Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Pain management is a critical part of treatment in patients with chest trauma. Opioids and nonsteroidal anti-inflammatory drugs have been the most commonly used medications. However, their side effects have drawn attention to other medications. In this study, we aimed to assess the effect of the analgesic dose of ketamine in patients with chest trauma in comparison to ketorolac. ⋯ Ketamine can be an effective analgesic in patients with chest trauma in acute settings with or without rib fracture.
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Sepsis remains the leading cause of in-hospital death and one of the costliest inpatient conditions in the United States, while treatment delays worsen outcomes. We sought to determine factors and outcomes associated with a missed emergency physician (EP) diagnosis of sepsis. ⋯ This prospective single-academic center study identified patient subgroups at risk of impaired diagnostic accuracy of sepsis, with clinicians often overdiagnosing rather than underdiagnosing these groups. Prompt abnormal laboratory test results can "rescue" initial missed diagnoses, serving as potential clinician- and systems-level intervention points to reduce missed diagnoses. Missed diagnoses delayed antibiotics, but not mortality after controlling for severity of illness.