Annals of emergency medicine
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Clinical Trial
Impact of portable pulse oximetry on arterial blood gas test ordering in an urban emergency department.
To determine the impact of portable pulse oximetry on physician use of arterial blood gas tests (ABGs) in an urban emergency department. ⋯ Portable pulse oximetry can provide a simple, noninvasive way to determine oxygen saturation in the ED. Routine use of portable pulse oximetry may substantially reduce rates of ABG testing and associated patient charges without adversely affecting the quality of emergency care.
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We present the case of a woman with myocardial infarction complicated by malignant ventricular arrhythmia and torsades de pointes. The torsades de pointes was refractory to conventional therapy but responsive to phenytoin. This case suggests the clinical usefulness of phenytoin for adjunct therapy of life-threatening ventricular arrhythmias when standard treatment modalities fail.
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To determine the ability of an emergency physician to detect a variety of foreign bodies in an experimental model using a portable ultrasound device. ⋯ Ultrasound has promise as a diagnostic tool for the detection of a variety of foreign bodies. Further clinical studies using ultrasound for the detection of foreign bodies are warranted.
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To determine the efficacy of flexion-extension (F/E) cervical-spine radiographs in detecting acute cervical-spine instability in emergency patients. ⋯ We believe that a large prospective study is required to determine which patients warrant F/E views.
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The purpose of this study was to isolate significant clinical or demographic findings concerning overdose patients treated during a China White (3-methyl fentanyl) epidemic and compare them with data for all unintentional narcotic overdose patients during a 24-month period. ⋯ China White was responsible for a dramatic rise in unintentional drug overdose deaths in Allegheny County in 1988. There were no significant clinical differences between China White overdose survivors and other unintentional narcotic overdose victims. Overdoses responsive to naloxone with inconsistent routine toxicologic screens may be due to a fentanyl analogue.