The American journal of emergency medicine
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The study objective was to determine the accuracy of initial triage assessment (ITA) in directing behavioral emergency patients to appropriate medical or psychiatric care, and to identify variables that enhance triage accuracy. A cohort study of 436 adult patients with 1 of 10 behavioral-related complaints was conducted. ITA compared with the final ED diagnosis, both of which were classified as either "medical" or "psychiatric." Patient triage characteristics correlated with the final ED diagnosis using logistic regression. ⋯ Dementia, past psychiatric history, family history of psychiatric illness, and ITA were significant predictors of final ED diagnosis. ITA is a fair predictor of the final ED diagnosis, but could be enhanced by screening for dementia and past psychiatric history. Improved triage accuracy could reduce length of stay for such patients.
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Comparative Study
Gas flow rates through transtracheal ventilation catheters.
The purpose of the study was to measure gas flow rates using different methods of transtracheal ventilation. Wall oxygen flow (WOF) at 10 and 15L/min, and a self-inflating ventilation bag (SIVB) were used to deliver gas flow through three transtracheal catheters: 13, 14, and 16 gauge (5 trials each). WOF mean gas flow rates (L/min) through the 16G, 14G, 13G catheters, respectively were: 15.7, 15.7, 16.8 at 15L/min, 10.5, 10.5, 10.3 at 10 L/min, and 5.7, 7.5, 7.7 via SIVB. ⋯ A 500 cc tidal volume can be delivered within 3 seconds (WOF) and 5 seconds (SIVB). Catheter size did not substantially affect gas flow rates (Poiseuille's law not applicable). Transtracheal ventilation is best done by using WOF, but if a device to perform this is not available, then an SIVB may still be sufficient.