Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Comparison of Outcomes for Children With Cervical Spine Injury Based on Destination Hospital From Scene of Injury.
Pediatric cervical spine injury is rare. As a result, evidence-based guidance for prehospital triage of children with suspected cervical spine injuries is limited. The effects of transport time and secondary transfer for specialty care have not previously been examined in the subset of children with cervical spine injuries. ⋯ Initial destination from scene (pediatric trauma center vs. local hospital) appears to be associated with neurologic outcome of children with cervical spine injuries. Markers of injury severity (altered mental status and focal neurologic findings) are important predictors of poor outcome in children with cervical spine injuries and should remain the primary guide for prehospital triage to designated trauma centers.
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Comparative Study
Retrospective Analysis of Etomidate Versus Ketamine for First-pass Intubation Success in an Academic Emergency Department.
The objective of this study was to compare first-pass intubation success between patients who received etomidate versus ketamine for rapid sequence intubation (RSI) in the emergency department (ED). ⋯ Etomidate and ketamine are associated with equivalent first-pass success when used in RSI. Ketamine may be an appropriate alternative to etomidate for RSI in the ED.
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Emergency department (ED) care for acute vascular diseases faces the challenge of overcrowding. A vascular unit is a specialized, protocol-oriented unit in the ED with a team trained to manage acute vascular disorders, including stroke, coronary syndromes, pulmonary embolism (PE), and aortic diseases. ⋯ The vascular unit strategy has the potential to reduce overall mortality for most acute vascular conditions.
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Organ donation after cardiac death (DCD) is increasingly considered as an option to address the shortage of organs available for transplantation, both in the United States and worldwide. The procedures for DCD differ from procedures for donation after brain death and are likely less familiar to emergency physicians (EPs), even as this process is increasingly involving emergency departments (EDs). This article explores the ED operational and ethical issues surrounding this procedure.