The American journal of emergency medicine
-
Although EDs are responsible for the initial care of critically ill patients and the amount of critical care provided in the ED is increasing, there are few data examining mechanical ventilation (MV) in the ED. In addition, characteristics of ED-based ventilation may affect planning for ventilator shortages during pandemic influenza or bioterrorist events. The study examined the epidemiology of MV in US EDs, including demographic, clinical, and hospital characteristics; indications for MV; ED length of stay (LOS); and in-hospital mortality. ⋯ Patients undergoing ED MV have particularly high in-hospital mortality rates, but their ED LOS is sufficient for implementation of evidence-based ventilator interventions.
-
We aimed to describe clinical and radiologic features of acute renal infarction (RI). ⋯ Renal infarction should be considered in the differential diagnosis of a patient presented to the emergency department with abdominal or flank pain. Laboratory workup should include lactate dehydrogenase levels. After ruling out stone disease, contrast-enhanced CT examination is essential for the diagnosis.
-
Randomized Controlled Trial
Less painful arterial blood gas sampling using jet injection of 2% lidocaine: a randomized controlled clinical trial.
The aim of this study was to compare pain levels from arterial blood gas (ABG) sampling performed with or without application of lidocaine via jet injector. ⋯ Lidocaine jet injection provides beneficial and rapid anesthesia, resulting in less pain and a greater rate of successful ABG sampling. Therefore, it is recommended for use before ABG sampling to decrease the patient's pain and the number of unsuccessful attempts and to enhance the patient's satisfaction.
-
Randomized Controlled Trial Comparative Study
Effects of antithrombin and gabexate mesilate on disseminated intravascular coagulation: a preliminary study.
We hypothesized that antithrombin is more effective for disseminated intravascular coagulation (DIC) than is gabexate mesilate, which is a protease inhibitor, suggested from the previous studies. Initially, we compared the effects of antithrombin and gabexate mesilate for treating infection-related DIC. ⋯ Antithrombin may be a more effective treatment for coagulation and fibrinolysis disorders than gabexate mesilate in infection-related DIC, but there was no difference in 28-day mortality.
-
The aim of this study was to determine the rates of laboratory confirmed gonorrhea (GC) and chlamydia (CT) in emergency department (ED) patients with pelvic inflammatory disease (PID) and cervicitis who were diagnosed clinically and treated empirically. A secondary goal examines which clinical criteria were present in patients with PID testing positive for GC/CT. ⋯ There is a generally low prevalence of GC and CT in this patient population diagnosed with cervicitis or PID. There is a very low prevalence of coinfection.