Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine whether previously developed triage criteria for refusal of care to patients presenting to an emergency department (ED) with nonurgent problems could be validated for an independent patient population. ⋯ The authors were unable to validate a previously developed predictive model for refusal of care to patients presenting to an ED. Refusal of care to selected ED patients based on current guidelines is not a viable solution to overcrowding. Alternative strategies must be sought.
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To define risk factors for infections from dog- bite wounds and to model the probability of wound infection in patients presenting without infection who are treated as outpatients. ⋯ A low wound infection rate was seen in this cohort of dog-bite victims who were treated on an outpatient basis. Wound depth, patient gender, and wound debridement were the clinical variables that best predicted the likelihood of developing infection. Future interventional studies should concentrate on wounds with high probabilities of infection.
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Editorial Comment
Triage of nonurgent patients out of the emergency department.
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Recovery from severe cyclic antidepressant overdose with hypertonic saline/dextran in a swine model.
To determine the effect of a hypertonic saline and dextran (HSD) solution on blood pressure and QS duration during severe cyclic antidepressant (CA) toxicity in swine. ⋯ In this swine model of severe CA toxicity, a solution of 7.5% saline/6% dextran significantly reversed hypotension and QRS prolongation. HSD also improved survival to 60 minutes.
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For educational purposes, the Residency Review Committee for Emergency Medicine requires that emergency medicine residencies "provide a mechanism for each resident to obtain information on outcomes of patients the resident has evaluated in the emergency department." The authors analyzed the current patient follow-up systems of emergency medicine residencies and, based upon survey results propose a comprehensive organized system of follow-up. ⋯ Most emergency residency-affiliated hospitals in our survey had follow-up systems in place. Of existing systems, only a minority were rated by residency directors as effective or satisfactory. A model for a comprehensive system of patient follow-up is proposed.