Articles: emergency-department.
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Nurses in the emergency department often encounter patients exhibiting signs of aggressive behavior. Nurses need to know the pharmacologic treatment appropriate for the patient scenario to ensure safety for the patient and the emergency department team. ⋯ After each case review is a discussion about the appropriate pharmacologic therapy for that patient. The cases portrayed are fictional but based on experience and previous observations.
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Emergency nurses, physicians, and patients experience occurrences of workplace violence. Having a team to respond to escalating behavioral events provides a consistent approach to reducing occurrences of workplace violence and increasing safety. The purpose of this quality improvement project was to design, implement, and evaluate the effectiveness of a behavioral emergency response team in an emergency department to reduce occurrences of workplace violence and increase the perception of safety. ⋯ Postimplementation, participants reported an increase in the perception of safety. Implementation of a behavioral emergency response team was effective in reducing assaults toward emergency department team members and increasing the perception of safety.
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Multicenter Study
Effectiveness and reliability of the 4-step STANDING algorithm performed by emergency interns and seniors for predicting central causes of vertigo.
For emergency physicians (EPs), acute vertigo is a challenging complaint and learning a reliable clinical approach is needed. STANDING is a four-step bedside algorithm that requires (1) identifying spontaneous nystagmus with Frenzel glasses or, alternatively, a positional nystagmus; (2) characterizing the nystagmus direction; (3) assessing the vestibuloocular reflex (head impulse test); and (4) assessing the gait. The objective was to determine its accuracy for diagnosing central vertigo when using by naïve examiners as such as interns and its agreement with senior EPs. ⋯ With a single training session, the algorithm reached high accuracy and reliability for ruling out central causes of vertigo in the hands of both novices and experienced EPs. A future multicenter randomized controlled trial should further its impact on unnecessary neuroimaging use and patient's satisfaction.