J Emerg Med
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Droperidol is used commonly to treat agitation in the emergency department (ED), however, data comparing doses are lacking. ⋯ In this large cohort, patients deemed appropriately treated with 5 mg of droperidol required less rescue sedation than patients determined to need 10 mg.
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Randomized Controlled Trial
Empathy Unmasked: Patient Perception of Physician Empathy in an Oncologic Emergency Setting. A Randomized Controlled Trial Comparing Personal Protective Equipment Wear versus Unmasked Video Communication.
Amidst the COVID-19 pandemic, telemedicine emerged as an important option that supports and facilitates clinical practice, however, its usefulness in emergency settings that treat patients with cancer is unclear. ⋯ Cancer patients presenting to the emergency department perceive empathy and compassion equally when approached by physicians virtually without PPE or in person while wearing PPE. Virtual services for specific aspects of clinical practice during emergency department visits in an oncology setting can be implemented to ensure safer interactions between patients and physicians without compromising the physician-patient relationship.
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Multicenter Study Observational Study
End-Tidal Oxygen as an Effective Noninvasive Measure of Preoxygenation during Rapid Sequence Intubation in the Emergency Department.
Preoxygenation is intended to extend the duration of apnea until desaturation occurs. End-tidal oxygen (ETO2) is the standard for measuring preoxygenation, however, peripheral capillary oxygen saturation (SpO2) is used more commonly within the emergency department. ⋯ Preoxygenation success was similar when measured by strict ETO2 and SpO2 criteria. ETO2 is more sensitive to periods of apnea than SpO2 and may serve as an early indicator of an imminent desaturation event.
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Observational Study
Cardiopulmonary Ultrasound to Predict Care Escalation in Early Sepsis: A Pilot Study.
It is challenging to identify emergency department (ED) patients with sepsis who will require resources such as positive-pressure ventilation, vasopressors, or intensive care unit (ICU) admission. ⋯ In patients with concern for sepsis early findings of ≥4 B-lines is associated with care escalation. Combining this finding with LVF and RV size assessment improves the positive predictive power and may be useful in rapid identification of patients likely to require care escalation.
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Gastrointestinal bleeding (GIB) is a common condition in the emergency department (ED) with high incidence and mortality. ⋯ In this manuscript, we present a case series of ED patients with upper GIB in whom emergency physicians (2 fellowship-trained attendings and 2 senior residents facile with point-of-care ultrasound) performed GUS. As a supplement to the clinical examination, this sonographic "lavage" (i.e., using GUS in patients with upper GIB) helped predict aspiration risk, support diagnostic reasoning, and expedite early goal-directed management and appropriate disposition. We also provide a step-by-step tutorial using high-quality media, as well as a novel algorithm for translation of this technique to the bedside for emergency physicians.