Sheehy's Manual of Emergency Care (Newberry, Sheehy's
Manual of Emergency Care)
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Table of Contents
Title page
Copyright
Dedication
Contributors
Previous Contributors
Reviewers
Preface
Acknowledgments
Unit 1: Basic Emergency Issues
Chapter 1: Legal Issues for Emergency Nurses
Nurse Practice Acts
Unlicensed Assistive Personnel
Confidentiality and HIPAA Regulations
EMTALA and Interfacility Transfers
Consent
Reportable Conditions
Documentation
Unusual Events
Restraints
Advance Directives
Forensics: Evidence Collection and Preservation
Violence and Workplace Safety
Chapter 2: Workplace Violence and Disruptive Behavior
Disruptive Behavior from Patients and Families
Violence
De-escalation11,12
Administrative Policies13
Other Considerations
Clinician Disruptive Behavior
Chapter 3: Mass Casualty Incidents
Defining a Disaster
Disaster Nursing
Emergency Management
3
Chapter 4: Patient Safety in the Emergency Department
What Is Patient Safety?
Building a Culture of Safety
System Challenges
Pediatric Safety Issues
A “Just Culture”
Disruptive Behavior
Reporting Medical Errors
Resources
Chapter 5: Ethical Dilemmas in Emergency Nursing
Ethical Frameworks for Decision Making1,2
Principles1–3
Code of Ethics
Decision Making
Specific Situations
Reflection: Handling Difficulties with Integrity and Ethics
Chapter 6: Forensics
Basics of Forensics
Special Considerations
Handling and Disposition of Evidence
Forensic Nursing Opportunities
Unit 2: Basic Clinical Issues
Chapter 7: Triage
Environment
Triage Systems
Triage Severity Rating Systems
The Triage Process
Emergency Medical Treatment and Active Labor Act
Left Without Being Seen
The Joint Commission
Infection Control
Managing the Waiting Room
Telephone Triage
Triage Qualifications
The Triage Role
Chapter 8: Airway Management
Assessment
4
History
Airway Emergencies
Airway Management
Ventilation of the Emergency Patient
Chapter 9: Cardiopulmonary Arrest
Management of Cardiopulmonary Arrest
The Team Approach
Family Presence During Resuscitation
Specific Causes of Cardiac Arrest
Traumatic Cardiopulmonary Arrest
Cardiopulmonary Arrest in the Pregnant Woman
Patient Management Following Successful Resuscitation
Chapter 10: Intravenous Therapy
Intravenous Fluids and Medications
The Infusion System
Vascular Access Devices
Catheter Insertion
Accessing Implanted Ports
Assessing the Catheter
Obtaining Blood Samples From Vascular Access Devices
Removing Central Venous Catheters
Vascular Access Devices Complications
Chapter 11: Care of the Patient with Pain
Types of Pain
Pain Assessment
Providing Comfort for the Patient in Pain
Summary
Chapter 12: Substance Abuse
Anabolic Steroids
Cocaine
Heroin
Inhalants
Phencyclidine
“Club” Drugs
Prescription Drug Abuse
Prevention Strategies and Treatment Modalities
Chapter 13: Alcohol Abuse
5
Alcohol Screening
General Assessment2
Alcohol-Related Conditions
Alcohol and Special Populations
Chapter 14: Wound Management
General Principles of Wound Management
Wound Assessment
Treatment Considerations
Wound Management by Type
Chapter 15: Procedural Sedation
Use of Procedural Sedation in the Emergency Department
Assessment, Preparation, and Continuous Monitoring for Procedural Sedation
Considerations in Pediatric Sedation
Pharmacological Options for Moderate Sedation
Postsedation Recovery and Discharge
Chapter 16: Laboratory Specimens
General Principles of Specimen Collection
Blood Collection Procedures
Other Specimen Collection
Common Laboratory Results
Chapter 17: End-of-Life Issues for Emergency Nurses
End-of-Life Decisions
Common Medical Emergencies at the End of Life
Organ and Tissue Donation
Death Notification and Postmortem Care
Pediatric Death
Unit 3: Common Non-Traumatic Emergencies
Chapter 18: Respiratory Emergencies
