Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The Emergency Severity Index (ESI) is a new five-level triage instrument. The objective of this study was to determine whether there is an association between ESI triage status and short-term survival. ⋯ The ESI triage status is associated with six-month survival. Patients with the highest three triage groups experienced decreased survival during the follow-up period, whereas all patients in the two lowest triage strata survived at least six months.
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To determine whether warm lavage liquid ventilation (LV) would provide rapid cardiopulmonary rewarming in swine with severe hypothermia and ventricular fibrillation. ⋯ During cardiac arrest, warm lavage liquid ventilation may produce rapid cardiopulmonary rewarming.
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As a method to control patient flow to overburdened hospitals, effective emergency medical services (EMS) systems provide policies for ambulance diversion. The Maryland state EMS system supports two types of alert for general hospital use: red alert, aimed at limiting the delivery of patients who may require intensive care unit (ICU) admission, and yellow alert, aimed at preventing further overload of already overtaxed emergency departments (EDs). ⋯ The ED diversion policy has some limited effect in preventing further patient volume in urban and suburban areas, but has virtually no impact in rural areas. However, an ICU diversion policy diverts patients of all acuities uniformly and inordinately diverts patients not likely to require ICU admissions while having only minimal impact on patients who do require ICU resources. The impact of red alert is uniform in all geographic areas. The impact and efficacy of ambulance diversion policies should be evaluated to ensure they are having the intended effect. While perhaps initially effective, the impact of alert policies may change over time.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intravenous midazolam with pentobarbital for sedation for head computed tomography imaging.
To compare the efficacy of intravenous (IV) midazolam with that of IV pentobarbital when used for sedation for head computed tomography (CT) imaging in emergency department (ED) pediatric patients. ⋯ Intravenous pentobarbital is more effective than IV midazolam for sedation of children requiring CT imaging.