The American journal of emergency medicine
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Comparative Study
Extended dwell and standard ultrasound guided peripheral intravenous catheters: Comparison of durability and reliability.
Background Vascular access is a critical component of emergency department (ED) care. Ultrasound guided placement of peripheral intravenous (USIV) catheters is increasingly common. However, USIV are thought to suffer from reduced durability and higher complication rates. ⋯ Multivariable Cox regression demonstrated survival benefit (longer dwell time) favoring EDC (HR 0.70 [95%CI 0.60-0.81]). Conclusion Use of EDC results in longer dwell time and reduces subsequent use of vascular access resources, while maintaining low complication rates. EDC demonstrate superior durability which may justify their selection over standard USIV in some patients.
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The four-hour (4 h') rule in the emergency department (ED) is a performance-based measure introduced with the objective to improve the quality of care. We evaluated the association between time in the ED with in-hospital mortality and hospital length of stay (LOS). ⋯ In-hospital mortality was not associated with time in the ED beyond 4 h'. LOS, however, was increased in this group of patients. Decreased LOS observed in patients with time in the ED within 4 h', does not support patients' risk as a contributing factor leading to higher trends in mortality observed in this patient group. In-hospital mortality was associated with an increase in DED-TED intervals in patients hospitalized in the internal medicine departments.
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Comparative Study
The comparison of psychological scales as hospitalization predictors between adult and elderly suicide attempters.
During the process of managing suicide attempters in the emergency department (ED), the importance of hospitalization has been emphasized. Lethality and intent have been suggested as hospitalization determinants of suicide attempters, but their predictive values remain limited in adult and elderly populations. ⋯ The age-by-RRRS interaction is significantly associated with hospitalization, and the RRRS implementation as a hospitalization determinant is more useful and suitable for elderly suicide attempters than for adult suicide attempters in an emergency setting.
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Observational Study
Neutrophil-to-lymphocyte ratio is a prognostic predictor in emergency department patients with cutaneous adverse drug reaction.
We aimed to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in emergency department (ED) patients with cutaneous adverse drug reactions to identify the severe patients at an early stage. ⋯ NLR is a useful and simple prognostic parameter as an indicator of systemic inflammatory involvement in ED patients with cutaneous adverse drug reactions. NLR is a useful parameter for deciding which patient will be admitted to the hospital in that patient group.
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Observational Study
Type of bystander and rate of cardiopulmonary resuscitation in nursing home patients suffering out-of-hospital cardiac arrest.
We investigated bystander cardiopulmonary resuscitation (CPR) provision rate and survival outcomes of out-of-hospital cardiac arrest (OHCA) patients in nursing homes by bystander type. ⋯ Although OHCA was detected more often by non-medical staff, they provided bystander CPR less frequently than the medical staff did. To improve survival outcome of nursing home OHCA, bundle interventions including increasing the usage of automated external defibrillators and expanding CPR training for non-medical staff in nursing home are needed.