The American journal of emergency medicine
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Observational Study
Corrected carotid flow time and passive leg raise as a measure of volume status.
The aim of this study was to investigate the value of corrected carotid flow time (FTc) with passive leg raise (PLR) as a non-invasive marker of volume status in end stage renal disease (ESRD) patients. ⋯ Corrected flow time in conjunction with passive leg raise seem to correlate with volume status in hemodialysis patients.
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To describe opioid prescribing practice patterns and trends in emergency department visits (EDs) by provider type: physicians and advanced practice providers (APPs), which include nurse practitioners (NPs) and physician assistants (PAs). ⋯ From 2005 to 2015, APPs, particularly NPs played an increasing role in opioid prescribing in EDs. Opioid prescribing practices of APPs and physicians varied by patient condition as well as by opioid type.
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Head injuries frequently occur in combat. Tactical Combat Casualty Care (TCCC) guidelines recommend pre-hospital use of ketamine for analgesia. Yet the use of this medication in patients with head injuries remains controversial, particularly among pediatric patients. We compare survival to hospital discharge rates among pediatric head injury subjects who received prehospital ketamine versus those who did not. ⋯ Within this data set, we were unable to detect any differences in mortality among pediatric head trauma subjects administered ketamine compared to subjects not receiving this medication in the prehospital setting.
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Lamotrigine [LTG] is primarily an anti-epileptic drug used to treat seizure disorders, depression, and bipolar disease. It is generally well tolerated with limited side effects reported during routine use. ⋯ Based on pharmacological properties, LTG is a candidate for extracorporeal removal, however, the successful use of HD for the treatment of this poisoning is not well described. We report the case of a 44 year-old female after a LTG overdose that experienced prolonged sedation that was ultimately treated with HD with an excellent response.
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Comparative Study
Reliability of smartphone measurements of vital parameters: A prospective study using a reference method.
In this study, we aimed to evaluate the accuracy of HR and SaO2 data obtained using a smartphone compared with the measurements of a vital signs monitor (VSM) and an arterial blood gas (ABG) device, respectively. ⋯ The HR and SaO2 values obtained by smartphone were found to be consistent with the measurements of the reference devices. With the growing use of smartphone technology in the health field, we foresee that patients will be able to make their own triage assessment before presenting to the hospital.