Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Prediabetes is an important public health issue. In 2011, 79 million Americans had prediabetes, and 7 million were undiagnosed. By 2025, the number of persons with prediabetes is projected to increase to 472 million globally. For many, the emergency department may be the only source of medical care or interaction with a health care provider. This makes the emergency department an ideal place to identify individuals with elevated random blood glucose levels, inform them of the elevation, and refer them for follow-up. ⋯ Emergency nurses and providers care for patients with elevated blood glucose levels who may have undiagnosed prediabetes. The finding that only 1 patient with an elevated glucose level was informed and referred for follow-up indicates opportunities to address this population of patients who are being missed. Failing to inform and provide referral minimizes patients' abilities to make relevant lifestyle changes to help prevent or delay progression to type 2 diabetes.
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The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED.
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The ED and Behavioral Health (BH) department developed a behaviorally-based alcohol intoxication scale (AIS) to assess when patients can be transferred to the BH unit from the ED rather than using blood alcohol levels. The purpose of this study was to determine the reliability and validity of the scale. A secondary purpose was to determine whether there was any correlation between blood alcohol level and the alcohol intoxication scale. ⋯ This study showed preliminary support for using a behaviorally-based assessment as a basis for transferring patients to the BH unit. More studies are needed to further substantiate the reliability and validity of this measure as a tool to accurately assess stability for transfer to a BH unit.