The American journal of emergency medicine
-
Multicenter Study Clinical Trial
Does the presence or absence of sonographically identified cardiac activity predict resuscitation outcomes of cardiac arrest patients?
This study evaluated the ability of cardiac sonography performed by emergency physicians to predict resuscitation outcomes of cardiac arrest patients. A convenience sample of cardiac arrest patients prospectively underwent bedside cardiac sonography at 4 emergency medicine residency-affiliated EDs as part of the Sonography Outcomes Assessment Program. Cardiac arrest patients in pulseless electrical activity (PEA) and asystole underwent transthoracic cardiac ultrasound B-mode examinations during their resuscitations to assess for the presence or absence of cardiac kinetic activity. ⋯ The presence of sonographically identified cardiac kinetic motion was associated with ROSC. Time interval durations of cardiac resuscitative efforts in the prehospital environment and in the ED were not accurate predictors of ROSC for this cohort. Cardiac kinetic activity, or lack thereof, identified by transthoracic B-mode ultrasound may aid physicians' decision making regarding the care of cardiac arrest patients with PEA or asystole.
-
To determine if endotracheal tubes (ETTs) that are opened, prepared, and stored in an ED airway cart are prone to bacterial contamination. ⋯ It appears that opening, preparing, and storing ETTs in an ED airway cart for up to 48 hours does not increase the risk of bacterial contamination of the ETTs.
-
To determine the compliance rate in filling outpatient medication prescriptions written upon discharge from the emergency department (ED). ⋯ This study demonstrates that filling a prescription after discharge from an ED represents a substantial barrier to medication compliance.
-
Clinical Trial
Moderate-to-severe blood pressure elevation at ED entry: hypertension or normotension?
It is controversial whether arterial hypertension (AHT) can be diagnosed in the emergency department (ED). We sought to prospectively investigate the natural time course of blood pressure (BP) to define an optimal period for AHT screening in ED patients with an elevated initial BP. ⋯ Screening for AHT in the ED is possible with high specificity and sensitivity. Blood pressure measurements between minutes 60 and 80 after entry into the ED yield the highest diagnostic value.
-
Comparative Study
The effect of pesticide spraying on the rate and severity of ED asthma.
We report on the incidence of emergency department (ED) asthma presentations and admissions to the Lincoln Hospital, located in the South Bronx of New York City, during the 1999 eradication program of the mosquito vector for West Nile virus. Spraying of Malathion and Resmethrin occurred in the hospital's geographic area over 4 days in September 1999. During that time, 1318 pediatric and adult patients were seen in the ED for asthma-related symptoms. ⋯ Emergency department visits, during days when spraying occurred, were compared with visits during days when no spraying occurred. Comparisons were made with previous years as a reference point. Findings showed that the spraying of insecticides did not increase the rate or severity of asthma presentations as measured by the Lincoln Hospital's ED asthma census or hospital admissions for asthma.