The American journal of emergency medicine
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Case Reports
Complication after treatment for resistant supraventricular tachycardia: the Bezold-Jarisch reflex.
The Bezold-Jarisch reflex may become clinically relevant in times of profound relative hypovolemia. This results in uncoupled cardio inhibition leading to the triad of hypotension, bradycardia and vasodilation.
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The objective of the study is to determine the safety of intravenously administered combination sedatives in the emergency department (ED). ⋯ Combination sedatives appear to be safe when administered intravenously in the ED. Combination sedatives may be more effective than single-agent sedatives in agitated alcohol-intoxicated patients.
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To investigate the relationship between early use of computed tomography (CT) and complications associated with esophageal foreign body impaction in adults. ⋯ Esophageal foreign bodies were associated with a high incidence of complications in adults. CT could detect foreign bodies accurately in the early stages, and then FBs could be removed as early as possible, which may reduce the incidence of complications. Moreover, the great majority of complications were of lower grades. Thus, CT may be a useful first-line radiological tool for the early diagnosis of esophageal foreign bodies in adults.
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To determine which factors predict death among trauma patients who are alive on arrival at hospital. ⋯ Age, premorbid conditions, hospital RTS, and NISS are significant predictors of death after trauma. The time intervals between the accident and arrival at the hospital, arrival at the hospital and the first computed tomography scan or the first crucial emergency intervention, do not appear to affect the risk of death.
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Prescription opioid overdoses and deaths constitute a public health epidemic, and recent studies show that emergency department (ED) prescribers may contribute to this crisis. We hypothesized that a multidisciplinary educational intervention would decrease ED opioid packs dispensed at discharge. ⋯ A staged, multidisciplinary intervention targeting nurses, residents, nurse practitioners, and attending physicians was associated with decreased orders for opioid discharge packs in 2 urban EDs. Opioid discharge pack orders decreased slightly more among patients with risk factors for prescription opioid dependence.