Mild Traumatic Brain Injury in the Emergency Department: A Clinical Practice Gap.

This article, "Concussion Care in the Emergency Department: A Prospective Observational Brief Report," by seeks to examine current clinician practice patterns related to the evaluation and management of patients identified as at risk for a sustained mild traumatic brain injury (mTBI). The findings are discussed in the context of an evaluation and management gap surrounding mTBI care among emergency department (ED) providers at a Level I trauma and emergency care center. Although variabilities exist among mTBI care in the ED, provider education, standardization of guidelines, and implementation practices are strategies for increasing the uptake of care in the ED for patients presenting with mTBI.

Are Antibiotics Useful in Acute Chronic Obstructive Pulmonary Disease Exacerbations? Implications for APRN Practice.

The Research to Practice column aims to provide advanced practice registered nurses (APRNs) with an analysis of current research topics with implications for practice change within emergency care settings. The article, "Antibiotics for Exacerbations of Acute Chronic Obstructive Pulmonary Disease?" conducted by D. Vollenweider, A. Frei, C. Streurer-Stey, J. Garcia-Aymerich, and M.A. Puhan (2018), examines a Cochrane systematic review and meta-analysis of randomized controlled trials. The investigators evaluate the findings that compare clinical outcomes including adverse events, re-exacerbation, treatment failure, and mortality among intensive care unit patients, inpatient, and outpatient populations treated with antibiotics or placebo medications for acute chronic obstructive pulmonary disease (COPD) exacerbations. The findings are discussed in the context of narrowing the evidence gap to improve clinical recommendations. Their findings have implications for APRN practice, including the signs and symptoms associated with an underlying bacterial triggered COPD exacerbation and the patient populations most likely to benefit from antibiotic therapy.