Articles: emergency-department.
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The Journal of urology · Sep 2013
Comparative StudyMedical expulsive therapy versus early endoscopic stone removal for acute renal colic: an instrumental variable analysis.
The use of medical expulsive therapy to hasten stone passage potentially decreases expenditures around episodes of renal colic. However, these efficiency gains may be mitigated if patients treated with medical expulsive therapy have frequent health care encounters due to pain while waiting for the stones to pass. ⋯ Findings on medical expulsive therapy are mixed, with lower 6-week payments but more frequent repeat emergency department visits. These data inform patients who are candidates for medical expulsive therapy or endoscopic stone removal when making decisions about their care.
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To predict the outcome of stroke at an acute stage is important but still difficult. Vomiting is one of the commonest symptoms in stroke patients. The aim of this study is threefold: first, to examine the percentage of vomiting in each of the three major categories of strokes; second, to investigate the association between vomiting and other characteristics and third, to determine the correlation between vomiting and mortality. ⋯ Compared with patients without vomiting, the risk of death was significantly higher in patients with vomiting at the onset of stroke. Vomiting should be an early predictor of the outcome.
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Kidney stone is normally treated by opioids with a variety of side-effects including hypotension, respiratory depression and apnea, nausea and vomiting. Regarding less complications of intravenous acetaminophen, we aimed to compare it with intravenous morphine in management of renal colic pain. ⋯ Comparing intravenous morphine and acetaminophen in renal colic pain reviled that morphine can develop greater pain relief, but more complications such as dizziness and hypotension. Acetaminophen can be also be effective in renal colic pain, so it is concluded that acetaminophen can be administered as a less harmful drug for patients with renal colic pain.
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Knives cause more disabling injuries than any other type of hand tool. ⋯ Knives represent an important source of morbidity and mortality to people of all ages. Manufacturers should develop safer knife designs that incorporate features, such as improved opening and closing mechanisms on pocket knives, to prevent these injuries. Other potential safety efforts include targeted educational interventions and changes in voluntary product safety standards and public policy.
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False-positive peripheral blood cultures due to contamination pose clinical and financial consequences for patients, families, and hospitals. Educating staff who draw peripheral blood cultures about hospital policy, using a blood culture-drawing kit, having a dedicated team obtaining peripheral blood cultures, and following up with staff who draw a contaminated peripheral blood cultures have been shown to reduce the rate of false-positive peripheral blood cultures. The objective of this study was to reduce the rate of false-positive peripheral blood cultures in a pediatric emergency department using the previously mentioned measures. ⋯ The decline in contaminated blood cultures shows that the interventions described significantly reduced the rate of false-positive peripheral blood cultures in the emergency department.