Karen Sue Hoyt

Wolters Kluwer - Lippincott

There are an estimated 2-3 million emergency department (ED) visits in the United States for eye complaints. Although most patients who present to the ED have nontraumatic eye complaints, many seek treatment for eye trauma, which is a leading cause of unilateral blindness and vison impairment. Given the prevalence of eye-related emergencies, it is...

Epigastric pain is a common complaint in patients who present to the emergency department (ED); abdominal pain is the most common chief complaint in older adult patients who request treatment by a provider (A. B. Friedman et al., 2022). These patients may experience atypical presentations, which can result in delayed or missed diagnosis altogether,...

This editorial highlights historical trends in ED practice, the role and scope of nurse practitioner (NP) practice in emergency care, and recent evidence of the emergency medicine (EM) workforce surplus to support reenvisioning the future ENP profession (American College of Emergency Physicians [ACEP], 2021; Bennett et al., 2020; Reiter & Allen, 20...

Background: Accuracy of emergency department (ED) diagnosis affects care management including tests, discharges, and readmissions. Purpose: This retrospective study compared nurse practitioners/physician assistants (NPs/PAs) with physicians (MDs/DOs) on accuracy of diagnosing Emergency Severity Index (ESI) level 3 pediatric abdominal pain (AP) i...

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 studi...

The role of the Emergency Nurse Practitioner (ENP) has evolved as a specialty and is appreciated within the context of the 2008 Consensus Model document (APRN Consensus Work Group & National Council of State Boards of Nursing APRN Advisory Committee, 2008). The first in a series of five articles, this article describes the appraisal of the ENP role...

The dynamic climate within health care policy-making and academia, in conjunction with updated Emergency Nurse Practitioner (ENP) competencies and a recent role delineation study, supports development of standardized curricula to ensure appropriate preparation for practice. Emergency NP curricular content should align with the updated ENP Practice...

The emergency nurse practitioner (ENP) specialty has grown rapidly, responding and adapting to changes within emergency care. Designation and advancement of nurse practitioner (NP) specialties follows a systematic process as defined by the profession. This includes establishment of scope and standards of practice, educational standards, and policy...

Background and purpose: A practice analysis of nurse practitioners (NPs) working in emergency care was undertaken to define their job tasks and develop a specialty certification by examination. Method: In phase I, clinical experts created a qualitative description of domains of practice, tasks performed, knowledge required, and procedures perfor...

Background/purpose: The growth of advanced practice nursing specialties requires additional expertise for practice that goes beyond entry-level competencies, knowledge, skills, and abilities. A practice standards model for specialty nurse practitioners (PSMSNPs) is introduced that differentiates entry-to-practice population foci competencies from...

Background and purpose: This retrospective study compared nurse practitioners and physician assistants (NPs/PAs) with physicians on their assignment of Emergency Severity Index level 3 (ESI level 3) acute abdominal pain (AAP) in the emergency department (ED). Methods: Data obtained from a large ED group staffing four hospitals yielded 12,440 de-...

Assessment of Acute Hand Injuries was discussed in Part I (E. Ramirez and K. S. Hoyt, 2014). Part I reviewed approaches to the assessment of the patient with a hand injury and established a process for basic identification of the hand structures and function. Approaches to history taking and specific evaluations for the hand were discussed, and exa...

Hand injuries are a frequent emergency department occurrence and account for most upper extremity injuries. Proper assessment and management of hand injuries can reduce morbidity and prevent long-term disability. "Assessment of Acute Hand Injuries" Part I was discussed in the Advanced Emergency Nursing Journal (E. G. Ramirez and K. S. Hoyt, 2014)....

Background and purpose: Our aim was to provide the outcome of a structured Model of Care (MoC) Evaluation Tool (MCET), developed by an FAANP Best-practices Workgroup, that can be used to guide the evaluation of existing MoCs being considered for use in clinical practice. Multiple MoCs are available, but deciding which model of health care delivery...

Croup, or laryngotracheobronchitis, is a common viral respiratory tract illness seen in the pediatric population (). This article describes the case of a child who presents with croup and the characteristic "steeple sign" seen on the radiograph. The patient received a diagnosis of croup secondary to the parainfluenza virus infection. It is imperati...

