Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Accuracy of triage decisions is a major influence on patient outcomes. Triage nurses' knowledge and experience have been cited as influential factors in triage decision-making. The aim of this article is to examine the independent roles of factual knowledge and experience in triage decisions. ⋯ Factual knowledge appears to be more important than years of emergency nursing or triage experience in triage decision accuracy. Many triage education programs are underpinned by the assumption that knowledge acquisition will result in improved triage decisions. A better understanding of the relationships between clinical decisions, knowledge, and experience is pivotal for the rigorous evaluation of education programs.
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Randomized Controlled Trial
Midazolam vs. diphenhydramine for the treatment of metoclopramide-induced akathisia: a randomized controlled trial.
To compare the effects of midazolam, which is a fast and short-acting benzodiazepine, and diphenhydramine, which is a widely used anticholinergic agent, in clinical practice for the treatment of metoclopramide-induced akathisia. ⋯ Midazolam can correct the symptoms of metoclopramide-induced akathisia faster than diphenhydramine, but it causes more sedation.
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Ectopic pregnancies are frequently present in women who present to the emergency department with pregnancy and abdominal pain or bleeding, a subset of whom may require operative intervention. ⋯ Free intraperitoneal fluid found in Morison's pouch in patients with suspected ectopic pregnancy may be rapidly identified at the bedside by EP-performed US and predicts the need for operative intervention.
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Editorial Comment
Commentary: Emergency department crowding as an ethical issue.
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Hypertension is common after intracranial hemorrhage (ICH) and may be associated with higher mortality and adverse neurologic outcome. The American Heart Association recommends that blood pressure be maintained at a mean arterial pressure (MAP) less than 130 mm Hg to prevent secondary brain injury. ⋯ Hypertension after acute ICH is associated with adverse neurologic outcome. The dose of hypertension may more accurately identify patients at risk for adverse outcomes than the American Heart Association guidelines and may lead to better outcomes if treated when identified in this manner.