Respiratory Assessment
Asthma Exacerbations
Acute Bronchitis
Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Community-Acquired Pneumonia
Pleural Effusion
Spontaneous Pneumothorax
Pulmonary Embolism
Noncardiogenic Pulmonary Edema
6
Acute Respiratory Distress Syndrome
Submersion Injury
Carbon Monoxide Poisoning
Mechanical Ventilation in the Emergency Department
Prevention of Respiratory Contamination
Chapter 19: Cardiovascular Emergencies
Assessment of Chest Pain
Diagnostic Procedures
Specific Cardiac Emergencies
Chapter 20: Shock
Pathophysiology
Stages of Shock
Monitoring the Patient in Shock
Types of Shock
End Points of Shock Resuscitation
Chapter 21: Sepsis
Definitions11
Identifying SIRS or Sepsis
Early Goal-Directed Therapy: Initial Resuscitation and the First Six Hours
Goals of Continuing Therapy
Ongoing Evaluation
Pediatric Considerations
Patient and Family Support
Considering Limitation of Support
Chapter 22: Infectious Diseases
Isolation Precautions
Blood-Borne Infections2
Airborne Infections
Water-Borne and Food-Borne Infections
Vector-Borne Infections
Dermal Infections
Miscellaneous Infections
Chapter 23: Hematologic and Immunologic Emergencies
Hematologic Emergencies
Hematologic Malignancies
Immunologic Emergencies
Oncologic Emergencies
7
Chapter 24: Stroke
Initial Assessment Tools
Ischemic Stroke
Transient Ischemic Attack
Hemorrhagic Stroke
Chapter 25: Neurologic Emergencies
Neurologic Assessment
Selected Emergencies
Chapter 26: Facial, ENT, and Dental Emergencies
Facial Emergencies
Ear, Nose, and Throat Emergencies
Dental Emergencies
Body Piercing of the Face, Ears, and Tongue
Chapter 27: Ocular Emergencies
Determining Visual Acuity
Conjunctivitis (Pink Eye)
Infections of the Eyelids and Cornea
Corneal Abrasion and Corneal Ulcer
Uveitis
Ocular Foreign Body
Ocular Burns
Central Retinal Artery Occlusion
Acute Retinal Detachment
Acute Angle Closure Glaucoma
Chapter 28: Abdominal Pain and Emergencies
Initial Evaluation
Specific Abdominal Emergencies
Chapter 29: Metabolic Emergencies
Diabetic Emergencies1–4
Pituitary Emergencies
Thyroid Emergencies
Adrenal Emergencies
Electrolyte Disorders7,9,15
Chapter 30: Toxicologic Emergencies
General Priorities for Poisoned Patients
Identifying the Poison
Therapeutic Interventions for Poisonings and Overdoses
8
Specific Toxicologic Emergencies
Currently Available Antidotes
Prevention and Education
Chapter 31: Environmental Emergencies
Cold-Induced Injuries
Heat-Induced Illnesses8–13
Lightning Injuries14–21
Diving Emergencies24–28
High Altitude Pulmonary Edema29
Chapter 32: Bite and Sting Emergencies
Rabies
Tick-Borne Illnesses
Snakebites
Spider (Arachnid) Bites
Scorpion Stings
Bee, Wasp, Hornet, and Fire Ant Stings13
Marine Bites and Envenomations
Chapter 33: Genitourinary Emergencies
Problems of the Urinary Tract
Genitourinary Problems Unique to Males
Emergencies in Dialysis Patients
Chapter 34: Sexually Transmitted Infections
Patient History and Assessment
Selected Emergencies
Unit 4: Trauma
Chapter 35: Assessment and Stabilization of the Trauma Patient
The Trauma System
Approach to Care of the Trauma Patient
The Primary Assessment
The Secondary Assessment
Reevaluation and Assessment
Chapter 36: Head Trauma
Physical Assessment of the Head-Injured Patient
Diagnostic Procedures
Management of Patients with Severe Traumatic Brain Injuries
Specific Head Injuries
Special Considerations
9
Chapter 37: Spinal Cord and Neck Trauma
Spinal Cord Injuries
Specific Vertebral and Spinal Cord Injuries
Trauma to the Neck
Chapter 38: Chest Trauma
Immediately Life-Threatening Chest Injuries
Potentially Life-Threatening Chest Trauma
Non–Life-Threatening Chest Trauma
Chapter 39: Abdominal Trauma
Blunt Trauma
Penetrating Trauma
Physical Assessment of the Abdomen
Diagnostic Procedures
Therapeutic Interventions
