Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the availability and completeness of selected data elements from administrative and clinical sources for emergency department (ED) visits in a national pediatric research network. ⋯ Data elements important in emergency medical care for children are frequently missing in existing administrative and medical record sources; completeness varies widely across EDs. Researchers must be aware of these limitations in the use of existing data when planning studies.
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Comparative Study
Changing opioid use for right lower quadrant abdominal pain in the emergency department.
To compare the use of opioid analgesia in the treatment of emergency department patients with acute right lower quadrant (RLQ) abdominal pain between 1998 and 2003 and to explore the relationship between opioid use and abdominal computed tomography (CT) scanning. ⋯ Opioid administration to patients with RLQ pain has dramatically increased between 1998 and 2003. During these five years, the number of patients receiving opioids more than doubled and the time to first administration of opioids decreased by one hour. The authors show that this cannot be attributed to an increased use of CT scanning.
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Comparative Study
The paradox of the nested pediatric emergency department.
Nested pediatric emergency departments (nPEDs) are defined as dedicated treatment areas operating during peak pediatric hours within general emergency departments (EDs). This study examined three staffing models for nPEDs and their impact on pediatric encounters. ⋯ Physicians practicing in facilities that include an nPED must dedicate some portion of their practice to the nPED to maintain equivalent pediatric encounters.
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Comparative Study
Assessment of a new method to distinguish esophageal from tracheal intubation by measuring the endotracheal cuff pressure in a porcine model.
With the knowledge of differences in anatomic structures between the trachea and the esophagus, the authors conducted an animal study to evaluate the usefulness of endotracheal cuff pressure in distinguishing endotracheal and esophageal intubations. ⋯ The cuff pressure in the esophageal intubation was significantly higher than that in the endotracheal intubation under the same inflated volume from 1 to 10 mL. This may provide the basis for an adjunctive, simple, rapid, and reliable method to verify endotracheal intubation.
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On September 18, 2003, Hurricane Isabel made landfall as a category 2 hurricane over the mid-Atlantic region, generating record conditions for the region's 27 years of monitoring. The purpose of this study was to investigate the impact of the hurricane on the number and type of emergency department (ED) patient visits and its impact on hospital admission rate from the day of landfall to day 5 postlandfall. Comparisons were made with a control group, which comprised average daily ED census during the six-month period preceding landfall and the average daily admission rates for the preceding six months. ⋯ A significant overall reduction in ED visits by almost half the typical average volume was noted on the day of landfall (-46%). During the four days immediately following landfall, however, there was a marked increase in the overall ED census, with a particularly high increase on day 1 postlandfall. The largest complaint category increase was minor trauma (+57%). Hospital admission rates were highest on the day of landfall and seemed to return to baseline on day 1 postlandfall. These data may be useful for structuring ED personnel and hospital resource allocation to better serve its community during hurricane preparedness planning.