The American journal of emergency medicine
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Observational Study
Effects of emergency department boarding on mortality in patients with ST-segment elevation myocardial infarction.
Patients with ST-segment elevation myocardial infarction (STEMI) are sometimes boarded in the emergency department (ED) after percutaneous coronary intervention (PCI). We evaluated the effects of direct and indirect admission to the CCU on mortality and the effect on length of stay (LOS) in patients with STEMI. ⋯ This study suggests that direct admission after PCI and indirect admission was not associated with mortality in patients with STEMI. In addition, the stay in ED also appears to be associated with the duration of stay under critical care.
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The aim of this study is to compare a point-of-care (POC) analysis, Enterprise POC (epoc), using the capillary blood obtained from skin puncture with conventional laboratory tests using arterial and venous blood in hypotensive patients. ⋯ Most parameters, except pO2, measured by the epoc system using the capillary blood in hypotensive patients were equivalent to or correlated with those measured by the reference analyzers.
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Multicenter Study
Variations in access to specialty care for children with severe burns.
Pediatric burns account for 120,000 emergency department visits and 10,000 hospitalizations annually. The American Burn Association has guidelines regarding referrals to burn centers; however there is variation in burn center distribution. We hypothesized that disparity in access would be related to burn center access. ⋯ The majority of children who met criteria were treated at burn centers. There was no significant difference between geographical regions. Of those who were treated at burn centers, more severe injury patterns were noted, but there was no significant mortality difference. Further study of optimal referral of pediatric burn patients is needed.
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Hands-on defibrillation (HOD) is a technique that has great potential to positively impact outcomes from cardiopulmonary resuscitation (CPR) with the removal of an interruption in chest compressions. The safety and efficacy of HOD, however, have yet to be proven. This review aims to examine the safety of HOD, and secondarily, its efficacy. ⋯ HOD generally appears safe, though significant uncertainty still remains for each protective barrier type. HOD appears to be efficacious in improving CPR with no strong evidence to suggest otherwise.