Annals of emergency medicine
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Randomized Controlled Trial
Successful Tobacco Dependence Treatment in Low-Income Emergency Department Patients: A Randomized Trial.
Tobacco use is common among emergency department (ED) patients, many of whom have low income. Our objective is to study the efficacy of an intervention incorporating motivational interviewing, nicotine replacement, and quitline referral for adult smokers in an ED. ⋯ An intensive intervention improved tobacco abstinence rates in low-income ED smokers. Because approximately 20 million smokers, many of whom have low income, visit US EDs annually, these results suggest that ED-initiated treatment may be an effective technique to treat this group of smokers.
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Observational Study
Communication of Vital Signs at Emergency Department Handoff: Opportunities for Improvement.
We describe the prevalence of vital sign communication errors during emergency department (ED) handoffs. Our secondary objective is to evaluate the association between handoff behaviors and ED crowding on vital sign handoff errors. ⋯ Providers omitted communication of patient hypotension or hypoxia in nearly 1 in 7 ED handoffs. These communication errors do not appear to be related to ED crowding or care interruptions.
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Helicobacter pylori infection is a known cause of gastritis, dyspepsia, and peptic ulcer disease. Testing for infection is indicated in high-prevalence outpatient settings. The objective of this prospective cohort study is to examine the feasibility of a test-and-treat strategy in the emergency department (ED) setting. ⋯ A test-and-treat strategy is feasible in the ED setting and could benefit symptomatic patients.
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Antipsychotic drugs are frequently reported to cause QT prolongation and torsade de pointes. We aim to investigate the potential risk of torsade de pointes in antipsychotic overdose by assessing the QT interval with the QT nomogram. ⋯ There appeared to be significant risk of QT prolongation with amisulpride and thioridazine overdoses. Although there were abnormal QT intervals for quetiapine, olanzapine, and risperidone overdoses, they were associated with tachycardia and not dose dependent, and so were unlikely to be associated with increased torsade de pointes risk.