscript explores the historical evolution of emergency nurse practitioner (ENP) education from its inception to its current state. It discusses key milestones, innovative leaders, curricular approaches and current program characteristics. The paper concludes with a review of the current state of ENP education, persistent challenges, and future directions. Professional organizations that have shaped both the ENP role and education over time are also considered. By examining the historical context, this review provides insights into the evolution of ENP education, contributing to a deeper understanding of the ENP role and education's significance in emergency care.

As demands in the way of healthcare delivery increase, nurse practitioners have become essential components in optimizing access to healthcare and improving outcomes around the globe. The authors recognize the vital role nurse practitioners play globally and that education, practice, and credentialing differ significantly across countries. Many countries have a wide variation in educational requirements, resulting in a lack of adequate advanced practice nursing training and regulation of practice. Additionally, many countries are experiencing increased demands in the form of emergency services, with long waiting times and severe crowding in emergency departments. Worldwide, many programs are being developed to educate advanced practice nurses on improving emergency medical care, but developing such programs is a complex process This article aims to discuss the scope of practice and roles of advanced practice nurses globally. We will also attempt to clarify and improve these global standards and discuss competencies in this role.

Over the past two decades, the emergency nurse practitioner (ENP) role has significantly enhanced emergency care in the United States. With the increasing complexity of emergency care, ENPs have expanded into nontraditional settings, necessitating regulatory updates to maintain patient safety. The Consensus Model for Advanced Practice Registered Nurse Regulation has influenced ENP practice, yet consistent regulatory recognition is still needed due to the marked evolution in ENP practice. Despite collaborative efforts to prepare the ENP workforce and ensure competency through standardized education, certification, and licensure, recent unethical publications and skewed statistics have threatened the specialty's progress. Addressing these challenges is crucial for advancing the ENP role and ensuring high-quality emergency care delivery.

The creation of the American Academy of Emergency Nurse Practitioners (AAENP) marked a significant milestone in the professionalization of emergency nurse practitioners (ENPs). This interview with Dr. Elda Ramirez, the founder of AAENP, explores the critical moments and challenges that led to the establishment of the organization. Driven by the need for a dedicated body to advocate for the unique role of ENPs, AAENP was founded to address gaps in regulatory recognition and professional standards within the broader nursing profession. The manuscript delves into the origins of AAENP, highlighting the pivotal roles of co-founders Drs. Arlo Weltge and Kyle Kincaid, and discusses the organization's early achievements, including the development of a specialized certification exam. AAENP's journey underscores the importance of professional societies in advancing specialty practices and advocating for the interests of their members.