Annals of emergency medicine
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Multicenter Study Clinical Trial
Multicenter study of a portable, hand-size, colorimetric end-tidal carbon dioxide detection device.
To evaluate continuous, semiquantitative end-tidal carbon dioxide (ETCO2) monitoring in the prehospital and emergency department setting for confirming proper endotracheal tube placement and assessing prognosis and blood flow during CPR. ⋯ The colorimetric ETCO2 device is highly accurate for confirming endotracheal tube position in nonarrest patients. In cardiac arrest patients, a reading signifying more than 0.5% ETCO2 confirms correct endotracheal tube placement, while a value signifying less than 0.5% ETCO2 during resuscitation suggests that something is wrong (eg. esophageal intubation, inadequate circulatory flow, prolonged down-time interval, hypothermia, or significant ventilation/perfusion mismatch).
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Randomized Controlled Trial Clinical Trial
Preformatted charts improve documentation in the emergency department.
To determine if the use of programmed charts with complaint-specific entry criteria results in improved documentation of patient encounters and better clinical outcome. ⋯ Programmed charts improve documentation by facilitation of the documentation process and allow more time for patient-physician interaction. Quality of documentation alone, however, is not a reliable indicator of patient outcome or of the quality of care received.
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Clinical Trial
Conscious sedation in the emergency department: the value of capnography and pulse oximetry.
The purpose of this observational study was to describe the use of nasal capnography and pulse oximetry in monitoring heavily sedated emergency department patients. ⋯ The use of pulse oximetry is recommended for the detection of unrecognized hypoxemia during conscious sedation. Capnography by nasal cannula appears to be a useful modality in monitoring during conscious sedation, but further research and clinical experience are required before routine use can be recommended.
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Case Reports
Lightning strikes: nature of neurological damage in patients evaluated in hospital emergency departments.
Emergency physicians and staff are usually the first to evaluate and manage victims of lightning strikes. Damage to the nervous system is often the most devastating consequence of lightning strikes. Contrary to most articles in the literature in which neurological disorders are said to be either transient or delayed, we report the cases of six patients with severe, immediate, and in at least three, permanent clinical problems. Patients with signs of spinal cord lesions are most likely to have permanent disabilities.
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Multicenter Study Clinical Trial
Acute myocardial infarction in chest pain patients with nondiagnostic ECGs: serial CK-MB sampling in the emergency department. The Emergency Medicine Cardiac Research Group.
This study tested the hypothesis that serial creatine phosphokinase (CK)-MB sampling in the emergency department can identify acute myocardial infarction (AMI) in patients presenting to the ED with chest pain and nondiagnostic ECGs. ⋯ Serial CK-MB determination in the ED can help identify AMI patients with initial nondiagnostic ECGs. Use of serial CK-MB analysis may facilitate optimal in-hospital disposition and help guide therapeutic interventions in patients with suspected AMI despite a nondiagnostic ECG.