Specific Organ Injuries
The Pregnant Patient with Abdominal Trauma
Chapter 40: Musculoskeletal Trauma
Initial Assessment
Emergency Care of an Injured Extremity
Acute Musculoskeletal Injuries
Chapter 41: Facial, Ocular, ENT, and Dental Trauma
Primary Assessment
Secondary Assessment
Facial Soft Tissue Trauma
Auricular Trauma
Ruptured Tympanic Membrane
Facial Fractures
Dental Trauma
Ocular Trauma
Chapter 42: Burns
Etiology
Pathophysiology
Triage Assessment
Primary Assessment
Secondary Assessment
Fluid Resuscitation
Pain Management
10
Wound Care
Additional Interventions
Assessing for Maltreatment
Interaction with Patients and Families
Chapter 43: Obstetric Trauma
Epidemiology and Priorities of Care
Assessment of the Obstetric Trauma Patient
Specific Obstetric Emergencies
Chapter 44: Pediatric Trauma
Assessment and Treatment of the Pediatric Trauma Patient
Specific Pediatric Injuries
Prevention of Pediatric Trauma
Chapter 45: Geriatric Trauma
The Impact of Trauma
Barriers to Trauma Care in the Older Adult
Mechanisms of Injury
Approach to the Geriatric Trauma Patient
Assessment
Diagnostic Procedures
Therapeutic Interventions
Injury Prevention
Unit 5: Special Populations
Chapter 46: Obstetric Emergencies
Complications of Pregnancy
Emergent Delivery
Complications of Delivery
Chapter 47: Gynecologic Emergencies
Abnormal Uterine Bleeding
Pelvic Pain
Gynecologic Infections
Infections of the External Genitalia
Contraceptive Emergencies
Chapter 48: Mental Health Emergencies
Mental Health Triage
Mental Health Assessment
General Approach to the Patient
Mental Health Emergencies Without Psychoses
11
Mental Health Emergencies With Psychoses
The Violent Patient
Mental Health Emergencies Due to a Medical or Neurologic Disorder
Drug-Related Mental Health Emergencies
Adverse Reactions to Psychiatric Drugs
Pediatric Mental Health Emergencies
Mental Health Patient Disposition
Chapter 49: Abuse and Neglect
Child Maltreatment
Munchausen Syndrome by Proxy
Elder and Dependent Adult Abuse
Chapter 50: Intimate Partner Violence
Types of Intimate Partner Violence
Identifying Intimate Partner Violence
Advocacy and Support Services
Legal Obligations
Making an Impact
Chapter 51: Sexual Assault
General Approach
History
Physical Assessment
Diagnostic Procedures
Therapeutic Interventions
Emotional Support for Sexual Assault Victims
Follow-Up
Chapter 52: Pediatric Considerations in Emergency Nursing
Pediatric Triage (Prioritization of Care)
Medication Administration and Intravenous Therapy
Pediatric Cardiopulmonary Arrest
General Pediatric Emergencies
Respiratory Emergencies
Neurologic Emergencies
Gastrointestinal Emergencies
Chapter 53: Geriatric Considerations in Emergency Nursing
Age-Related Changes Affecting Vulnerability
Cross-Cultural Issues in the Elderly
Quality Indicators for Older Adult Emergency Care
12
Primary Assessment of the Geriatric Patient
Secondary Assessment of the Geriatric Patient
Chapter 54: Considerations for the Patient with Morbid Obesity
Assessing and Treating the Special Needs of the Patient with Morbid Obesity
Staff Safety
Disease Risk in the Obese Population
Pediatric Considerations
Disease Risk in the Obese Pediatric Population
Index
13
Copyright
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St. Louis, Missouri 63043
SHEEHY’S MANUAL OF EMERGENCY CARE ISBN 978-0-323-07827-6
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
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Previous editions copyrighted 2005, 1999, 1995, 1990, 1984, 1979
Library of Congress Cataloging-in-Publication Data or Control Number
Sheehy’s manual of emergency care / Emergency Nurses Association.—7th ed. / edited by Belinda B.
Hammond, Polly Gerber Zimmermann.
p. ; cm.
Manual of emergency care
Includes bibliographical references and index.
