Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Prospective multicenter study of the viral etiology of bronchiolitis in the emergency department.
To determine the viral etiology of bronchiolitis and clinical characteristics of children age < 2 years presenting to the emergency department (ED) with bronchiolitis. ⋯ In this multicenter study, RSV was the most frequent cause of bronchiolitis (64%). RV was present in 16%, and these children have a distinct profile in terms of demographics, medical history, and ED treatment.
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One of the first stages in the development of new clinical decision rules (CDRs) is determination of need. This study examined the clinical priorities of emergency physicians (EPs) working in Australasia, Canada, the United Kingdom, and the United States for the development of future CDRs. ⋯ This international survey identified the sampled EPs' priorities for the future development of CDRs. The top priority overall was investigation of the febrile child < 36 months. These results will be valuable to researchers for future development of CDRs in EM that are relevant internationally.
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There is substantial variation in the emergency department (ED) disposition of patients with transient ischemic attack (TIA), and the factors responsible for this variation have not been determined. In this study, the authors examined the influence of clinical, sociodemographic, and hospital characteristics on ED disposition. ⋯ While clinical factors predictably and appropriately impact the ED disposition of patients diagnosed with TIA, several nonclinical factors are also associated with differences in disposition. Additional research is needed to better understand the basis for these disparities and their potential impact on patient outcomes.
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Comparative Study
Comparison of 15:1, 15:2, and 30:2 compression-to-ventilation ratios for cardiopulmonary resuscitation in a canine model of a simulated, witnessed cardiac arrest.
This experimental study compared the effect of compression-to-ventilation (CV) ratios of 15:1, 15:2, and 30:2 on hemodynamics and resuscitation outcome in a canine model of a simulated, witnessed ventricular fibrillation (VF) cardiac arrest. ⋯ In a canine model of witnessed VF using a simulated scenario, CPR with three CV ratios, 15:1, 15:2, and 30:2, did not result in any differences in hemodynamics, arterial oxygen profiles, and resuscitation outcome among the three groups. CPR with a CV ratio of 15:1 provided comparable chest compressions and shorter pauses for ventilation between each cycle compared to a CV ratio of 30:2.
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Comparative Study
Differences in long-term mortality for different emergency department presenting complaints.
To characterize long-term mortality based on previous emergency department (ED) presenting complaints. ⋯ Long-term age- and gender-adjusted mortality is the highest with seizures out of 33 presenting complaints and differs markedly between different ED admission complaints. Furthermore, depending on the admission complaint, long-term mortality differs within the same discharge diagnosis. Hence, the presenting complaint adds unique information to the discharge diagnosis regarding long-term mortality in nonsurgical patients.