Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Bispectral electroencephalographic analysis of head-injured patients in the emergency department.
Bispectral analysis of single-lead electroencephalographs (BIS) has proven valuable in assessing the level of awareness in sedated patients. In this study, the authors sought to determine if BIS values had a predictive value in patients with traumatic brain injuries (TBIs). Therefore, the objective was to determine in emergency department (ED) patients presenting with head trauma whether BIS and Glasgow Coma Scale score (GCS) prior to sedation would be sensitive and specific in predicting TBI. ⋯ BIS scores obtained prior to sedative medicines in the face of trauma are predictive of TBI and neurologic outcome at discharge.
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Bronchiolitis is the most common disease of the lower respiratory tract in the first year of life. Treatment is controversial, with studies giving conflicting views on the benefits of bronchodilators and steroids. The objectives of this study were 1) to characterize the management of bronchiolitis in pediatric emergency departments (PEDs) in Canada, 2) to determine patient outcomes following emergency department (ED) visits, and 3) to provide descriptive data regarding bronchiolitis symptoms and family/personal medical history of these patients. ⋯ This study prospectively describes the treatment of bronchiolitis in the pediatric ED. The findings are consistent with the literature regarding the reported use of bronchodilators; however, use of steroids was found to be much lower than reported in other studies. Bronchodilator use in the ED and at discharge varied significantly by site. The results capture variation in treatment practices in Canadian PEDs, which may be the result of discordant randomized controlled trial evidence. Further research is needed to establish best practices.
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Promotion of prescription drugs represents a growing source of pharmaceutical marketing expenditures. This study was undertaken to identify the frequency of items containing pharmaceutical advertising in clinical emergency departments (EDs). ⋯ Numerous items containing pharmaceutical advertising are frequently observed in EDs. Policies restricting pharmaceutical representatives in the ED are associated with reduced pharmaceutical advertising.
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Little is known about gaps in quality and the extent to which clinical standards are used in emergency department (ED) practice. ⋯ Deficits in adherence to recommended guidelines for the diagnosis and treatment of STDs exist in ED practice.
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Aortic dissection (AD) is the most common acute aortic condition requiring urgent surgery. AD, if not diagnosed in the emergency department (ED), is frequently fatal. AD is a difficult antemortem diagnosis. ⋯ All seven patients with an AD who had D-dimer assays performed in the ED had positive results by latex agglutination.