The American journal of emergency medicine
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Few studies have examined visits to hospital EDs and subsequent admission for the treatment of nontraumatic dental emergencies. The present study of Medicaid-eligible adults was conducted to gain a better understanding of the magnitude of this problem. Data tapes describing adult Medicaid patients' hospital ED and admission claims were obtained from the Maryland Medicaid Management Information System. ⋯ The mean total cost for claims associated with hospital admissions was $5793 US dollars, whereas the minimum cost was $949 and the maximum was $43,524 US dollars. Although the frequency of hospital admissions associated with nontraumatic dental emergencies is not great, a hospital admission is among the most extreme consequences of failing to prevent or treat dental problems. Although some hospital admissions related to dental problems could be unavoidable, further studies are needed to better understand mechanisms for reducing the use of EDs for care best provided in community-based dental offices.
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Comparative Study
Accuracy of portable quantitative capnometers and capnographs under prehospital conditions.
This study was designed to assess the pCO(2) accuracy of portable mainstream (Tidal Wave, Novametrix; Propaq 106, Protocol) and sidestream capnometers (Capnocheck 8200, BCI; Capnocount mini, Weinmann; NPB-75, Nellcor Puritan Bennett; SC-210, Pryon) with respect to international standards and preclinical emergency conditions. Measurements were performed under temperature conditions of +22 degrees C and -20 degrees C using dry gas mixtures with different CO(2) concentrations (STPD) and in patients ventilated with pure oxygen (BTPS). ⋯ The measurements were affected by low ambient temperature only in the NPB-75 (+15%). Our results indicate that portable quantitative capnometers are able to fulfill accuracy requirements as requested by international standards but can be affected by changing ambient temperatures.
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The objective of this study was too determine if patients can accurately read a visual analog scale (VAS) for pain. A 100-mm visual analog pain scale designed for patient use was printed on the top page of carbonless copy paper with a perfectly aligned hatched scale on the second (bottom) page. Patients over the age of 18 in acute pain were enrolled in this prospective, descriptive study. ⋯ One hundred thirty-eight (95.2%) read their VAS within +/-2 mm of physician readings. Ninety-five percent of patients are able to read a VAS within +/-2 mm of physician readings. The data suggests this instrument could be used by discharged patients in longitudinal pain studies or with help in management of chronic pain.
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The purpose of this study was to determine whether there is a lateralizing predisposition toward injury in right hand-dominant (RHD) individuals. The distal radius fracture was used as the injury for evaluation because it is easily defined and can be objectively documented by roentgenography. A prospective case-series design was used to include consecutive RHD patients with a distal radius fracture. ⋯ After adjustment for gender, the odds of developing a left compared with right distal radius fracture was 2.3-fold greater for the older compared with the younger age group (95% confidence interval, 1.0-5.2). Preliminary evidence suggests a lateralizing predisposition for left distal radius fractures in older compared with younger individuals who are RHD. If this data holds up, finding the etiology/mechanism of this predisposition might help in designing environments to minimize the impact of this injury pattern in the slightly older individual.