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2020 year of the nurse and midwife: Meeting new challenges</text>
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                <text>As we ease into 2020 it is important to recognise that the World Health Organization has designated this as the “Year of the Nurse and Midwife”, in honor of the 200th birth anniversary of Florence Nightingale. Nurses and midwives play a vital role in providing health services and in many communities they are the first and only point of care– this is especially true in the emergency care arena. As we enter into this new year, we are confronted by the fact that we are facing a changing world with many new challenges and these will often first land on the doorstep of the emergency nurse. A case in point is the novel Coronavirus (COVID-19) which has been named a public health emergency of international concern, a rare designation given to worldwide public health threats. The effects of COVID-19 worldwide are already unprecedented. As of this writing, the number of deaths continues to climb, already surpassing the SARS epidemic of 2002-3 [1]. In the United States, a White House proclamation is currently barring any non-US residents who have been in China in the past 14 days from entering the country. Multiple other countries have followed suit, including restricting air travel to and from China for an indefinite period of time. While these steps are extreme, they have been taken to prevent further spread of this new virus, as scientists and public health experts race to understand the transmissibility and severity of the virus. </text>
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Editorial Board&#13;
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Evaluation of the intensity and management of pain before arrival in hospital among patients with suspected hip fractures </text>
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                <text>Background: Pain management needs to be comprehensively investigated in patients with hip fractures, as it represents a fast-growing challenge to emergency care. The purpose of this study was to describe reported pain&#13;
in patients with suspected hip fractures in a prehospital setting.&#13;
Methods: In this observational study, 1,426 patients with a suspected hip fracture were included. Dynamic and static pain were assessed on the arrival of the emergency medical services (EMS) and on hospital admission using the Numerical Rating Scale (NRS), if feasible, and the Behaviour Rating Scale (BRS), if not. &#13;
Results: On EMS arrival, the median dynamic NRS pain score was eight and 84% of the patients had severe or moderate dynamic pain according to the BRS. On admission to hospital, the median dynamic NRS pain score was reduced to five and 45% of the patients had reduced dynamic pain according to the BRS. Among all patients, the NRS was judged to be feasible and was therefore used in 36%. Furthermore, there was an association between the decrease in pain and the increase in the number of administered medications, as well as the duration of prehospital care.&#13;
Conclusions: Patients with suspected hip fractures suffered substantial pain on EMS arrival. Only half experienced a reduction in pain on hospital admission and only 75% received pain-relieving medication. </text>
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                <text>International Emergency Nursing Vol. 49 March 2020</text>
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