ISBN 978-0-323-07827-6 (pbk. : alk. paper)
I. Hammond, Belinda Burns. II. Zimmermann, Polly Gerber. III. Sheehy, Susan Budassi, 1948-
Manual of emergency care. IV. Emergency Nurses Association. V. Title: Manual of emergency care.
[DNLM: 1. Emergency Medical Services—Handbooks. 2. Emergency Medicine—
Handbooks. 3. Emergency Nursing—Handbooks. WX 39]
14
616.02′5–dc23
2011040164
Senior Editor: Sandra E. Clark
Associate Developmental Editor: Jennifer Palada
Consulting Developmental Editor: Sophia Oh Gray
Publishing Services Manager: Jeff Patterson
Project Manager: Bill Drone
Design Manager: Teresa McBryan
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
15
Dedication
To Gail Lenehan—
You have inspired so many emergency nurses because of your caring, mentoring, passion, advocacy, support, and
friendship. Thank you for being our leader and role model.
16
Contributors
Maria E. Albright, MSN, APRN, ACNS-BC, CMSRN
Clinical Nurse Specialist for Acute Care
Ochsner Medical Center
New Orleans, Louisiana
Colleen Andreoni, MSN, ANP-BC, CEN
Assistant Professor
Loyola University Chicago, Niehoff School of Nursing
Chicago, Illinois;
Nurse Practitioner
Loyola University Health System
Maywood, Illinois;
Nurse Practitioner
Delnor Community Hospital
Geneva, Illinois
Randal Bryan Badillo, BSN, RN, CSPI
Clinical Supervisor Oklahoma Poison Control Center
University of Oklahoma College of Pharmacy
Oklahoma City, Oklahoma
Sharon L. Biby, MSN, BSN, ANP-BC, GNP-BC
Stroke Center Nurse Practitioner
Moses H. Cone Hospital
Greensboro, North Carolina
Shelley A. Calder, MSN, RN, CEN
Clinical Nurse Specialist, Emergency Department
Beth Israel Deaconess Medical Center
Boston, Massachusetts
C.J. Carringer, MSN, RN, CEN, CCRN
Policy and Procedure Coordinator
Patient Disability Officer
Piedmont Medical Center
Rock Hill, South Carolina
Sharon Saunderson Cohen, MSN, RN, CEN, CCRN
Adjunct Faculty
Broward, College
Davie, Florida;
Guest Speaker
Nova Southern University
Davie, Florida;
Interim Director and Clinical Nurse Specialist
Emergency Preparedness Department
Broward Health
Fort Lauderdale, Florida
17
Shelley Cohen, MSN, RN, CEN
Educator/Consultant
Health Resources Unlimited
Hohenwald, Tennessee;
PRN Staff Emergency Department Nurse
Williamson Medical Center
Franklin, Tennessee
Linda K. Cook, PhD, RN, APRN-BC, CCRN, CCNS, ACNP
Professor, Nursing
Prince George’s Community College
Largo, Maryland;
Staff Nurse
Doctors Community Hospital
Lanham, Maryland
Laura M. Criddle, PhD, RN, ACNS-BS, CEN, CFRN, CCRN, CPEN, CNRN, ONC, FAEN
Affiliate Professor and Clinical Nurse
Oregon Health and Science University, School of Nursing
Portland, Oregon
Tina D. Cronin, MSN, RN, CNS, CCRN, CNRN
Director of Neurosciences
Piedmont Medical Center
Rock Hill, South Carolina
Megan DeVries, BSN, RN, NE-BC
Clinical Nurse Manager
Spectrum Health Regional Burn Center
Grand Rapids, Michigan
Jeanne Eckes-Roper, MBA, RN
Adjunct Instructor
Barry University
Miami Shores, Florida;
Adjunct Instructor
Broward College
Fort Lauderdale, Florida;
Specialty Registered Nurse
Emergency Department
Memorial Hospital Miramar
Miramar, Florida
Darcy Egging, MS, RN, C-ANP, CEN
Part-Time Faculty
Loyola University
Maywood, Illinois;
Nurse Practitioner
Delnor Hospital
Emergency Department
Geneva, Illinois
Faye P. Everson, RN
Clinical Educator for the Emergency Department