Many pregnancy-related dermatological problems are benign conditions such as melisma or pruritic urticarial papules and plaques of pregnancy and require only conservative measures before spontaneous postpartum resolution. However, intrahepatic cholestasis of pregnancy is one potentially dangerous condition that occurs almost specifically during pre...

The role of the nurse practitioner (NP) or physician assistant (PA) in the emergent or urgent care setting requires proficient assessment skills in addition to the constant integration of information that leads to a sound medical decision-making (MDM) process. In every patient encounter, the NP/PA must efficiently gather adequate data to formulate...

More than 140,000 hand injuries occur yearly, and an estimated 5 days of loss of work per patient occurs (). Advanced practice registered nurses (APRNs) are responsible for managing many of these injuries in primary and emergency care settings. Hand injuries are responsible for approximately 10% of all emergency department visits annually (). This...

Patients who present to the emergency department want definitive care by a health care provider who can perform an initial assessment, initiate treatment, and implement a disposition plan. The traditional "nurse triage" model often creates barriers to the process of rapidly evaluating patients. Therefore, innovative strategies must be explored to i...

This is Part II of a 2-part series on wound care and laceration repair for advanced practice nurses. In Part I, the phases and categories of wound healing were outlined. The factors that affected wound healing were also discussed along with an approach for systematic wound management. Patient assessment, special circumstances involving underlying s...

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This is part one of a 2-part series on wound care and laceration repair for advanced practice nurses. The purpose of this article is to outline the phases and categories of wound healing and to discuss factors that affect wound healing. This article also describes an approach for systematic wound management so as to decrease the risk for infection...

The Emergency Nurses Association (ENA) convened a Nurse Practitioner (NP) Validation Work Team and conducted a Delphi study to verify and gain consensus on professional and clinical competencies for NPs in emergency care. This document describes entry-level competencies for NPs practicing in emergency care, regardless of setting. A Delphi study was...

An abstract is unavailable. This article is available as HTML full text and PDF.

Ingestion of a foreign body (FB) is a common occurrence for pediatric patients presenting to the emergency department (ED) for emergent care. The purpose of this article is to present the case of a 13-month-old pediatric patient who presented to the ED with an incidental complaint (i.e., foot laceration) and was also found to have a FB in the esoph...

Mandibular fractures occur primarily as the result of blunt trauma (e.g., motor vehicular crashes, assaults). Patients not only sustain single-system injuries but they must also be managed as multisystem trauma patients. The purpose of this article is to present a case of a patient with a mandibular fracture due to a fall. Patient assessment and ma...

Mastoiditis represents one of the most clinically challenging diagnoses encountered by advanced practice nurses in emergency care. Malignant mastoiditis is a potentially fatal infection that invades and destroys underlying structures (Nuber & Muller, 2000). Management of patients with mastoiditis includes correction of underlying conditions, ear hy...

The primary responsibility of peer review is to ensure high-quality professional publications. The purpose of this article is to outline the responsibilities for both the publication and the reviewer. This article also discusses the review process and some of the benefits of the peer review process.

Knee injuries represent some of the most clinically challenging musculoskeletal disorders in emergency department patients. One of these is knee effusion. Knee joint swelling may be due to inflammation, infection, trauma, or other causes. The purpose of this article is to discuss the assessment and management of patients with knee effusions via an...

Staphylococcus aureus is a commonly found bacteria on the skin and in the nares of healthy people (Centers for Disease Control and Prevention, 2006). However, when bacteria cause an infection, it is the primary reason patients present to emergency departments with skin and soft tissue infections (SSTIs). The SSTIs have changed over the past four de...

Pericarditis is an inflammation of the pericardium frequently manifested by effusion (K. Goyle & A. Walling, 2002). Characteristic findings are found by performing an echocardiogram, chest radiograph, and electrocardiogram. Physical manifestations are usually chest pain and shortness of breath (T. Carter & C. Brooks, 2005; S. Holcomb, 2004). Viral...

Eye trauma is a common reason for emergency department visits. Eye complaints of a nontraumatic nature can also account for significant numbers of patients seeking care in the emergency department. Advanced practice nurses (APNs) are practicing in the emergency department in innovative ways to assess, diagnose, and manage eye complaints in adults a...

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 rapi...

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 rapi...

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 oft...

Thesis (Ph.D.) -- University of San Diego, 2006. Thesis committee: Diane Hatton, Chair; Susan Instone; Dorothy Kleffel--T.p.