The American journal of emergency medicine
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The two new uses for the nasopharyngeal airway include facilitation of nasogastric intubation and nasotracheal intubation. First this technique takes advantage of the nasopharyngeal airway's unique ability to traverse the nasopharynx atraumatically and serve as a conduit for the smaller nasogastric tube. This technique also utilizes the nasopharyngeal airway to dilate the nasopharyngeal passage atraumatically, thus facilitating the passage of an endotracheal tube during nasotracheal intubation.
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Pediatric cardiopulmonary resuscitation drug therapy is based upon body weight, a statistic that often requires estimation. Using two current techniques of estimating body weight and the devised weight-estimating method (DWEM), the authors estimated the weights of 258 children. ⋯ Using height, habitus, sex, and age in a multiple regression analysis, habitus and height--two readily available measurements--were the best predictors of body weight. The DWEM, based on these two measurements, is a simple method of estimating children's weights and is more accurate than currently used body-weight estimations.
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This is a descriptive and evaluative report regarding a clinical pharmacy residency in-house on-call program that facilitates the provision of 24-hour clinical pharmacy consultative services within the emergency department. During the two-year evaluation period, clinical pharmacy residents completed 3.1 consultations per 14-hour call period. ⋯ These consultations were usually solicited by internal medicine physicians within the emergency department, involved patient-specific drug therapy recommendations, and required about 100 minutes (mean per consultation) of the clinical pharmacist's time. Thus, clinical pharmacy consultative services can be a useful addition to health care within the emergency department in teaching hospitals.
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The case records of 39 patients with classic (non-exertional) heatstroke presenting to an urban emergency department were reviewed. Eight of 39 patients died. ⋯ The rate of mortality in the rapid cooling group was four of 27 (15%), while in the delayed cooling group, the mortality rate was four of 12 (33%) (P = 0.18). Factors such as advanced age, hypotension, altered coagulation status, and the necessity for endotracheal intubation on presentation dictated a poor outcome despite successful cooling measures.
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Randomized Controlled Trial Clinical Trial
Topical anesthesia for laceration repair: tetracaine versus TAC (tetracaine, adrenaline, and cocaine).
Topical anesthetics have always had a place in anesthetizing mucous membranes. The earliest writing in Greek medical literature makes reference to the use of these topical anesthetizing agents. Previous studies utilized a mixture of tetracaine, Adrenaline, and cocaine in the pediatric population with increased patient compliance. ⋯ The results indicate that the most efficacious use of TAC is on facial lacerations, regardless of length or depth. Of the 46 participants available for follow-up, one patient in the tetracaine group reported a wound infection. A recommendation of increased use of TAC on facial lacerations, in both the adult and pediatric populations, is made based on the results of this study.