Bold Voices - June 2018 - 11

AT THE BEDSIDE

* Nurse was about 93 miles from nearest medical facility
* Performed and emailed his electrocardiograms to an
emergency physician
* Self-cannulated for intravenous access

A

Nurse Treats Himself
for Myocardial
Infarction Using
Telehealth

44-year-old nurse working in a remote nursing post
in Coral Bay, Australia, treated himself for a myocardial infarction (MI) using a telehealth service.
According to "Self-Management of an Inferior ST-Segment
Elevation Myocardial Infarction," a letter to the editor in The
New England Journal of Medicine, Ryan Franks was about 93
miles from the nearest medical facility. No other medical personnel
were on duty when he began to experience MI symptoms.

* Conducted at 52 barbershops in Los Angeles County
* Study involved 319 black male patrons
* With pharmacists' intervention, barbers help reduce
patrons' blood pressure

Barbershops Help
Black Patrons Control
Hypertension

B

lack men with uncontrolled hypertension do better
with health promotion and medication management encouraged in barbershop meetings with
pharmacists.

"A Cluster-Randomized Trial of Blood-Pressure Reduction in
Black Barbershops," in The New England Journal of Medicine,
concludes that barbers can help reduce blood pressure (BP)
among non-Hispanic black men when they encourage drug
therapy from specialty-trained pharmacists. "Pharmacists
made drug therapy convenient by bringing it to the
barbershop."
Conducted at 52 barbershops in Los Angeles County, the study
involved 319 black male patrons, ages 35 to 79, with systolic

The nurse performed and
"I was seeing the
emailed his electrocardiograms
situation from both
to an emergency physician
the patient and the
via the Emergency Telehealth
Service (ETS), which the Western
nurse situation all
Australian Department of Health
the time."
initiated in 2012 to provide care for
-Heart attack survivor,
isolated communities.
Coral Bay nurse Ryan Franks
After receiving the results,
the nurse self-cannulated for intravenous access "and
self-administered aspirin, clopidogrel, sublingual nitroglycerin, intravenous heparin, and opiates." He prepared for
thrombolysis and interacted with ETS via video in real time.
After thrombolysis, the ST-segment elevation and symptoms
resolved. The Royal Flying Doctor Service then transferred him
to a tertiary cardiology unit in Perth, about 600 miles away.
Angiography showed "severe stenosis in the mid-right
coronary artery with blood flow of thrombolysis in myocardial
infarction (TIMI) grade 3 and mild left ventricular systolic
dysfunction." A stent was inserted "and his residual moderate
coronary artery disease was managed medically." The nurse
was discharged two days later and continued therapy. d
REFERENCE: Lee F, Maggiore P, Chung K. Self-management of an inferior ST-segment elevation
myocardial infarction. N Engl J Med. 2018;378(10):960-962. Quote: Government of Western
Australia, Department of Health

BP of 140 mm Hg or higher. Barbershops were assigned to either
a pharmacist-led intervention "in which barbers encouraged
meetings in barbershops with specialty-trained pharmacists who
prescribed drug therapy" or an active control approach, "in which
barbers [only] encouraged lifestyle modification and doctor
appointments."
Baseline mean systolic BP was 152.8 mm Hg in the intervention
group and 154.6 mm Hg in the control group. "At 6 months, the
mean systolic blood pressure fell by 27.0 mm Hg (to 125.8 mm Hg)
in the intervention group and by 9.3 mm Hg (to 145.4 mm Hg) in
the control group," the study reveals.
"Nearly two-thirds of the men who got the drug therapy achieved
a healthy blood pressure of less than 130/80 mm Hg, while only
about 12 percent of the second group did," adds a related article
in Kaiser Health News.
"We all expected the intervention to be effective, but I don't
think any of us could have predicted the magnitude of the effect
we ultimately saw," pharmacist and study co-author Ciantel
Adair Blyler says in the related article. "When you meet people
where they are, there is a different level of trust and respect that's
earned," she says. "I think that's why this intervention was ultimately so successful." d
REFERENCE: Victor RG, Lynch K, Li N, et al. A cluster-randomized trial of blood-pressure
reduction in black barbershops [published online March 12, 2018]. N Engl J Med. doi:10.1056/
NEJMoa1717250.

