A primer for clinical POCUS leadership in your emergency department

According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...

Donning PPE must be completed before contact with the patient. This process protects from infectious agents. The sequence and action included in each donning are critical, and the steps must be systematic to avoid exposure to pathogens. The institutional policy also needs to be followed while donning PPE. The pre-donning preparations are gathering equipment, inspecting the PPE equipment for tears, holes, or damage, removing jewelry, removing any garments below the elbows, and tying the hair...

The sequence of removing or doffing PPE starts with the gloves, as they are the most contaminated. Next is removal of the face shield or goggles, as they would interfere with removing other PPE. Then remove the gown, followed by the mask or respirator. Perform hand hygiene between steps if hands become contaminated and immediately after removing all PPE. Generally, the outside front and sleeves of the isolation gown, the goggles or the mask, the respirator, and the face shield are contaminated.

The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.

The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...