Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Predictors and outcomes of frequent emergency department users.
To identify predictors and outcomes associated with frequent emergency department (ED) users. ⋯ Frequent ED visits are associated with socioeconomic distress, chronic illness, and high use of other health resources. Efforts to reduce ED visits require addressing the unique needs of these patients in the emergency and primary care settings.
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Verbally administered numerical rating scales (NRSs) from 0 to 10 are often used to measure pain, but they have not been validated in the emergency department (ED) setting. The authors wished to assess the comparability of the NRS and visual analog scale (VAS) as measures of acute pain, and to identify the minimum clinically significant difference in pain that could be detected on the NRS. ⋯ The findings suggest that the verbally administered NRS can be substituted for the VAS in acute pain measurement.
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Randomized Controlled Trial Clinical Trial
The self-inflating bulb as an airway adjunct: is it reliable in children weighing less than 20 kilograms?
To confirm the ability of the self-inflating bulb to indicate endotracheal tube (ETT) position in children weighing less than 20 kilograms, and to determine whether the presence of air in the stomach affects the bulb's accuracy. ⋯ The self-inflating bulb is a reliable method of detecting endotracheal tube position in children weighing less than 20 kg, even with the use of uncuffed endotracheal tubes. Furthermore, the presence of air in the stomach, simulating field conditions, does not affect bulb effectiveness in detecting endotracheal tube position.
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Patients with altered level of consciousness may be suffering from elevated intracranial pressure (EICP) from a variety of causes. A rapid, portable, and noninvasive means of detecting EICP is desirable when conventional imaging methods are unavailable. ⋯ Despite small numbers and selection bias, this study suggests that bedside ED US may be useful in the diagnosis of EICP.
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Comparative Study
Underdosing of midazolam in emergency endotracheal intubation.
To determine whether midazolam, when used as an induction agent for emergency department (ED) rapid-sequence intubation (RSI), is used in adequate and recommended induction doses (0.1 to 0.3 mg/kg), and to compare the accuracy of the dosing of midazolam for ED RSI with the accuracy of dosing of other agents. ⋯ Underdosing of midazolam during ED RSI is frequent, and appears to be related to incorrect dosage selection, rather than to a deliberate intention to reduce the dose used.