Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The authors sought to develop and validate an emergency department (ED) work score that could be used in real time to quantify crowding and staff workload in an ED. This work score could be used by public health officials to direct ambulance traffic based on an objective measure of ED status and to track ED conditions over time. In addition, the authors sought to determine which portion of ED care was most responsible for crowding. ⋯ An ED work score was successfully developed and internally validated. External validation should be performed before widespread use.
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To describe and analyze the intubating conditions and hemodynamic effects of etomidate in patients undergoing rapid sequence intubation (RSI) in the emergency department. ⋯ Etomidate appears to provide appropriate intubating conditions in a heterogeneous group of patients undergoing RSI in the emergency department. Hemodynamic stability appears to be present following administration of this agent, even in patients with low pre-RSI blood pressure. This attribute must be weighed against potential adverse effects of this agent, including adrenal suppression.
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Dyspnea is one of the most common emergency department (ED) symptoms, but early diagnosis and treatment are challenging because of multiple potential causes. Impedance cardiography (ICG) is a noninvasive method to measure hemodynamics that may assist in early ED decision making. ⋯ Impedance cardiography data result in significant changes in ED physician diagnosis and therapeutic plan during the evaluation of dyspneic patients 65 years and older.
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To evaluate the effect of diagnostic soft-tissue ultrasound (US) on management of emergency department (ED) patients with clinical cellulitis. ⋯ Soft-tissue US changes physician management in approximately half of patients in the ED with clinical cellulitis. US may guide management of cellulitis by detection of occult abscess, prevention of invasive procedures, and guidance for further imaging or consultation.