Advanced Emergency Nursing Journal最新文献

A Skene gland cyst is one of several benign anterior wall masses that may not be identified until a woman's first pelvic examination. The Skene gland cyst may confound emergency provider's differential diagnosis if the female patient presents with gynecological or urologic complaints. A patient with a Skene gland cyst is presented in this article. The purpose of this case study is to review information about the Skene gland to enable emergency providers to identify and consider the Skene gland cyst or abscess in the list of differential diagnoses for urological and gynecological symptoms or as an incidental finding that has no relationship to the presenting complaint. Accurate diagnosis of a Skene gland cyst, infected cyst, or another anterior vaginal wall mass allows the emergency provider to decide whether any immediate treatment is needed and appropriate gynecological referral for definitive treatment.

Emergency electrocution incidents present with various injuries, which can range from minor to severe injuries including death. Cardiac-related complications have a higher mortality incidence among patients with low-voltage injuries (M. R. Zemaitis et al., 2023). When managing electrical injury patients, the literature recommends managing them as both trauma and cardiac cases. However, the diagnostic approach is based on each individual case and patient presentation. Electrical injury complications include arrhythmias, myocardial tissue damage, and conduction disturbances (Pilecky et al., 2019). The purpose of this case study is to discuss a postelectrocution atrial fibrillation case and common related arrhythmias associated with electrical injuries.

Patients with headaches who present to the emergency department (ED) need prompt pain management. Headaches are a common complaint in the ED. Urgent evaluation is critical to assess for life-threatening headache causes. Once the causes of secondary headaches are ruled out, various pain control modalities for primary headaches can be used. This article and case will illustrate the treatment of primary headaches using battlefield acupuncture (BFA) as it is effective, minimally invasive, and has minimal undesired side effects or interactions. BFA will continue to work after the patient has left the ED. Average pain relief can be 4-7 days but varies depending on etiology. BFA presents an opportunity to minimize costly resource overutilization while still providing an option for quick, safe, and effective pain control. The article will also briefly mention some crucial headache assessments (detailed education on headache assessment should be done separately by the reader).

Tick-borne diseases occur throughout the United States, with a disease burden that ranges from mild to severe. As temperatures rise with climate change, the active season for ticks increases, and more tick-borne illness is seen (Centers for Disease Control and Prevention, 2022a). Many patients present to the ED for suspected tick bites, rashes, and generalized medical complaints that may be related to a tick-borne disease, so it is important for the emergency nurse practitioner (ENP) to accurately diagnose these conditions. Because of this increasing disease burden, it has become vital for these illnesses to be recognized early, as early diagnosis can reduce possible complications of chronic illness. Familiarity with the cutaneous rashes present in several tick-borne diseases can aid the ENP to effectively diagnose and treat these conditions.

This article reviews the results of a randomized controlled trial, "Rapid Agitation Control with Ketamine in the Emergency Department: A Blinded, Randomized Controlled Trial" by D. Barbic et al. (2021), comparing time to sedation, level of sedation, and adverse outcomes between intramuscular ketamine versus intramuscular midazolam and haloperidol among acutely agitated patients presenting to the emergency department (ED). The findings are discussed in the context of practice change for patient stabilization within the ED. Emergency department nurse practitioners must employ continuing education and remain current with clinical practices and treatment options to ensure that patients receive optimal safe care. Although the use of midazolam and haloperidol has historically been the first-line treatment for the acutely agitated patient, use of ketamine shows promise in providing a safe alternative for expedited patient stabilization for acutely agitated patients presenting to the ED.

A catamenial pneumothorax is a very rare condition resulting in spontaneous and recurrent pneumothoraces that occur in relationship with menses (T. Marjański et al., 2016). Although rare, emergency providers should consider this condition when female patients present to the emergency department with chest discomfort and dyspnea during menstruation. This case describes a patient who presented to the emergency department with abdominal pain who was incidentally found to have a catamenial pneumothorax on diagnostic imaging for her complaint of acute abdominal pain.