The American journal of emergency medicine
-
Right bundle-branch block (RBBB) in the patient with acute coronary syndrome is a marker of significant potential cardiovascular risk; the RBBB pattern in the patient with acute coronary syndrome identifies a subgroup of patients with quite high short- and long-term morbidity and mortality. Right bundle-branch block is not an uncommon finding on an electrocardiogram in the emergency department patient, noted incidentally and thus without clinical import or, conversely, encountered in the early phase of significant cardiovascular dysfunction. This review will address RBBB in the acute coronary syndrome setting.
-
The objective was to assess agreement between end-tidal carbon dioxide values measured by a handheld capnometer (Petco(2)) and values measured by a blood gas analyzer (Paco(2)) in nonintubated patients with respiratory distress in an out-of-hospital setting. ⋯ Petco(2) measurements poorly reflected Paco(2) values in our population of nonintubated patients with respiratory distress of various origins.
-
Multicenter Study
ED visit volume and quality of care in acute exacerbations of chronic obstructive pulmonary disease.
The purpose of this study is to determine whether emergency department (ED) visit volume is associated with ED quality of care in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). ⋯ Traditional positive volume-quality relationships did not apply to emergency care of COPD exacerbation. High-volume EDs used less guideline-recommended diagnostic procedures, had a higher admission threshold, and had a worse short-term patient-centered outcome.
-
Controlled Clinical Trial
A better way to estimate adult patients' weights.
In the emergency department (ED), adult patients' weights are often crudely estimated before lifesaving interventions. In this study, we evaluate the reliability and accuracy of a method to rapidly calculate patients' weight using readily obtainable anthropometric measurements. We compare this method to visual estimates, patient self-report, and measured weight. ⋯ This technique using readily obtainable measurements estimates weight more accurately than ED providers. The technique correlates well with actual patient weights. When available, patient estimates of their own weight are most accurate.
-
Tricyclic antidepressant (TCA) morbitity is primarily due to cardiac arrhythmias and hypotension, which become more refractory to treatment as acidosis progresses (Ann Emerg Med. 1985;14:1-9; Clin Toxicol. 2007;45:203-233; Flomenbaum N, Goldfrank L, Hoffman R, et al. Goldfrank's toxicologic emergencies. 8th ed. McGraw-Hill Companies, Inc, 2006). Early recognition and aggressive treatment are necessary for patient survival.