J Emerg Med
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Multicenter Study
Whole fentanyl patch ingestion: a multi-center case series.
Fentanyl is a potent synthetic opioid with large abuse potential. A common preparation of fentanyl is a sustained-release transdermal patch. To our knowledge, there are only two published case reports of whole patch ingestion. A case series of 76 patients with a history of whole patch ingestion is reported. ⋯ Ingestion of whole fentanyl patches may lead to prolonged and significant toxicity based on these poison center data.
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The management of emergency department (ED) patients with presumed recent-onset atrial fibrillation or flutter≤48h in duration varies widely. ⋯ Our approach to ED patients with presumed recent-onset atrial fibrillation or flutter seems to be safe and effective, with a high rate of cardioversion and discharge to home coupled with a low ED adverse event and 30-day thromboembolic event rate.
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Multicenter Study
Emergency airway management: a multi-center report of 8937 emergency department intubations.
Emergency department (ED) intubation personnel and practices have changed dramatically in recent decades, but have been described only in single-center studies. We sought to better describe ED intubations by using a multi-center registry. ⋯ Emergency physicians perform the vast majority of ED intubations. ED intubation is performed more commonly for medical than traumatic indications. Rapid sequence intubation is the most common method of ED intubation.
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Multicenter Study
Can we defer/omit a type and screen blood test for pregnant women who know their blood type?
Current clinical practice in many emergency departments (EDs) includes checking a type and screen blood test (T&S) for Rhesus (Rh) status on all pregnant patients presenting with vaginal bleeding or abdominal pain. The test is expensive, and awaiting results may delay disposition. ⋯ Pregnant women reporting that "yes, definitely" they know their blood type, are reliable. Deferring T&S testing test may be reasonable.
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There are limited published data examining Emergency Department (ED) presentations associated with amusement parks, and even fewer data on presentations not associated with roller coaster rides. ⋯ The majority of ED visits from nearby amusement parks were benign and did not require hospitalization.