www.aacnboldvoicesonline.org 11


http://www.nejm.org/doi/full/10.1056/NEJMc1716701 http://www.nejm.org/doi/full/10.1056/NEJMc1716701 https://www.khn.org/news/black-mens-blood-pressure-is-cut-along-with-their-hair/ https://www.khn.org/news/black-mens-blood-pressure-is-cut-along-with-their-hair/ http://www.nejm.org/doi/full/10.1056/NEJMoa1717250?query=featured_home& http://www.nejm.org/doi/full/10.1056/NEJMoa1717250?query=featured_home& http://www.aacnboldvoicesonline.org

Table of Contents for the Digital Edition of Bold Voices - June 2018

Urine
The Power of Possibility
Sepsis: What Nurses Can Do
New Sepsis Bundle From Surviving Sepsis Campaign
Understanding CERPs for Specialty Certification Renewal
In Our Journals
Transitions
America’s ‘Other’ Drug Problem Needs Attention
Effect of Haloperidol on Reducing Mortality
Transitional Care Nurses Can Reduce Admissions of Older Patients
ASHP Developing Standardized Medication Concentrations
Online AACN Course on Care of Older Adults
Hospital Programs Help Employees Cope With Traumatic Events
National Summit on Identification, Prevention and Management of Burnout
Barbershops Help Black Patrons Control Hypertension
Nurse Treats Himself for Myocardial Infarction Using Telehealth
We Have Consensus: TeleICU Continues to Evolve
Cooking Classes Help Patients With CHF
Beware of Chicken Nuggets — and Other Ultra-Processed Foods
Apple Watch Might Randomly Reboot in ICUs
Wound-Monitoring App Helps Reduce Hospital Readmissions
All Antidepressants Beat Placebo for Acute Major Depressive Disorder
Patients’ Online Search Trends
‘Timeout’ Reduces Medication Errors
Possible Link Between High Fitness and Reduced Risk of Dementia
DAISY Award Honors Nurses Who Exemplify Exceptional Compassion and Skill
Interviews With Two Acute Care Nurse Practitioners
Hiring for Cultural Fit
AACN Unveils Updated Online Pharmacology Course
Appreciating the Little Things
Bold Voices - June 2018 - Cover1
Bold Voices - June 2018 - Cover2
Bold Voices - June 2018 - Urine
Bold Voices - June 2018 - The Power of Possibility
Bold Voices - June 2018 - New Sepsis Bundle From Surviving Sepsis Campaign
Bold Voices - June 2018 - Understanding CERPs for Specialty Certification Renewal
Bold Voices - June 2018 - Transitions
Bold Voices - June 2018 - Effect of Haloperidol on Reducing Mortality
Bold Voices - June 2018 - Online AACN Course on Care of Older Adults
Bold Voices - June 2018 - National Summit on Identification, Prevention and Management of Burnout
Bold Voices - June 2018 - Nurse Treats Himself for Myocardial Infarction Using Telehealth
Bold Voices - June 2018 - We Have Consensus: TeleICU Continues to Evolve
Bold Voices - June 2018 - 13
Bold Voices - June 2018 - Beware of Chicken Nuggets — and Other Ultra-Processed Foods
Bold Voices - June 2018 - Wound-Monitoring App Helps Reduce Hospital Readmissions
Bold Voices - June 2018 - Patients’ Online Search Trends
Bold Voices - June 2018 - Possible Link Between High Fitness and Reduced Risk of Dementia
Bold Voices - June 2018 - DAISY Award Honors Nurses Who Exemplify Exceptional Compassion and Skill
Bold Voices - June 2018 - 19
Bold Voices - June 2018 - Hiring for Cultural Fit
Bold Voices - June 2018 - AACN Unveils Updated Online Pharmacology Course
Bold Voices - June 2018 - Appreciating the Little Things
Bold Voices - June 2018 - Cover3
Bold Voices - June 2018 - Cover4
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