Annals of emergency medicine
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Rapid access to emergency services is essential for emergency care-sensitive conditions such as acute myocardial infarction, stroke, sepsis, and major trauma. We seek to determine US population access to an emergency department (ED). ⋯ Although the majority of the US population has access to an ED, there are regional disparities in ED access, especially by rurality. Future efforts should measure the relationship between access to emergency services and outcomes for emergency care-sensitive conditions. The development of a regionalized emergency care delivery system should be explored.
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Multicenter Study Comparative Study
Validation of 3 termination of resuscitation criteria for good neurologic survival after out-of-hospital cardiac arrest.
Several termination of resuscitation criteria have been proposed to identify patients who will not survive to hospital discharge after out-of-hospital cardiac arrest. However, only 1 set has been derived to specifically predict survival to hospital discharge with good neurologic function. The objectives of this study were to externally validate the basic life support (BLS) termination of resuscitation, advanced life support (ALS) termination of resuscitation, and neurologic termination of resuscitation criteria and compare their abilities to predict survival to hospital discharge with good neurologic function after out-of-hospital cardiac arrest. ⋯ All 3 termination of resuscitation criteria had equally high abilities to identify patients requiring continued resuscitation. The BLS termination of resuscitation criteria, however, had the best combined ability to predict good neurologic survival and poor neurologic survival or death. These findings and the relative simplicity of the BLS termination of resuscitation criteria support their use.
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Although ketamine is one of the most commonly used sedatives to facilitate painful procedures for children in the emergency department (ED), existing studies have not been large enough to identify clinical factors that are predictive of uncommon airway and respiratory adverse events. ⋯ Risk factors that predict ketamine-associated airway and respiratory adverse events are high intravenous doses, administration to children younger than 2 years or aged 13 years or older, and the use of coadministered anticholinergics or benzodiazepines.