Annals of emergency medicine
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Randomized Controlled Trial
Color-Coded Prefilled Medication Syringes Decrease Time to Delivery and Dosing Error in Simulated Emergency Department Pediatric Resuscitations.
The Institute of Medicine has called on the US health care system to identify and reduce medical errors. Unfortunately, medication dosing errors remain commonplace and may result in potentially life-threatening outcomes, particularly for pediatric patients when dosing requires weight-based calculations. Novel medication delivery systems that may reduce dosing errors resonate with national health care priorities. Our goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared with conventional medication administration, in simulated pediatric emergency department (ED) resuscitation scenarios. ⋯ A novel color-coded, prefilled syringe decreased time to medication administration and significantly reduced critical dosing errors by emergency physician and nurse teams during simulated pediatric ED resuscitations.
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Multicenter Study
Use of Oral Contrast for Abdominal Computed Tomography in Children With Blunt Torso Trauma.
We compare test characteristics of abdominal computed tomography (CT) with and without oral contrast for identifying intra-abdominal injuries. ⋯ Oral contrast is still used in a substantial portion of children undergoing abdominal CT after blunt torso trauma. With the exception of a slightly better specificity, test characteristics for detecting intra-abdominal injury were similar between CT with and without oral contrast.
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Randomized Controlled Trial
Successful Tobacco Dependence Treatment in Low-Income Emergency Department Patients: A Randomized Trial.
Tobacco use is common among emergency department (ED) patients, many of whom have low income. Our objective is to study the efficacy of an intervention incorporating motivational interviewing, nicotine replacement, and quitline referral for adult smokers in an ED. ⋯ An intensive intervention improved tobacco abstinence rates in low-income ED smokers. Because approximately 20 million smokers, many of whom have low income, visit US EDs annually, these results suggest that ED-initiated treatment may be an effective technique to treat this group of smokers.
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Although all emergency physicians are familiar with catastrophic causes of free intraperitoneal air, we describe the case of a healthy 26-year-old woman who presented to our emergency department (ED) with a nonsurgical and previously unreported cause of pneumoperitoneum. The patient presented to our ED with complaints of shoulder and neck pain several hours after having undergone FemVue ultrasonography (Femasys, Suwanee, GA) for infertility evaluation. The technique uses an air and saline solution mixture injected into the uterine cavity to assess for tubal patency and uterine cavity morphology. Although the cause of her free air and pain was determined to be iatrogenic and ultimately benign, this complication is previously unreported and, without complaints of abdominal pain, presented a diagnostic challenge.