An Unusual Presentation of Intussusception

This is the case of a 9-month-old female infant who presented to the emergency department with a history of several episodes of nonbilious and nonbloody emesis. The patient was found to be afebrile with normal vital signs and an otherwise normal physical examination. Initial plain film radiography was concern for possible obstruction. Imaging studies with ultrasonogram demonstrated intussusception. This was an unusual case of intussusception because children are typically more ill-appearing with vomiting, diarrhea, fevers, lethargy, and blood in stool. Management options included surgery, pneumatic enema reduction, and barium enema reduction. Pneumatic enema reduction was performed. This procedure has been shown to have superior outcomes in infants with intussusception. Advanced practice providers need to provide a detailed history, complete a thorough physical examination, order the appropriate diagnostics, and be vigilant of the clinical manifestation of intussusception.

The San Diego County wildfires: perspectives of healthcare providers [corrected]

The wildfires of October 2003 burned a total of 10% of the county of San Diego, California. Poor air quality contributed to an increased number of patients seeking emergency services, including healthcare providers affected by smoke and ash in hospital ventilation systems. Two large hospitals with special patient populations were threatened by rapidly approaching fires and had to plan for total evacuations in a very short time frame. A number of medical professionals were forced to prioritize responding to the hospital's call for increased staff during the disaster and the need to evacuate their own homes.

Preparing for hospital site review for trauma center designation: a survey of nurse evaluators

Trauma nurse experts often are included on the professional teams who survey hospitals for trauma center designation. Evaluation of trauma nursing care includes interviews with staff and review of policies, procedures, and other documents. Medical records are reviewed to validate the verbal reports and examine compliance with protocols. Nursing often provides the "glue" for the system, which integrates medicine, ancillary departments, and administration. Hospitals may use the information gleaned from trauma nurse surveyors to prepare their personnel for a trauma site review.