What the Advanced Practice Nurse in the Emergency Department Needs to Know About the Health Risks and Hazards of...

Despite the decline in traditional tobacco use among teens and young adults, the rapid increase in electronic cigarette (EC) use has filled the gap, raising concern that this will usher in a new generation of tobacco users. Although long-term effects have not been clearly established, EC use is not without risks or hazards that may be encountered by the advanced practice nurse in the emergency department (ED). The ED presents an opportune moment for health promotion and risk reduction education for patients and families, but there are also dangers to EC use that the practitioner should be aware of and prepared to manage. Nicotine, found in most EC liquids, is well known to be a neurotoxin that affects brain development in young people. It is important to inform young people and families that EC products may contain not only nicotine but also other harmful chemicals and are not just harmless water vapor. Other toxins found in EC liquids and vapors raise questions about the health impact of long-term EC use and add additional concerns for secondhand exposure for children and pregnant women. The EC is also used by youth to inhale concentrated forms of cannabis, which could be a precursor to EC use for other illicit drugs. Hazards to be prepared for in the ED are accidental ingestion of EC liquids by children and intentional overdose of concentrated liquids. Severe injuries have been reported from explosions of EC devices as well. The ED is a starting point for EC screening and education of young people and families. Advanced practice nurses must also anticipate and be prepared to handle any other untoward effects from exposures to devices and liquids. The purpose of this article is to inform and prepare advanced practice nurses with the latest information to manage these patient encounters.