The American journal of emergency medicine
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Because baclofen is eliminated mostly by the kidney, baclofen-related encephalopathy is usually found in patients with renal failure. Therefore, hemodialysis has been suggested for those patients to alleviate symptoms and shorten recovery time. We present a case of baclofen intoxication with normal renal function benefiting from hemodialysis. ⋯ Hisconsciousness returned 9 hours after hemodialysis was finished, and he was extubated smoothly thereafter. The elimination half-life of baclofen before and during hemodialysis was 15.7 and 3.1 hours, respectively. As patients with baclofen overdose could have prolonged elimination even with normal renal function, hemodialysis would be beneficial to those patients with normal renal function.
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The aim of this study was to investigate whether emergency department (ED) patients who were newly diagnosed with atrial fibrillation (AF) displayed risk factors for incident AF on prior ED visits. ⋯ Nearly 40% of patients diagnosed with new AF had previous ED visits and displayed validated risk factors for incident AF. The ED provides an opportunity to identify and educate these patients as well as refer them for primary prevention interventions.
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In an effort to compensate for crowding, many emergency departments (EDs) evaluate and treat patients in nontraditional settings such as gurneys in hallways and conference rooms. The impact of this practice on ED evaluation time is unknown. ⋯ Use of nontraditional beds is associated with increases in mean ED evaluation time; however, these increases are small and may be further minimized by restricting the use of nontraditional beds to patients with specific chief complaints. Nontraditional beds may have a role in improving ED throughput during times of crowding.
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The objective of this study is to determine the number of primary stroke centers (PSCs) that exist concurrently (synergic relationship) with designated higher level trauma centers (level I or level II trauma centers) and associated characteristics. ⋯ Despite evidence of higher capability among institutions with coexisting PSC-trauma centers, two thirds of PSCs are in hospitals without advanced trauma systems. These findings have implications for establishing stroke systems in the United States.
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The purpose of this study is to develop and validate the excess mortality ratio-based Emergency Severity Index (EMR-ESI) that feasibly and objectively assesses the severity of emergency department (ED) patients based on their chief complaints. ⋯ The EMR-ESI was notably useful in predicting hospital mortality and the admission of emergency patients.