Articles: emergency-department.
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There is currently conflicting data as to the effects of hypercapnia on clinical outcomes among mechanically ventilated patients in the emergency department (ED). These conflicting results may be explained by the degree of acidosis. We sought to test the hypothesis that hypercapnia is associated with increased in-hospital mortality and decreased ventilator-free days at lower pH, but associated with decreased in-hospital mortality and increased ventilator-free days at higher pH, among patients requiring mechanical ventilation in the emergency department (ED). ⋯ Higher pCO2 is associated with decreased mortality and greater ventilator-free days when pH is >7.10; however, it is associated with increased mortality and fewer ventilator-free days when the pH is below 7.00. Targeting pCO2 based on pH in the ED may be a potential intervention target for future clinical trials to improve clinical outcomes.
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The incidence of injuries caused by electric bicycles (E-bikes) and powered scooters (P-scooters) continues to increase. Data on the severity of those injuries is conflicting. The purpose of this study was to explore secular trends in the incidence and severity characteristics of patients following E-bike and P-scooter injuries and predictors for major trauma. ⋯ The incidence of E-bike and P-scooter injuries sharply increased over time, with a parallel elevation in numbers of hospitalizations, surgical interventions, and major trauma cases. Major trauma percentages did not increase during the study period. Male sex and E-bikes emerged as independent predictors for major trauma.
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The national pediatric mental and behavioral health crisis dramatically increased emergency department mental and behavioral health visits and changed emergency nursing practice. Acuity assessment determines patient severity level and supports appropriate resources and interventions. There are no established nursing tools that assess pediatric mental or behavioral health acuity in the emergency department setting. Our goal was to develop and implement the novel pediatric emergency nurse Emergency Behavioral Health Acuity Assessment Tool. ⋯ For emergency nurses, the Emergency Behavioral Health Acuity Assessment Tool provided an objective measure of patient acuity. Targeted interventions can improve the care of this population.