The American journal of emergency medicine
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Multicenter Study
Intranasal ketamine for procedural sedation in children: An open-label multicenter clinical trial.
There are limited options for pain and distress management in children undergoing minor procedures, without the burden of an intravenous line insertion. Prior to this study, we conducted a dose-escalation study and identified 6 mg/kg as a potentially optimal initial dose of intranasal ketamine. ⋯ ClinicalTrials.gov (NCT03053947).
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Conceptually, inpatient boarding is a result in the delay of admitting patients from the Emergency Department (ED) to inpatient units, but there is no consistent definition across academic EDs. The purpose of this study was to evaluate the definition of boarding across academic EDs, and to identify mitigation strategies used by EDs to alleviate crowd management. ⋯ We found that definitions for boarding varied widely. Inpatient boarding has serious consequences to patient care and well-being, suggesting the need for standardized definitions to describe inpatient boarding.
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Violence directed at healthcare workers (HCWs) is common and may be more frequent in the emergency department (ED). In addition to physical injury, other consequences of workplace violence in the ED include an increased risk of burnout, post-traumatic stress disorder, reduced job satisfaction, and feelings of avoidance and futility. Understanding behaviors underlying workplace violence is the first step to employing mitigation strategies. The objective of this descriptive study was to assess the prevalence and types of violence against HCWs in a large, urban ED. ⋯ We found that workplace violence against HCWs was common in this study, and sometimes involved a component of racist, sexist, or homophobic bias. Consistent with previous ED literature, we found that abusive events occurred almost daily and that approximately 20% of events involved physical violence. Future efforts toward policy change to address workplace violence in health care is needed at local, state, and national levels.
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Observational Study
Clinical factors predicting return emergency department visits in chemotherapy-induced febrile neutropenia patients.
Although chemotherapy-induced febrile neutropenia (FN) is the most common and life-threatening oncologic emergency, the characteristics and outcomes associated with return visits to the emergency department (ED) in these patients are uncertain. Hence, we aimed to investigate the predictive factors and clinical outcomes of chemotherapy-induced FN patients returning to the ED. ⋯ High shock index, lactic acid, thrombocytopenia, and ED arrival type can predict return visits to the ED in chemotherapy-induced FN patients.