The American journal of emergency medicine
-
Comparative Study
How emergency department (ED) admission decisions differ when the same physician works in two different EDs.
Emergency physicians often work in multiple hospital emergency departments (EDs). We study how emergency physician admission decisions vary in different settings. ⋯ In this sample, some ED physicians made similar admission decisions in different settings while others increased or decreased their admission rates up to 25% when practicing in a different ED.
-
Comparative Study Observational Study
Ketamine as a first-line treatment for severely agitated emergency department patients.
Emergency physicians often need to control agitated patients who present a danger to themselves and hospital personnel. Commonly used medications have limitations. Our primary objective was to compare the time to a defined reduction in agitation scores for ketamine versus benzodiazepines and haloperidol, alone or in combination. Our secondary objectives were to compare rates of medication redosing, vital sign changes, and adverse events in the different treatment groups. ⋯ In highly agitated and violent emergency department patients, significantly fewer patients receiving ketamine as a first line sedating agent were agitated at 5-, 10-, and 15-min. Ketamine appears to be faster at controlling agitation than standard emergency department medications.