This newsletter is published by Association Revenue Partners

Sept. 15, 2022

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AAENP continues to partner with known names in medical education to offer exclusive opportunities and discounts for our AAENP Members. This month, we are highlighting opportunities with the Marfan Foundation and ROSH Review.   


An online Vascular Ehlers-Danlos Syndrome (VEDS) CME course is now available to nurse practitioners to increase awareness and diagnosis of this rare, life-threatening condition. Individuals with VEDS are predisposed to medical emergencies that include aortic/arterial dissection or rupture, intestinal perforation, pneumothorax, and uterine rupture during pregnancy or delivery. Understanding the complexities involved with VEDS can reduce medical errors and risk in the ER and save a life. AAENP members receive a 10% discount on this 1.5 hour CME, for a total cost of $47. To access this offering, click HERE.


Opportunity for Advocacy: The Drug Enforcement Administration (DEA) is issuing advance notice of proposed rulemaking to obtain information regarding the procurement of controlled substances by a medical officer for emergency kits on board ocean vessels, aircraft, and certain other entities. The regulations permitting controlled substances acquired by and dispensed under the general supervision of a medical officer to be stored in and dispensed from emergency kits on board ocean vessels, aircraft, and other entities were established in 1971 and have not been significantly modified since. DEA is considering revising these regulations and seeks to gain a better understanding of the industry's current needs and practices.

AAENP members may want to consider suggesting that the definition of “Medical officer” be updated from “physician” to “NP, PA, & physician”. Electronic comments must be submitted on or before September 16, 2022 at 11:59 p.m. Eastern Time. To review the notice and to submit a formal comment, go HERE.  



Don’t forget about all of the ROSH review products. Here is an example of the type of information you can anticipate:   An 8-year-old boy presents to the emergency department with a facial laceration after a fall. He has a 2 cm linear laceration vertically through his lower lip on the left side, crossing the vermillion border. Which of the following is the most appropriate method of analgesia for his repair?

A. Inhaled nitrous oxide

B. Local lidocaine with epinephrine

C. Mental nerve block

D. Topical lidocaine-epinephrine-tetracaine

Correct Answer: C  


Explanation: The vermillion border of the lip is a thin white line that separates the lips from the face. A laceration with even 1 mm of misalignment through the vermillion border will be instantly noticeable at arm’s length, so perfect alignment is needed during the repair. The benefits and risks of chemical sedation should be weighed for any repair of the vermillion border, as helping younger children remain still improves the safety of the procedure and the cosmetic outcome of the repair. A regional block is recommended for analgesia, as it is less likely to obscure important structures, and it can reduce the amount of chemical sedation administered. For the outer lower lip, an injection of lidocaine with epinephrine near the mental nerve (e.g., mental nerve block) is the most appropriate regional block. Older children might be cooperative enough for a regional block without chemical sedation, especially intraoral attempts after the application of a small amount of topical lidocaine to the injection site. The first suture in the repair should be a 6-0 nonabsorbable suture at the vermillion border with perfect approximation. The mucosal surface can then be closed with 5-0 absorbable material, and the skin closed with 6-0 nonabsorbable material. Inhaled nitrous oxide (A) can be used as an adjunct to a regional block, but it will obscure the suturing site if a facial mask is needed and will not result in analgesia. Locally injected lidocaine with epinephrine (B) will result in blanching and swelling of nearby tissues, obscuring the vermillion border and resulting in an inferior repair. Topical lidocaine-epinephrine-tetracaine (D) should not be applied to mucosal surfaces due to systemic absorption of lidocaine and epinephrine.  

One Step Further

Question: Why should benzocaine be avoided as a mucosal topical anesthetic in children? Answer: Due to its high risk of causing methemoglobinemia in children.


  1. Attia MW, Durani Y, Weihmiller SN. Minor trauma. In: Shaw KN, Bachur RG, Chamberlain J, Lavelle J, Nagler J, Shook JE, eds. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine. 7th ed. Wolters Kluwer; 2016:(Ch) 118.
  2. Trott AT, ed. Special anatomic sites. In: Wounds and Lacerations Emergency Care and Closure. 4th ed. Saunders; 2012:(Ch) 12.  

Want more questions like this? Click here to start a free trial!




AAENP/AENJ Journal Clubs are growing! The most recent online Journal club hosted by AAENP and AENJ in August was a huge success – the biggest one yet with over 120 attendees! Mark your calendars now for these FREE quarterly CE opportunities which occur on the 2nd Tuesdays of February, May, August, & November at 8pm EST.  


Our partners at ROSH review continue to support AAENP members in their EM careers. For those starting out in emergency care, ROSH offers a special package with free trial.     


ICYMI – Some members have missed the prior newsletters sent out monthly this year. You can find them below.




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Looking for a way to get involved at AAENP?  Leadership opportunities exist for a Northeastern Regional Director, and State Representatives are needed for the following states: Alaska, Connecticut, Delaware, Kansas, Maine, Montana, New Jersey, North Dakota, Rhode Island, South Carolina, & Washington D.C.  State Representatives are essential connections to our members and actively support the values and mission of AAENP. If interested, please apply through the AAENP website at and submit a current CV and letter of interest.   



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