18
University of Massachusetts Medical Center
Worcester, Massachusetts
Nicki Gilboy, MS, RN, CEN, FAEN
Associate Chief Nurse for Emergency Medicine
University of Massachusetts Memorial Medical Center
Worcester, Massachusetts
Valerie Aarne Grossman, BSN, MA, RN
Registered Nurse, Imaging Sciences
University of Rochester Medical Center
Rochester, New York
Lynn Hadaway, MEd, RN, BC, CRNI
President
Lynn Hadaway Associates, Inc
Milner, Georgia
Judith S. Halpern, MSN, RN, FNP-BC
Instructor, School of Nursing
Ferris State University
Big Rapids, Michigan;
Nurse Practitioner, Occupational Health
Comp Care Partners
Kalamazoo, Michigan
Belinda B. Hammond, MSN, RN, CEN, CCRN
Clinical Nurse Educator, Critical Care
Cone Health System
Greensboro, North Carolina
Catherine Harris, MSN, RN, CEN, CPEN, CNE
Cape Cod Community College
Barnstable, Massachusetts;
Laboure College
Dorchester, Massachusetts;
Educator, Clinical Nurse Specialist
Massachusetts General Hospital
Boston, Massachusetts
Bernard Heilicser, DO, MS, FACFP, FACOEP
Medical Director, South Cook County EMS Systems;
Director, Medical Ethics Program
Ingallo Hospital
Harvey, Illinois
Robert D. Herr, MD, MBA, FACEP
Attending Physician
Grays Harbor Community Hospital
Aberdeen, Washington;
Medical Director
Regence Blue Shield
Seattle, Washington
Susan McDaniel Hohenhaus, MA, RN, CEN, FAEN
19
Executive Director
Emergency Nurses Association
Des Plaines, Illinois
Kimberly Hovseth, ND, MS, Pa-C, CSPI
Certified Specialist in Poison Information
Oklahoma Poison Control Center;
Guest Lecturer, Physician Assistant Program
University of Oklahoma Health Sciences Center
College of Pharmacy
Oklahoma City, Oklahoma
Jeane Jackson, MS, RN
Nurse Coordinator, Maternal-Fetal Medicine
Department of OB/GYN
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
Bethany Chimento Jennings, MN, APRN, FNP
Midlevel Provider Emergency Medical Services
Ochsner Medical Center
New Orleans, Louisiana
Linda Kelly, MS, RN, ANP-BC
Nurse Director Ambulatory Gynecology
Massachusetts General Hospital
Boston, Massachusetts
Mary Kemper, MSW
Medical Social Worker
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania
Anne P. Manton, PhD, RN, PMHNP-BC, FAEN, FAAN
Psychiatric-Mental Health Nurse Practitioner
Cape Code Hospital
Hyannis, Massachusetts
Benjamin E. Marett, MSN, RN-BC, CEN, CCRN, NE-BC, FAEN
Director of Education
Piedmont Medical Center
Rock Hill, South Carolina
Lauren Wheatley McCauley, BSN, RN, CCRN
Staff Educator and Staff Nurse, Moderate Sedation
Piedmont Medical Center
Rock Hill, South Carolina
Jill C. McLaughlin, RN, CEN
Staff Nurse
Orange Regional Medical Center
Middletown, New York
Diana Meyer, MSN, RN, CCRN, CEN, FAEN
Clinical Nurse Specialist
20
Peace Health St. Joseph Medical Center
Bellingham, Washington
Rita D. Mintmier, BSN, RN, CNRN
Stroke Center Coordinator
Moses H. Cone Hospital
Greensboro, North Carolina
Julie V. O’Neal, BSN, RN, CEN
Registered Nurse IV, Clinical Educator
Moses H. Cone Hospital
Greensboro, North Carolina
Judith H. Poole, PhD, MHA/MBA, RNC-OB, C-EFM
Nurse Manager, Birthing Care
Presbyterian Hospital
Charlotte, North Carolina
Susanne Quallich, MSN, BSN, BS, ANP-BC, NP-C, CUNP
Clinical Faculty, School of Nursing;
Nurse Practitioner, Division of Sexual Reproductive Medicine, Department of Urology
