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Assessment and treatment of cutaneous leishmaniasis in the emergency department.Cutaneous leishmaniasis is endemic in more than 70 countries worldwide. It is a non-fatal disease caused by the Leishmania parasite that is transmitted to humans via bites of infected female sandflies. Cutaneous leishmaniasis causes skin lesions on areas of exposed skin, such as the face and limbs, which often produce scarring and atrophy. If untreated, cutaneous leishmaniasis can develop into mucocutaneous leishmaniasis, which is potentially life-threatening. Furthermore, patients with cutaneous leishmaniasis commonly experience psychosocial issues such as anxiety, distress, stigma and rejection. Cutaneous leishmaniasis is spreading outside of its traditional endemic areas because of the effects of environmental changes such as urbanisation and climate change. In the UK, healthcare professionals may encounter the disease in migrants from endemic areas, members of the armed forces, tourists and expatriates. Therefore, emergency nurses need to be able to assess and support patients who present with symptoms suggestive of cutaneous leishmaniasis. This article provides an overview of the epidemiology, aetiology, pathophysiology, clinical presentation, diagnosis, treatment and prevention of the disease.
Lyme’s Disease: Recognition and Management for Emergency NursesOver the last 10 years there has been a significant rise in the numbers of patients who present to the Emergency Department (ED) with a diagnosis of Lyme disease. Although some patients may remain asymptomatic a significant number of patients present with a rash focused around a previous tick bite. Others may present with a wide range of debilitating symptoms that can be very problematic, if left untreated. Due to the growing prevalence of Lyme disease within the United Kingdom (UK) and the US, this article offers an overview of the vector borne nature of this illness and provides the Emergency Nurse with information on the pathophysiology, prevention, presenting symptoms, and management of Lyme disease.
Nerve agents: A guide for emergency nurses. Part 1Recent incidents in the UK and the alleged chemical attacks in Syria by the Bashar al-Assad regime have brought the subject of chemical weapons back into the public domain. To date these types of event have been relatively rare because terrorist plans to harm large numbers of people have mostly been thwarted. This is the first part of a two-part article on nerve agents. Part one gives an overview of these agents, their historical background and manufacture, and how the agents affect physiology. Part two, which will appear in the next issue, considers the pre-hospital response to the use of nerve agents, including effective triage and decontamination, and in-hospital treatment.
Responding to nerve agent poisoning: A guide for emergency nurses. Part 2The release of chemical agents can cause loss of life and result in major incidents. Chemical agent-related major incidents require a modified response by emergency services due to the chemicals’ transmissibility, lethality, latency and persistence. In general, modifications to casualty flow, triage and treatment are made to reduce transmissibility, and lethality of chemical hazards. This article, the second of a two-part series on nerve agents, describes the adapted response and explains how emergency nurses must be familiar with principles of care including incident and casualty management.