Articles: emergency-services.
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Pediatric emergency care · Feb 1992
A one-year series of pediatric emergency department wheezing visits: the Hawaii EMS-C project.
During a 12-month period ending on November 30, 1988, data were collected on 2468 pediatric patients with wheezing who visited a pediatric ED. Cohort characteristics included: sex (64% male, 36% female), history of prematurity (12%), evidence of concurrent infection (82%), taking theophylline (35%), taking beta adrenergics (60%), taking cromolyn (6%), and taking corticosteroids (4%). The hospitalization rate was 10.5%. ⋯ Initial oxygen saturation (OSAT) correlated with disease severity as measured by hospitalization risk and the number of bronchodilator treatments required in the ED. A suggestion for categorizing the treatment of asthma based on past history is proposed. Using this system in conjunction with pulse oximetry, wheezing severity and appropriate therapy can be more objectively determined.
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To determine the potential usefulness of external cardiac pacing for the termination of sustained ventricular tachycardia in the emergency department setting. ⋯ We conclude that external noninvasive pacing may be an effective means of terminating ventricular tachycardia in the ED setting.
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To evaluate the nature of the decision to write a do-not-resuscitate (DNR) order in the Emergency Department (ED). ⋯ Because there remains considerable reluctance on the part of physicians to discuss the DNR issue before patients become critically ill, it is often necessary for ED physicians to write a DNR order. Although the ED is not an ideal setting for discussion of DNR orders and patients and families do not generally initiate this discussion, DNR orders can be written by ED physicians after consultation with the family.