Annals of emergency medicine
-
To describe the clinical and ECG features of cocaine abusers evaluated in the emergency department and admitted to the medical coronary care unit with chest pain consistent with myocardial ischemia. ⋯ Our findings confirm a small but significant incidence of myocardial infarction in cocaine abusers presenting to the ED with chest pain. The chronicity of cocaine abuse, the persistence of ECG abnormalities, and the variable temporal relationship of chest pain to cocaine abuse suggest possible chronic myocardial changes as etiologies of ischemia.
-
Randomized Controlled Trial Clinical Trial
Use of portable ultrasound to assist urine collection by suprapubic aspiration.
To determine whether portable ultrasound can improve the success rate of suprapubic aspiration (SPA). ⋯ Portable ultrasound can significantly improve the success rate of SPA and limit nonproductive attempts at SPA.
-
To evaluate whether the capillary refill test can correctly differentiate between hypovolemic and euvolemic emergency department patients. ⋯ Capillary refill does not appear to be a useful test for detecting mild-to-moderate hypovolemia in adults.
-
Documentation practices of staff physicians, residents, and nurses managing critically ill children were reviewed for completion of standard documentation requirements. ⋯ ED record documentation of pediatric patients treated in a cardiopulmonary/trauma resuscitation room often does not meet standard guidelines. Complete documentation is important due to the frequency of legal review of these records and the need to ensure post-ED continuity of care.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Rectal thiopental compared with intramuscular meperidine, promethazine, and chlorpromazine for pediatric sedation.
We studied the hypothesis that rectal thiopental is an effective agent for emergency department pediatric sedation and may have advantages over a more traditional regimen. ⋯ Rectal thiopental is superior to this drug combination for pediatric sedation because it can be administered painlessly, has a more rapid onset and offset of action, and is of equal safety and efficacy at the dosage studied.