Articles: emergency-services.
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Droperidol is used commonly to treat agitation in the emergency department (ED), however, data comparing doses are lacking. ⋯ In this large cohort, patients deemed appropriately treated with 5 mg of droperidol required less rescue sedation than patients determined to need 10 mg.
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To determine the prevalence and pattern of hypoglycemia among children admitted to the Emergency Pediatric Unit (EPU) at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. ⋯ Hypoglycemia is a common occurrence among children admitted to the EPU. Factors such as being under five years old, in a coma, weakness, severe malaria, and prolonged fasting were all identified as independent predictors of hypoglycemia. Therefore, routine blood glucose monitoring of children admitted to the EPU, specifically those at higher risk, is recommended.
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Eur. J. Intern. Med. · Jan 2025
Prospective study of risk factors for community-acquired acute kidney injury.
Causes and risk factors for community-acquired acute kidney injury (CA-AKI) have not been thoroughly studied. The aim of this study was to examine the risk factors for CA-AKI. ⋯ Events in the setting of acute illness and medication use, including OTC NSAIDs, may play a greater role in the development of CA-AKI than comorbid conditions. Frequent use of OTC NSAIDs is a concern and should be addressed in view of serious adverse effects.
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Despite research linking chemical and physical restraints to negative outcomes including unplanned intubations and psychological distress, there is little guidance for their use in the care of trauma patients. We used institutional data to describe recent trends in chemical and physical restraint in the emergency department evaluation and treatment of trauma patients and to identify characteristics associated with their use. ⋯ In this institutional study, nearly one-in-twelve trauma patients were restrained during emergency department evaluation and treatment. Restraint utilization increased during the study driven primarily by increases in ketamine and restraints utilized during trauma bay evaluation and resuscitation. Future research should assess the generalizability of these findings. It is important that rigorous guidelines are established to ensure the safe and effective use of restraints in trauma.
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Eur. J. Intern. Med. · Jan 2025
A large language model-based clinical decision support system for syncope recognition in the emergency department: A framework for clinical workflow integration.
Differentiation of syncope from transient loss of consciousness can be challenging in the emergency department (ED). Natural Language Processing (NLP) enables the analysis of free text in the electronic medical records (EMR). The present paper aimed to develop a large language models (LLM) for syncope recognition in the ED and proposed a framework for model integration within the clinical workflow. ⋯ The anamnesis model had an AUC of 0·98 for the Italian BERT and 0·97 for Multi BERT. The LLM identified syncope when not explicitly mentioned in the EMR and also recognized common prodromal symptoms preceding syncope. Both models identified syncope patients in the ED with a high discriminative capability from nurses and doctors' notes, thus potentially acting as a tool helping physicians to differentiate syncope from others transient loss of consciousness.