University of Michigan
Ann Arbor, Michigan
Kathleen A. Ribbens, MSN, RN, CEN
Injury Prevention and Organ Donation Program Coordinator
Trauma and Burn Education, Regional Outreach
Spectrum Health
Grand Rapids, Michigan
Karen L. Rice, DNS, APRN, ACNS-BC, ANP
Adjunct Instructor, Graduate Research
School of Nursing, Health Sciences Center
Louisana State University
New Orleans, Louisiana;
Program Director, The Center for Nursing Research
Ochsner Medical Center
New Orleans, Louisiana
Diana Ropele, MSN, RN, CCRN
Pediatric Trauma Nurse Manager
Helen DeVoss Children’s Hospital
Grand Rapids, Michigan
Scott Schaffer, RPh, DABAT
Adjunct Faculty
University of Oklahoma College of Pharmacy
Oklahoma City, Oklahoma;
Managing Director
Oklahoma Poison Control Center
Oklahoma City, Oklahoma
S. Kay Sedlak, MS, RN, CEN, FAEN
Faculty, Laboratory Manager
Western Nevada College
21
Carson City, Nevada
William R. Short, MD, MPH
Assistant Professor of Medicine
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Jeff Solheim, MSN, RN-BC, CEN, CFRN, FAEN
Adjunct Faculty
Portland Community College;
President
Project Helping Hands and Solheim Enterprises
Portland, Oregon
Leona Stout-Demps, MSN, RN, CEN
Clinical Unit Educator for Emergency Services
Orlando Regional Medical Center
Orlando, Florida
Joanne E. Thompson, MSN, RNC-OB, CNS
Perinatal Clinical Nurse Specialist
Presbyterian Hospital
Charlotte, North Carolina
Robin Walsh, BSN, RN
Clinical Nurse Supervisor
University Health Services
University of Massachusetts
Amherst, Massachusetts
Barbara Weintraub, MSN, MPH, RN, PNP-AC, CEN, CPEN, FAEN
Director, Pediatric and Adult Emergency and Trauma Services
Northwest Community Hospital
Arlington Heights, Illinois
Darleen A. Williams, MSN, CNS, CEN, CCNS, CNS-BC, EMT-P
Clinical Nurse Specialist for Emergency Services
Orlando Regional Medical Center
Orlando, Florida
Dawn M. Williamson, MSN, RN, PMHCNS-BC
Addictions Consultation Clinical Nurse Specialist, Emergency Department
Massachusetts General Hospital
Boston, Massachusetts
Fiona Winterbottom, MSN, RN, APRN, ACNS-BC, CCRN
Clinical Nurse Specialist, Critical Care
Ochsner Medical Center
New Orleans, Louisiana
Lisa Wolf, PhD, RN, CEN
Clinical Assistant Professor
University of Massachusetts
Amherst, Massachusetts;
Staff Educator
22
Cooley Dickinson Hospital
Northhampton, Massachusetts
Polly Gerber Zimmermann, MS, MBA, RN, CEN, FAEN
Associate Professor
Harry S Truman College
Chicago, Illinois
23
Previous Contributors
Colleen Andreoni, MSN, ANP-BC, CEN
Nancy M. Ballard, MSN, RN
Gwen Barnett, RN
Darcy T. Barrett, MSN, RN, CNRN
Nancy M. Bonalumi, MS, RN, CEN
Elizabeth Burke, BA
Patricia M. Campbell, MSN, RN, CCRN, ANP-CS
Patricia L. Clutter, MEd, RN, CEN
Nancy J. Denke, MSN, RN, FNP-C, CCRN
Kathy M. Dolan, MS, RN, CEN
Gretta J. Edwards, BS, RN, CEN
Faye P. Everson, RN, CEN, EMT-B
John Fazio, MS, RN
LCDR Andrew A. Galvin, MSN, APRN, BC, CEN
Tamara Gentry, BSN, RN
Nicki Gilboy, MS, RN, CEN
Chris M. Gisness, MSN, RN, CEN, CS, FNP-C
Donna S. Gloe, BSN, MSN, EdD, RN, BC
Katy Hadduck, BSN, RN, CFRN
Jeff Hamilton, BA, RN
M. Lynn Herman, MSN, RN
Robert Herr, MD, MBA, FACEP
Reneé Semonin Holleran, PhD, RN, CEN, CCRN, CFRN
Mary Jagim, BSN, RN, CEN
Anita Johnson, BSN, RN
LCDR, Jeffrey S. Johnson, NC, USN, MSN, RN, CEN
Kimberly P. Johnson, BSN, RN
Mara S. Kerr, MS, RNC
24
