Emergency medicine journal : EMJ
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We describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED. ⋯ In this series of ketamine sedations in an urban, resource-limited ED, there were no serious adverse events attributable to ketamine.
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A shortcut review was carried out to establish whether the use of intravenous vitamin C can reduce mortality or morbidity in patients diagnosed in the early phases of severe sepsis. Three directly relevant papers were found using the reported search strategy. ⋯ It is concluded that there is insufficient high-quality research to justify the routine use of vitamin C in severe sepsis. Further multicentre, double-blinded randomised controlled trials are required in order to establish the role of vitamin C in sepsis.
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Observational Study
Frequent use of emergency departments for mental and substance use disorders.
We described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD. ⋯ Findings highlight disparities in the receipt of specialist care based on use of ED services for SUD, coupled with a greater mortality risk. There is a need for policies and procedures to help address unmet needs for care and to connect members of this vulnerable subgroup with services that are better able to support recovery and improve survival.
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Patients with respiratory distress present a frequent and challenging dilemma for emergency physicians (EPs). The accurate diagnosis and treatment of the underlying pathology is vitally important in these sick patients to ensure the best outcome and minimise harm from unnecessary treatments. ⋯ However, despite advances in techniques and the evidence for the use of LU in the diagnosis of respiratory pathology, it remains poorly understood and rarely used by EPs. This clinical review article provides an overview of LU and its relevance as a diagnostic aid to the detection of respiratory pathology in the Emergency Department (ED).
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Observational Study
Thirty-day hospital readmissions among mechanically ventilated emergency department patients.
Unplanned 30-day readmissions have a negative impact on patients and healthcare systems. Mechanically ventilated ED patients are at high risk for complications, but factors associated with readmission are unknown. ⋯ Almost one in four mechanically ventilated ED patients are readmitted within 30 days, and readmission is associated with patient-level and institutional-level factors. Strategies must be developed to identify, treat and coordinate care for the most at-risk patients.