Annals of emergency medicine
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Family presence has broad professional organizational support and is gaining acceptance. We seek to determine whether family presence prolonged pediatric trauma team resuscitations as measured by time from emergency department arrival to computed tomographic (CT) scan, and to resuscitation completion. ⋯ This prospective trial shows that family presence does not prolong time to CT imaging or to resuscitation completion for pediatric trauma patients. Family presence does not negatively affect the time efficiency of the pediatric trauma resuscitation.
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We determine the rates of past year nonpartner violent assault, both victimization and aggression, and assess variables associated with nonpartner violent assault, particularly with regard to substance use. ⋯ Fourteen percent of patients seeking care in this inner-city ED experience violence with a nonpartner. Substance use-specifically cocaine-was the strongest predictor of any nonpartner violent assault.
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Case Reports
Massive, fatal, intracardiac thrombosis associated with prothrombin complex concentrate.
Prothrombin complex concentrates are frequently used to rapidly reverse anticoagulation with vitamin K antagonists associated with life-threatening bleeding. We report a patient receiving warfarin who presented to the emergency department with an international normalization ratio greater than 12.8 in cardiac tamponade and received prothrombin complex concentrate for rapid reversal of anticoagulation. ⋯ Thrombogenic complications of treatment with prothrombin complex concentrate have been reported before. Caution should be used when using prothrombin complex concentrates for reversal of anticoagulation.
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Although it has been suggested that high hospital occupancy leads to emergency department (ED) overcrowding and impedes ED throughput, there are limited data defining this relationship. The objective of this study is to examine whether high inpatient hospital occupancy negatively affects throughput in a pediatric ED. ⋯ High hospital occupancy has a significant and quantifiable negative influence on ED throughput, affecting patients both discharged and hospitalized.