Annals of emergency medicine
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The current outbreak of Ebola virus disease in West Africa is the largest on record and has overwhelmed the capacity of local health systems and the international community to provide sufficient isolation and treatment of all suspected cases. The goal of this study is to develop a clinical prediction model that can help clinicians risk-stratify patients with suspected Ebola virus disease in the context of such an epidemic. ⋯ The Ebola Prediction Score can be used by clinicians as an adjunct to current Ebola virus disease case definitions to risk-stratify patients with suspected Ebola virus disease. Clinicians can use this new tool for the purpose of cohorting patients within the suspected-disease ward of an Ebola treatment unit or community-based isolation center to prevent nosocomial infection or as a triage tool when patient numbers overwhelm available capacity. Given the inherent limitations of clinical prediction models, however, a low-cost, point-of-care test that can rapidly and definitively exclude Ebola virus disease in patients should be a research priority.
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Multicenter Study Observational Study
Opioid Prescribing in a Cross Section of US Emergency Departments.
Opioid pain reliever prescribing at emergency department (ED) discharge has increased in the past decade but specific prescription details are lacking. Previous ED opioid pain reliever prescribing estimates relied on national survey extrapolation or prescription databases. The main goal of this study is to use a research consortium to analyze the characteristics of patients and opioid prescriptions, using a national sample of ED patients. We also aim to examine the indications for opioid pain reliever prescribing, characteristics of opioids prescribed both in the ED and at discharge, and characteristics of patients who received opioid pain relievers compared with those who did not. ⋯ In a study of ED patients treated during a single week across the country, 17% of discharged patients were prescribed opioid pain relievers. The majority of the prescriptions had small pill counts and almost exclusively immediate-release formulations.
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Randomized Controlled Trial Comparative Study
Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial.
We assess and compare the analgesic efficacy and safety of subdissociative intravenous-dose ketamine with morphine in emergency department (ED) patients. ⋯ Subdissociative intravenous ketamine administered at 0.3 mg/kg provides analgesic effectiveness and apparent safety comparable to that of intravenous morphine for short-term treatment of acute pain in the ED.