The American journal of emergency medicine
-
Comparative Study
EZ-IO in the ED: an observational, prospective study comparing flow rates with proximal and distal tibia intraosseous access in adults.
Intraosseous (IO) access is an important alternative to conventional intravenous access when intravenous access is difficult. ⋯ Flow rates are significantly faster in the proximal tibia compared with the distal tibia. In addition, flow rates with pressure bags are significantly faster than without pressure bags in both groups.
-
The primary purpose of this study was to investigate the overall accuracy of bedside extremity tendon ultrasound performed by emergency physicians in the emergency department. We also sought to investigate whether or not bedside tendon ultrasonography can be used to expedite the diagnosis and discharge planning in patients with suspected tendon injuries. ⋯ Bedside ultrasound is more sensitive and specific than physical examination for detecting tendon lacerations, and takes less time to perform than traditional wound exploration techniques or MRI.
-
The University of Utah emergency department (ED) observation unit (EDOU) cares for over 2500 patients each year, with a significant portion of these patients being trauma activation patients. We evaluated the safety and efficacy of our EDOU trauma protocol and described patient characteristics and outcomes of trauma patients managed in an EDOU. ⋯ There were no adverse outcomes in trauma patients admitted to the EDOU, and our inpatient admission rate was within the generally accepted admission rate for patients in observation status. The EDOU appears to be a safe alternative to inpatient admission for the evaluation of minimally injured trauma activation patients.
-
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.
-
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.