Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Brain edema occurs following clinical as well as experimental cardiac arrest (CA) and predicts a poor neurologic outcome. The objective of this study was to determine the expression of cerebral cortex aquaporin (AQP)-4, a member of a family of membrane water-channel proteins, in brain edema formation following normothermic or hypothermic CA. ⋯ Cerebral cortical AQP4 expression is up-regulated after normothermic CA, which is attenuated by hypothermia induced before CA.
-
The Society for Academic Emergency Medicine believes that protection of human subjects is vital in emergency medicine research and that, whenever feasible, informed consent is at the heart of that protection. At the same time, the emergency setting presents unique barriers to informed consent both because of the time frame in which the research is performed and because patients in the emergency department are a vulnerable population. This report reviews the concept of informed consent, empirical data on patients' cognitive abilities during an emergency, the federal rules allowing exemption from consent under certain circumstances, issues surrounding consent forms, and the new Health Insurance Portability and Accountability Act regulations as they relate to research. ⋯ Sometimes resuscitation and other emergency medicine research must be conducted without the ability to obtain consent. In these cases, special protections of subjects under the exception from consent guidelines must be followed. Protection of research subjects is the responsibility of every researcher in emergency medicine.
-
To examine the Rapid Emergency Medicine Score (REMS) as a predictor of long-term (4.7 years) mortality in the nonsurgical emergency department (ED). ⋯ REMS was a powerful predictor of long-term mortality in patients attending the ED for a wide range of common nonsurgical disorders.
-
Comparative Study
Ethanol and illicit drugs do not affect the diagnostic utility of base deficit and lactate in differentiating minor from major injury in trauma patients.
Base deficit (BD) and lactate are valuable screening tools for injured patients. They reflect the degree of oxygen debt and have been shown to predict outcome. Intake of ethanol and illicit drugs may further derange acid-base status. The authors evaluated the effect of blood alcohol level (BAL) and illicit drugs on admission BD and lactate levels in trauma patients. ⋯ The presence of ethanol and/or illicit drugs did not affect the ability of BD or lactate to identify patients with major injuries.
-
To describe the characteristics and admission patterns of patients with syncope presenting to U.S. emergency departments (EDs). ⋯ Syncope is a frequent reason for ED visits and admissions. Elders and patients with associated cardiovascular diagnoses are frequently discharged, and admission practices appear to deviate from consensus panel guidelines.