J Emerg Med
-
Behavioral disorders are frequent in seniors with cognitive impairments. The ailment responsible for presentation to the Emergency Department (ED), in combination with preexisting conditions, can bring about a temporary cognitive disturbance or worsen an existing cognitive disturbance, thus increasing the frequency of behavioral disorders. ⋯ The findings of this study suggest that the risk of behavioral disorders in seniors attending the ED may be predicted by screening them for cognitive impairment and pain, and by monitoring the time period they are in the ED.
-
Pain management is an important part of prehospital care, yet few studies have addressed the effects of age, sex, race, or pain severity on prehospital pain management. ⋯ This study suggests that Caucasians are more likely than African-Americans or Hispanics to receive prehospital analgesia for blunt trauma injuries. In addition, patients with whom paramedics spend more time and for whom a pain score is recorded are more likely to receive analgesia.
-
Suspected ingestions are a common chief complaint to the emergency department although the majority of ingestions by children are insignificant. ⋯ Screening laboratory tests and ECGs were of limited utility and rarely changed management despite being ordered in a significant number of patients. Screening tests are rarely indicated in unintentional overdoses in children who are asymptomatic.
-
Snake bites are an important cause of mortality and morbidity worldwide, especially in rural areas. ⋯ Patients with snake bite envenomation had increased oxidants (MPO and LOOH) and decreased antioxidants (PON, ARLY, and -SH). Results obtained in this study demonstrate that snake bites are associated with a shift to oxidative status. Therapy with antioxidants can lead to an increase in the antioxidant defense system, and thus improvements in clinical symptoms.
-
Comparative Study
Accuracy of end-tidal CO2 capnometers in post-cardiac surgery patients during controlled mechanical ventilation.
The determination of end-tidal carbon dioxide (etCO2) is very helpful in cardiac resuscitation for confirmation and monitoring of endotracheal tube placement and as an indicator of return of circulation and effectiveness of chest compressions. There is now also widespread use of capnometry on-site at emergency and trauma fields. ⋯ A good correlation between etCO2 and PaCO2 was shown with the three capnometers in the present study. However, etCO2 measurements were not valid to estimate PaCO2 in these patients. Therefore, capnometry cannot be used to replace serial blood gas analyses completely, but may be a good cardiopulmonary trend monitor and alerting system in catastrophic events.