Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Every year, approximately 500 000 patients in the United States present to emergency departments for treatment after an episode of self-harm. Evidence-based practices such as designing safer ED environments, safety planning, and discharge planning are effective for improving the care of these patients but are not always implemented with fidelity because of resource constraints. The aim of this study was to provide insight into how ED staff innovate processes of care and services by leveraging what is available on-site or in their communities. ⋯ Despite significant challenges in meeting the mental health needs of patients treated in the emergency department after self-harm, the staff identified opportunities to provide mental health care and services within the emergency department and leverage community resources to support patients after discharge.
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Neutrophilic dermatosis of the dorsal hands is a rare neutrophilic dermatosis that can be associated with inflammatory bowel disease, rheumatoid arthritis, and underlying malignancies. The occurrence of trauma as an initiating factor and its early features of pain and inflammation followed by blistering or ulceration mean that it can be mistaken for necrotizing infection. ⋯ A case review design was used to analyze the presentation of a woman aged 65 years in the United Kingdom, seeking care for a painful rash on the hand in the emergency department that was subsequently diagnosed as neutrophilic dermatosis of the dorsal hands. Emergency clinician awareness of neutrophilic dermatosis of the dorsal hands as a rare differential diagnosis for patients presenting with necrotic ulceration may prevent unnecessary antibiotic therapy and surgical intervention.
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Moral Dilemmas of Nurses and Paramedics During In-Flight Medical Emergencies on Commercial Airlines.
During commercial flights, in-flight medical emergencies may lead the cabin crew to request assistance from qualified health care professionals among the passengers. Although a physician's function and role are well known and virtually universal globally, the role, education, and scope of practice of nurses and paramedics varies significantly. This article analyzes the possible dilemmas that medical professionals other than physicians who assist during in-flight medical emergencies may face and presents recommendations for aviation authorities. There is an identified need for universal cross-border regulations and an awareness of legal and ethical boundaries for medical responders other than physicians on board commercial international aircraft.