Annals of emergency medicine
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Review Comparative Study
Failure of adjunctive bicarbonate to improve outcome in severe pediatric diabetic ketoacidosis.
Although adjunctive intravenous bicarbonate therapy is commonly recommended for children with severe diabetic ketoacidosis (DKA), no studies assessing clinical outcome with this therapy have ever been performed. Our objective was to determine whether bicarbonate therapy influenced outcome for pediatric DKA. ⋯ We found no evidence that adjunctive bicarbonate improved clinical outcome in children with severe DKA. The rate of metabolic recovery and complications were similar in patients treated with and without bicarbonate, and prolonged hospitalizations were noted in the bicarbonate group. We conclude that adjunctive bicarbonate is unnecessary and potentially disadvantageous in severe pediatric DKA.
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To determine how emergency physicians and nurses spend their time on emergency department activities. ⋯ Emergency physicians and nurses spent almost half of their time on indirect patient care. Physicians spent significantly more time on indirect patient care activities and significantly less time on personal activities than did nurses.
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See editorial Objective: Patients with lacerations are most concerned about the ultimate cosmetic appearance of their wound. We evaluated methods to assess the long-term cosmetic appearance by telephone survey.
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Comparative Study
Long-term evaluation of cosmetic appearance of repaired lacerations: validation of telephone assessment. The Stony Brook Wound Registry Study Group.
Patients with lacerations are most concerned about the ultimate cosmetic appearance of their wound. We evaluated methods to assess the long-term cosmetic appearance by telephone survey. ⋯ The long-term cosmetic appearance of lacerations repaired in the ED can be assessed by asking patients to grade their lacerations from 0 to 100 over the telephone. By contrast, categorical assessment over the telephone is not concordant with physician assessment in the ED. This information may allow easier assessment of injuries and their long-term consequences.