Pediatric emergency department triage-based pain guideline utilizing intranasal fentanyl: Effect of implementation.

Background: Pain management guidelines in the emergency department (ED) may reduce time to analgesia administration (TTA). Intranasal fentanyl (INF) is a safe and effective alternative to intravenous opiates. The effect of an ED pain management guideline providing standing orders for nurse-initiated administration of intranasal fentanyl (INF) is not known.

Does the emergency medical treatment and labor act affect emergency department use?

Background: Emergency departments (EDs) face increasing patient volumes and economic pressures. These problems have been attributed to the Emergency Medical Treatment and Labor Act (EMTALA).

Study Objective: To determine whether modifying EMTALA might reduce ED use.

An emergency department septic shock protocol and care guideline for children initiated at triage.

Background: Unrecognized and undertreated septic shock increases morbidity and mortality. Septic shock in children is defined as sepsis and cardiovascular organ dysfunction, not necessarily with hypotension.

Objective: Cases of unrecognized and undertreated septic shock in our emergency department (ED) were reviewed with a focus on (1) increased recognition at triage and (2) more aggressive treatment once recognized.

Early recognition and treatment of shock in the pediatric patient.

Pediatric cardiopulmonary arrest is frequently a terminal event of an unrecognized progressive shock state. This article describes predisposing factors and classifications of shock as they relate to pediatric patients. It assists the experienced pediatric nurse as well as the nurse who is less experienced in caring for children in identifying early shock in this population and provides practical advice on the assessment of children.