The American journal of emergency medicine
-
Randomized Controlled Trial Comparative Study
Randomized comparison of three guidewire insertion depths on incidence of arrhythmia during central venous catheterization.
Guidewire-induced arrhythmias that occur during central venous catheterization can progress to malignant arrhythmias in rare cases. This study compared the incidence of arrhythmia during central venous catheterization using three different depths of guidewire insertion into the right internal jugular vein. ⋯ During central venous catheterization through the right internal jugular vein, inserting guidewires to depths of 15 or 17.5cm before tissue dilation reduced the incidence of arrhythmic episodes compared to a depth of 20cm.
-
The effect of the Affordable Care Act on emergency department (ED) high utilizers has not yet been thoroughly studied. We sought to determine the impact of changes in insurance eligibility following the 2014 Medicaid expansion on ED utilization for ambulatory care sensitive conditions (ACSC) by high ED utilizers in an urban safety net hospital. ⋯ Although the proportion of high utilizers decreased significantly after Maryland's Medicaid expansion, ACSC-associated ED visits by high ED utilizers were unaffected.