Annals of emergency medicine
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To determine the prevalence of delirium and other alterations in mental status in older adults in the emergency department setting. ⋯ Alterations in mental status are prevalent in ED patients. Older adults with alterations in mental status, particularly alterations in consciousness and delirium, are at high risk for admission to an inpatient unit and institutionalization after discharge. Standardized mental status testing identified high-risk older adults in the ED.
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To assess whether bystander CPR (BCPR) on collapse affects initial rhythm and outcome in patients with witnessed, unmonitored out-of-hospital cardiac arrest (OHCA). ⋯ Patients who receive BCPR are more often found in VT/VF and have an increased rate of live discharge, with controls for age and response and definitive care intervals. For VT/VF patients, BCPR is associated with an increased rate of live discharge.
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End-tidal CO2 (ETCO2) measurement can be used to predict death in prehospital cardiac arrest patients with pulseless electrical activity (PEA). ⋯ This study suggests that a low ETCO2 (10 mm Hg or less) can be used to predict irreversible death in patients with pulseless electrical activity undergoing prehospital advanced cardiac life support. If future studies validate this model, use of ETCO2 may allow for triage decisions in the field.
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To describe emergency department quality assurance (QA)/improvement (QI) practices for pediatric patients. ⋯ The bulk of pediatric emergency patients are cared for in a general ED. Most ACEP members surveyed reported the use of separate QA indicators to monitor the care of pediatric patients seen in the ED. This survey provides the first description of QA/QI practices for pediatric patients by EDs nationwide.