The American journal of emergency medicine
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Nebulized particles must have diameters between 1 to 5 μm (optimal particle size range [OPSR]) to be deposited in the lower respiratory tract. The purpose of this study is to determine factors that affect the particle size distributions of nebulized albuterol. ⋯ Single-use disposable nebulizers do not degrade with use, but their performance is highly dependent on gas flow rates. At the flow rate achieved by the home pump, the semipermanent nebulizer performs better than the SUD nebulizer.
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Optimal resuscitation duration before the first rescue shock (RS) to maximize the probability of success after prolonged ventricular fibrillation (VF) cardiac arrest remains unknown. The purpose of this study was to determine the occurrence of return of spontaneous circulation (ROSC) and survival by RS attempt after 12 minutes of untreated VF. ⋯ Our data suggest that during the metabolic phase of VF, 3 minutes of CPR and 1 standard dose of epinephrine may be insufficient to achieve ROSC on the first RS attempt. A longer duration of CPR and/or additional vasopressors may increase the likelihood of successful defibrillation.
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Implementation of a novel point-of-care ultrasound billing and reimbursement program: fiscal impact.
The aim of this study was to determine the fiscal impact of implementation of a novel emergency department (ED) point-of-care (POC) ultrasound billing and reimbursement program. ⋯ Within 1 year of inception, our novel POC ultrasound billing and reimbursement program generated significant revenue through ultrasound billing.
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Methylene blue is the first-choice treatment of methemoglobinemia, but it is not readily available in most Korean emergency departments because of an import suspension. An 84-year-old woman with dapsone-induced massive methemoglobinemia visited our emergency department for unclear mentality and cyanosis. ⋯ Vitamin C (10 g intravenously) administered 6 hourly successfully treated the dapsone-induced methemoglobinemia and did not adversely affect renal functions. Thus,we recommend that if methylene blue is unavailable, 6 hourly intravenous administrations of 10 g of VC should be considered for dapsone-induced methemoglobinemia.
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Various emergency department (ED) HIV testing models are reported in the literature but may not all be sustainable. We sought to determine whether changing an ED rapid HIV testing program from counselor-based to ED technician-based resulted in more testing. ⋯ We present a novel approach to HIV testing using existing staff within the ED. This new ED technician-based model led to large increases in rates of testing.