BMC emergency medicine
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BMC emergency medicine · Jan 2007
Paediatric out-of-hospital resuscitation in an area with scattered population (Galicia-Spain).
Cardiorespiratory arrest (CRA) is a rare event in childhood. Our objective was to determine the characteristics of paediatric CRA and the immediate results of cardiopulmonary resuscitation (CPR) in Galicia, a community with a very scattered population. ⋯ Despite the handicap of a highly disseminated population, paediatric CRA characteristics and CPR results in Galicia are comparable to references from other communities. Programs to increase bystander CPR, equip laypeople with basic CPR skills and to update life support knowledge of health staff are needed to improve outcomes.
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BMC emergency medicine · Jan 2007
National study of United States emergency department visits for acute pancreatitis, 1993-2003.
The epidemiology of acute pancreatitis in the United States is largely unknown, particularly episodes that lead to an emergency department (ED) visit. We sought to address this gap and describe ED practice patterns. ⋯ ED visits for acute pancreatitis are rising in the U.S., and ED visit rates are higher among blacks than whites. At many visits analgesics are not administered, and diagnostic imaging is rare. There was greater likelihood of admission among whites than blacks. The observed race disparities in ED visit and admission rates merit further study.
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BMC emergency medicine · Jan 2007
Can latent heat safely warm blood? - in vitro testing of a portable prototype blood warmer.
Trauma/retrieval patients are often in shock and hypothermic. Treatment of such patients usually involves restoring their blood volume with transfusion of blood (stored at 2 degrees C - 6 degrees C) and/or crystalloids or colloids (stored at ambient temperature). Rapid infusion of these cold fluids can worsen or even induce hypothermia in these patients. Warming of intravenous fluids at accident sites has traditionally been difficult due to a lack of suitable portable fluid warmers that are not dependent on mains electrical or battery power. If latent heat, the heat released when a liquid solidifies (an inherently temperature limiting process) can warm intravenous fluids, portable devices without a reliance on electrical energy could be used to reduce the incidence of hypothermia in trauma patients. ⋯ Using latent heat as an energy source can satisfactorily warm cold blood or other intravenous fluids to near body temperature, without any adverse affects.
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BMC emergency medicine · Jan 2007
Comparison of a nurse initiated insulin infusion protocol for intensive insulin therapy between adult surgical trauma, medical and coronary care intensive care patients.
Sustained hyperglycemia is a known risk factor for adverse outcomes in critically ill patients. The specific aim was to determine if a nurse initiated insulin infusion protocol (IIP) was effective in maintaining blood glucose values (BG) within a target goal of 100-150 mg/dL across different intensive care units (ICUs) and to describe glycemic control during the 48 hours after protocol discontinuation. ⋯ The safety and effectiveness of nurse initiated IIP was similar across different ICUs in our hospital. Marked variability in glucose control after the protocol discontinuation suggests the need for further research regarding glucose control in patients transitioning out of the ICU.
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BMC emergency medicine · Jan 2007
Failure of psychiatric referrals from the pediatric emergency department.
Recognition of mental illness in the pediatric emergency department (PED) followed by brief, problem oriented interventions may improve health-care seeking behavior and quality of life. The objective of this study was to compare the frequency of mental health follow up after an enhanced referral compared to a simple referral in children presenting to the PED with unrecognized mental health problems. ⋯ Children screened in the ED for unrecognized mental health problems are very unlikely to follow-up for a mental health evaluation with or without an enhanced referral. Understanding the role of ED based mental health screening and the timing of an intervention is key in developing ED based mental health interventions.