Articles: emergency-department.
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Int J Crit Illn Inj Sci · Oct 2014
Characteristics of patients who died from traumatic brain injury in two rural hospital emergency departments in Maharashtra, India, 2007-2009.
Trauma is one of the leading causes of morbidity and mortality in the world and in India. ⋯ Most of the TBI patients who died within 24 h after admission to EDs in this study were not transported to EDs in emergency medical vehicles; most were of working age (ages 20-50 years); were male; and were day laborers working on busy interstate roads where they were hit by vehicles.
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Observational Study
Blood culture diagnostic yield in a paediatric emergency department.
Blood culture (BC) is one of the most commonly used microbiological tests in the paediatric emergency department (PED) despite its lack of immediate diagnostic utility. Our objectives were to uncover the reasons for BC in the PED, to review adherence to the current protocol for this technique, and to analyse the diagnostic yield (DY) of BC in localized bacterial infections. ⋯ FWS is the main reason for BC in the PED. One-quarter of the BCs were not indicated, with the DY null in these cases. Due to the low DY in certain localized bacterial infections, a strict individualized ordering of BC in these cases should be considered.
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The influence of high blood alcohol level (BAL) on the outcome of severely injured patients and the corresponding pathophysiological changes is a controversial issue. ⋯ Severely injured patients with a raised BAL have a higher incidence of severe traumatic brain injury and worse initial physiological parameters. However, the survival rate and in-hospital stay is not influenced. This supports the theory of a neuroprotective role of alcohol.
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Pediatric emergency care · Oct 2014
Observational StudyPediatric procedural sedation with propofol using a higher initial bolus dose.
We sought to describe the doses of propofol used for sedation in our pediatric emergency department, along with the range of procedures performed under propofol sedation. We also planned to describe clinically important physiologic changes seen and physician satisfaction with propofol at the doses observed. ⋯ A 2-mg/kg initial bolus dose of propofol for pediatric sedation was well tolerated and useful for a wide range of procedures. Physicians should expect to find a high level of satisfaction with this dose.
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Pediatric emergency care · Oct 2014
Case ReportsAcute obtundation in a 9-month-old patient: ethanol ingestion.
Alcohol ingestion in the pediatric patient can be life threatening. Younger patients consume larger volumes per body weight with accidental ingestions, and children have more serious adverse effects at lower blood alcohol levels. Complications of alcohol poisoning can include hypothermia, hypoglycemia, seizures, coma, and death. ⋯ The infant responded to supportive measures including mechanical ventilation, fluids, and dextrose, and hemodialysis was not necessary. Her alcohol clearance followed zero-order kinetics at an average rate of 28.6 mg/dL per hour over 15.5 hours from her peak level of 524 mg/dL to the lowest measured value of 80 mg/dL. The kinetics of ethanol clearance at this level of toxicity, which is the highest reported in an infant to date, enhance our knowledge of ethanol metabolism and will assist in management decisions in cases of severe intoxication.