The American journal of emergency medicine
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Haloperidol and ketorolac have been recommended as therapies that may decrease opioid use for treatment of pain in emergency department patients. The objective of our study is to determine if administration of haloperidol or ketorolac is associated with lower use of i.v. opioids for patients with non-specific abdominal pain. ⋯ Haloperidol was not associated with decreased i.v. opioid use. Ketorolac was associated with a modest decrease in i.v. opioid use. Providers should consider the use of haloperidol and ketorolac as potentially beneficial in some cases, but there is a need for high quality studies before they can be recommended as standard therapy.
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Observational Study
A prospective study to assess the association of body mass index and contamination of urinalysis samples.
There is a commonly held belief that overweight women are more likely to offer contaminated urine samples (UAs) in the emergency department (ED) than women with normal body mass index (BMI). However, there is a paucity of research evaluating this potential concern. ⋯ Obesity was significantly associated with contamination of clean catch mid-stream samples in our population.
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Patients who may be a danger to themselves or others often are placed on involuntary hold status in the Emergency Department (ED). Our primary objective was to determine if there are demographic and/or clinical variables of involuntary hold patients which were associated with an increased ED LOS. ⋯ Involuntary hold patients had an increased ED LOS associated with alcohol use, urine drug test screening, and barbiturate use. Protocol development to help stream-line ED evaluation of alcohol and drug use may improve ED LOS in this patient population.
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Vaginal cuff dehiscence is a rare, but potentially morbid, complication of a total hysterectomy. Bowel evisceration can lead to serious sequelae and is considered a surgical emergency however there is a paucity of information on it in the Emergency Medicine literature. ⋯ The history and physical exam were concerning for vaginal cuff dehiscence (VCD). The patient underwent an Exam Under Anesthesia (EUA) and subsequent laparoscopic repair of the vaginal cuff defect and fully recovered.
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This work investigates the potential of photoplethysmography (PPG) to detect a spontaneous pulse from the finger, nose or ear in order to support pulse checks during cardiopulmonary resuscitation (CPR). ⋯ PPG signals at all investigated sites can indicate pulse presence at the moment the heart resumes beating as verified via the ABP signal. Therefore, PPG may provide decision support during CPR, especially related to preventing and shortening interruptions for unnecessary pulse checks. This could have impact on CPR outcome and should further be investigated.