Articles: emergency-department.
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To investigate the performance characteristics in children with moderate and minor injuries of prehospital paediatric triage tools currently in use in England for identifying seriously injured children. ⋯ Three tools (East Midlands, North West and Northern) demonstrated acceptable over- and under-triage rates in this population of minor and moderately injured children. All tools reached recommended standards for over-triage, but the majority favoured under-triage.
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Control of blood pressure is considered essential in the management of trauma patients. In patients with head injuries, both hypotension and hypertension are associated with poor outcomes. The present study was undertaken to ascertain whether hypertension at emergency triage is associated with traumatic intracranial haemorrhage. ⋯ The presence of hypertension at emergency triage is associated with traumatic intracranial haemorrhage.
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Pediatric emergency care · May 2015
Observational StudyAssessing Physician-Parent Communication During Emergency Medical Procedures in Children: An Observational Study in a Low-Literacy Latino Patient Population.
Effective physician-patient communication is critical to the clinical decision-making process. We studied parental recall of information provided during an informed consent discussion process before performance of emergency medical procedures in a pediatric emergency department of an inner-city hospital with a large bilingual population. ⋯ A gap in communication may exist between physicians and patients (or parents of patients) during the consent-taking process, and this gap may be impacted by socio-demographic factors such as language and education level.
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Emergency physician (EP)-performed focused cardiac ultrasound (EP FOCUS) has been increasingly recognized as a crucial tool to help clinicians diagnose and treat potentially life-threatening conditions. The existing literature demonstrates a variety of EP FOCUS applications and protocols; however, EP FOCUS is not taught, practiced, or interpreted consistently between institutions. ⋯ Each of these assessments has been well described in the emergency medicine literature and is within the scope of EP-performed echocardiography. This approach provides a reliable and easily recalled framework for assessing, teaching, and communicating EP FOCUS findings that are essential in caring for the patient in the emergency setting.
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A nurse-initiated high dose, opioid protocol for vaso-occlusive crisis (VOC) was implemented. Total intravenous morphine sulfate equivalents (IVMSE) in mgs] and safety was evaluated. ⋯ High opioid doses were safely administered to patients with sickle cell disease.