Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To prospectively determine whether end-tidal carbon dioxide (ETCO2) monitors can detect respiratory depression (RD) and the level of sedation in emergency department (ED) patients undergoing procedural sedation (PS). ⋯ There was no correlation between ETCO2 and the OAA/S score. Using the criteria of an ETCO2 >50 mm Hg, an absolute change >10 mm Hg, or an absent waveform may detect subclinical RD not detected by pulse oximetry alone. The ETCO2 may add to the safety of PS by quickly detecting hypoventilation during PS in the ED.
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To describe pediatric emergency department (ED) utilization within a Medicaid managed care system and to investigate the association between pediatric ED utilization and the type of medical home. ⋯ Despite the presence of a defined medical home, ED use was common among preschool children enrolled in the statewide Medicaid managed care program. The type of medical home was an important determinant of ED use in this population.
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To determine the effects of delaying fluid on the rate of hemorrhage and hemodynamic parameters in an injury involving the arterial system. ⋯ Rates of hemorrhage from an arterial injury are related to changes in mean arterial pressure. In this animal model, early aggressive fluid resuscitation in penetrating thoracic trauma exacerbates total hemorrhage volume. Despite resumption of hemorrhage from the site of injury, delaying fluid resuscitation results in the best hemodynamic parameters.
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Comparative Study Clinical Trial
Determination of left ventricular function by emergency physician echocardiography of hypotensive patients.
To determine whether emergency physicians (EPs) with goal-directed training can use echocardiography to accurately assess left ventricular function (LVF) in hypotensive emergency department (ED) patients. ⋯ Emergency physicians with focused training in echocardiography can accurately determine LVF in hypotensive patients.