Canadian Journal of Emergency Nursing (CJEN)
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Methamphetamine intoxication and related emergency situations
Get PDFA 19-year-old male arrives by ambulance at the emergency department with a chief complaint of polysubstance abuse. He has been camping with friends for the past three days, during which he apparently consumed quantities of alcohol, Ecstasy, ‘mushrooms’ and crystal methamphetamine. His friends had called an ambulance after the patient was found unresponsive. On arrival, the patient was combative, verbally abusive, dehydrated, cold and wet. He was reported to have not slept for the past three days. During his 12-hour stay in the emergency department, he required respiratory support, intravenous fluids, benzodiazepines, physical restraints and close monitoring. He was discharged in the care of his father. Clinical management of patients with polysubstance abuse can be complicated, especially if the patient history is vague. This article will focus on acute methamphetamine intoxication and related emergency situations surrounding this drug
Randomness in nursing research - who needs it?
Get PDFThis article is one of a series in which we explore aspects of research interpretation that are relevant to emergency nurses. Here, we review the concepts of random selection and random assignment and their importance to nursing research designs. We look at the definitions of both and explore the major types of research designs. Implications for participating in research and interpreting research are suggested
What about those long, "barky" nights?
Get PDFThis article was submitted by Janielee Williamson, RN, Cochrane, Alberta. Janie is the project coordinator for a multi-centre research project across Alberta looking at the best method for disseminating practice guidelines to physicians. The project personnel are working in collaboration with the Alberta Medical Association CPG Committee to determine which method improves the delivery of best practice for children with croup, while ensuring optimum care for the child and determining which method has the best overall benefit for the health care system and the family.
All emergency department personnel are familiar with this scenario: 18-month-old boy presents to the emergency department at 2 a.m. on December 18. Parents look worried, yet they are baffled. As they tell their story, they are almost apologetic, “Really, he was much worse at home, he seems so much better since we drove to the hospital. He woke up in distress, he couldn’t breathe and he was making this awful noise when he took a breath in. And his cough – I’ve never heard anything like it – he sounded like a dog... or no, more like a seal. Really, it was terrible!”
There, in mom’s arms, is a happy, quiet boy looking around. When you try to examine him, his cry is stridorous and you hear the bark... reassuringly you smile back at the mom. “Yes, we know, and no we don’t have magic doors. HE HAS CROUP.
Head injury: the importance of trending and reporting assessments
Get PDFAn all-too-familiar scenario presents to the emergency department (ED) at 0200 involving alcohol and trauma. This time, it is a 48-year-old male who sustained an unwitnessed fall down eight stairs. He was found by family members who promptly called EMS. At the scene, EMS found the patient lying with a pool of blood around his head. Their initial neurological assessment revealed a Glasgow Coma Score (GCS) of three with unequal and sluggish pupils (Rt pupil = 2, Lt pupil = 6). EMS performed a Rapid Sequence Intubation using Rocuronium and Fetanyl. Due to the patient’s focal neurological findings, a 20-gram dose of Mannitol 20% solution was administered