International emergency nursing
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The role of the emergency nurse in South Africa is a challenging one due to a variety of reasons. This article describes the healthcare system of South Africa with particular attention to the emergency medical system as well as the reason why most emergency clients present to the emergency departments. The actual experience of working as an emergency nurse in South Africa is highlighted.
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Violence in the emergency department (ED) is a global problem. In our first paper, we highlighted the potential psychological effects of alcohol intoxication, the literatures discussion of alcohol related violence in the emergency department and the importance of developing positive nurse/service user relationships. In this second paper, we discuss personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.
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There are many pressures placed on Emergency Departments (EDs) and anecdotally patients with low acuity abdominal pain can spend a long time in ED waiting for treatment. ⋯ Low acuity abdominal presentations waited a significant amount of time for initiation of treatment. This convenience sample demonstrates the lack of a standardized protocol for abdominal pain presentations in the ED.
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Delirium occurs frequently among elderly patients in the Emergency Department (ED), and accurate assessment is difficult without knowledge of the patient's usual cognitive functioning. This audit was designed to determine whether routine cognitive screening of elderly patients in ED could lead to early identification of delirium. ⋯ ED nurses should routinely establish baseline cognitive functioning and assess for delirium. The AMT4 may be more suitable because of its brevity, but requires further research.
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There has been extensive coverage of acute myocardial infarction (AMI) and the acute coronary syndromes (ACS) in recent years, yet heart blocks involving the right and left bundle branches have received little coverage, despite their frequent co-existence. This article will commence with an overview of the ACS with which LBBB is synonymous, discussion on the initial management of these patients, and progress into highlighting both the clinical signs and symptoms related to the pathophysiological changes associated with blocks involving the bundle branches, and the associated electrical changes that can be identified on an electrocardiogram (ECG). The overall intension of this article is to increase practitioners' awareness and knowledge base surrounding this common clinical patient presentation and enhance clinical proficiency, thereby improving patient care and the management of patient's experiencing LBBB.