Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
-
Immunoglobulin A vasculitis is historically more commonly found in children after certain viral infections such as Epstein-Barr, varicella virus, and parvovirus B19. COVID-19 has not been formally established in literature as a trigger for immunoglobulin A vasculitis. However, a main pathogenetic mechanism of COVID-19 is vascular damage, which makes it likely that vasculitis associated with COVID-19 (ie, COVID-19-mediated immunoglobulin A vasculitis) could be biologically plausible, with serious implications, especially for adults. The purpose of this review is to assist emergency nurses in gaining knowledge on the pathophysiology, symptoms, and treatment of COVID-19-mediated immunoglobulin A vasculitis. ⋯ The analysis of published clinical cases showed that COVID-19-associated immunoglobulin A vasculitis affected mostly adults and was characterized by a more severe course because of renal involvement. COVID-19 may be a possible trigger for immunoglobulin A-related disorders. More research is needed to better understand the relationship between immunoglobulin A vasculitis and COVID-19.
-
Calcium chloride is commonly used in emergency departments in the treatment of a variety of emergencies. Historically, administration via central venous catheters has been preferred owing to its high osmolarity and vesicant properties. Although preferred, central access may not always be available in time-sensitive, emergent situations leading to many instances of peripheral administration. The objective of this analysis was to evaluate the charted safety of peripheral venous administration of 10% calcium chloride. ⋯ This study demonstrated that administration of 10% calcium chloride via peripheral venous catheters may be feasible and seemed to carry a low incidence of documented complications. Further prospective studies are needed to confirm study observations.
-
ED health care professionals are at the frontline of evaluation and management of patients with acute, and often undifferentiated, illness. During the initial phase of the SARS-CoV-2 outbreak, there were concerns that ED health care professionals may have been at increased risk of exposure to SARS-CoV-2 due to difficulty in early identification of patients. This study assessed the seroprevalence of SARS-CoV-2 antibodies among ED health care professionals without confirmed history of COVID-19 infection at a quaternary academic medical center. ⋯ At this quaternary academic medical center, among those who volunteered to take an antibody test, there was a low seroprevalence of SARS-CoV-2 antibodies among ED clinicians who were asymptomatic at the time of blood draw and not known to have had prior COVID-19 infection.
-
Coronavirus disease 2019 was declared a national emergency in the United States on March 13, 2020, at which time the Children's National Hospital Emergency Department in Washington, DC, mobilized to develop and implement a unit-based Incident Command System. Anticipating that the unique and challenging nature of this pandemic might require a large interprofessional team, emergency nurses, emergency physicians, and emergency physician assistants were placed in traditional Incident Command System roles to provide an organizational framework for the ED response. This framework served multiple purposes but most importantly it helped to efficiently streamline and coordinate communications within the emergency department, with hospital leadership and with other hospital departments. ⋯ This paper highlights a unique concept of applying the Incident Command System model to a single hospital department in a disaster scenario, using existing ED staff to function in various roles not typically held during regular operations. Given that policies and procedures can be ever-changing during a pandemic, emergency departments can implement an interprofessional incident command structure to provide a framework for communications and operational planning that allows for agility based on evolving priorities. The Children's National Hospital ED Incident Command System model established during the coronavirus disease 2019 pandemic can serve as a guide for other emergency departments during a disaster response.