Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
The prophylactic coadministration of atropine or other anticholinergics during dissociative sedation has historically been considered mandatory to mitigate ketamine-associated hypersalivation. Emergency physicians (EPs) are known to omit this adjunct, so a prospective study to describe the safety profile of this practice was initiated. ⋯ When adjunctive atropine is omitted during ketamine sedation in children, excessive salivation is uncommon, and associated airway complications are rare. Anticholinergic prophylaxis is not routinely necessary in this setting.
-
There are no disposition guidelines for the management of acute pyelonephritis (APN) in women. Recent studies have demonstrated considerable variation in admission rates for women with APN. The authors evaluated the effect of a predetermined, written protocol for the management of APN on the admission rates and medical costs in adult women with APN. ⋯ Use of a standardized written protocol reduced the admission rates and medical costs in women presenting to the ED with APN.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of nebulized epinephrine to albuterol in bronchiolitis.
To compare the effect of nebulized racemic epinephrine to nebulized racemic albuterol on successful discharge from the emergency department (ED). ⋯ In children up to the 18th month of life, ED treatment of bronchiolitis with nebulized racemic albuterol led to more successful discharges than nebulized epinephrine.
-
The objective was to develop methodology for predicting demand for emergency department (ED) services by characterizing ED arrivals. ⋯ At this facility, demand for ED services was well approximated by a Poisson regression model. The expected arrival rate is characterized by a small number of factors and does not depend on recent numbers of arrivals.
-
Trends in charges and payments for nonhospitalized emergency department pediatric visits, 1996-2003.
To compare charges and payments for outpatient pediatric emergency visits across payer groups to provide information on reimbursement trends. ⋯ Reimbursements for outpatient ED visits in the pediatric population have decreased from the period of 1996 to 2003 in all payer groups: public (Medicaid/SCHIP), private, and the uninsured. Medicaid/SCHIP has consistently paid less per visit than the privately insured and the uninsured. Further research on the effects of these declining reimbursements on the financial viability of ED services for children is warranted.