Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Comparison of the National Emergency Department Overcrowding Scale and the Emergency Department Work Index for quantifying emergency department crowding.
Emergency department (ED) crowding is just beginning to be quantified. The only two scales presently available are the National Emergency Department Overcrowding Scale (NEDOCS) and the Emergency Department Work Index (EDWIN). ⋯ Both scales had high AUCs, correlated well with each other, and showed good discrimination for predicting ED overcrowding. This establishes construct validity for these scales as measures of overcrowding. Which scale is used in an ED is dependent on which set of data is most readily available, with the favored scale being the NEDOCS.
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Randomized Controlled Trial Comparative Study
Age effect on efficacy and side effects of two sedation and analgesia protocols on patients going through cardioversion: a randomized clinical trial.
Cardioversion (CV), a painful procedure, requires sedation and analgesia. Although several sedation agents currently are in use for CV, data on age-specific efficacy and side effects of midazolam and propofol have been limited. ⋯ Propofol appears to be a better choice for CV sedation in elders because of its short recovery time, fewer side effects, and its more comfortable sedative effect.
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To compare the demographic and injury characteristics of children visiting the emergency department (ED) for nonfatal injuries occurring at school with those of same-aged children who were injured outside of school. ⋯ A significant proportion of injuries to school-aged children occur at school. Notable differences exist between the epidemiology of in- and out-of-school injuries. The nature of these injuries differs by age group. Efforts to reduce school injuries will require that these differences be examined further and incorporated into prevention initiatives.
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The value of ventilation monitoring with end-tidal carbon dioxide (ETCO2) to anticipate acute respiratory events during emergency department (ED) procedural sedation and analgesia (PSA) is unclear. The authors sought to determine if ETCO2 monitoring would reveal findings indicating an acute respiratory event earlier than indicated by current monitoring practices. ⋯ Abnormal ETCO2 findings were observed with many acute respiratory events. A majority of patients with acute respiratory events had ETCO2 abnormalities that occurred before oxygen desaturation or observed hypoventilation.
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To assess waiting times in emergency departments (EDs) for on-call specialist response and how these might vary by facility or neighborhood characteristics. Limited availability of on-call specialists is thought to contribute to ED overcrowding. ⋯ Although the majority of on-call specialists met the federal recommendation of a 30-minute response, those in poor neighborhoods were less likely to do so. One in ten on-call specialists did not respond at all. State and federal policies should focus on making more funding available for on-call specialist panels in poor areas.