Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Although major strides have been made with regard to organ and tissue donation, there continues to be a lack of available donors. Currently more than 100,000 persons are awaiting a life-saving transplant, and 1 million others have conditions such as blindness, dermal burns, and malfunctioning heart valves that could be improved with a tissue transplant. Because approximately 40 persons can benefit from just one donor and because many families are comforted knowing that their loved one was able to help others in need, tissue donation efforts are a priority for health care professionals. ⋯ This article discusses the development and implementation of a tissue donation advocacy program in a rural emergency department. Planning, training, and recommendations for others wishing to implement a similar program are highlighted. Preliminary outcome information and planned evaluations are included.
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Randomized Controlled Trial Comparative Study
Hemolysis of coagulation specimens: a comparative study of intravenous draw methods.
Hemolysis of blood samples creates significant delays in the treatment and disposition of patients in the emergency department. The purpose of this study was to compare the hemolysis rates of coagulation blood samples obtained during insertion of an intravenous (IV) catheter without (group 1) or with (group 2) extension tubing connected to the IV catheter hub. A secondary purpose of this study was to determine whether the investigators could predict whether a coagulation sample was hemolyzed based on visual observation during the specimen withdrawal process. ⋯ High hemolysis rates occurred equally when coagulation blood samples were drawn via a peripheral IV catheter either at the hub or through extension tubing. Emergency nurse investigators could not accurately predict by visualization whether a coagulation sample was hemolyzed at the time of blood withdrawal. Venipuncture as the preferred method of blood draw is an industry recommendation. This method has been shown in prior experimental studies to reduce hemolysis rates to less than 4%. Therefore, if hemolysis rates are a concern, one should consider obtaining blood whenever possible through a venipuncture rather than through an IV catheter. Replication studies are needed to determine whether the findings of this study can be generalized to the larger population.
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The American Heart Association and other scientific guidelines recommend emergency medical services acquire prehospital (PH) electrocardiography (ECG) in all patients with symptoms of acute coronary syndrome. The purpose of this article is to critically review the scientific literature about PH ECG. ⋯ PH ECG plays a major role in emergency cardiac systems of care and can facilitate early intervention by identifying patients with acute coronary syndrome sooner.