European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Liberal oxygen therapy has been a cornerstone in the treatment of critically ill patients. Recently, awareness of hyperoxia toxicity has emerged. We investigated the partial pressure of oxygen in arterial blood (PaO2) in sepsis patients admitted to the emergency department treated with a reduced inspired oxygen fraction of 0.4 instead of 0.6-0.8. ⋯ Of the hyperoxic patients, 8% died in hospital versus 6% with normoxia. Less than 8% of patients had hypoxia with 10 l O2/min; 66% were hyperoxic. Titration of oxygen therapy to normoxia in the emergency department should be evaluated.
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Review Comparative Study
Are two penicillins better than one? A systematic review of oral flucloxacillin and penicillin V versus oral flucloxacillin alone for the emergency department treatment of cellulitis.
Flucloxacillin either alone or combined with penicillin V is still the first-line antibiotic drug of choice for the treatment of cellulitis in emergency departments (EDs) in Ireland. The rationale for this antibiotic regimen is their anti-staphylococcal and anti-streptococcal activity. ⋯ Despite its common use, there are no published randomized-controlled trials comparing flucloxacillin monotherapy with a combination of flucloxacillin and penicillin V in the ED management of cellulitis. We discuss existing European and North American prescribing rationale and current guidelines.
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Patients who have undergone a total laryngectomy have altered anatomy and physiology. This results in unique and specific issues that must be recognized in order to ensure that this group of patients experience appropriate care. This article looks at the current literature and attempts to highlight specific areas of concern, so that emergency care providers can deliver an equally high standard of care to this patient group as they do to others. ⋯ The results were analyzed to identify the most relevant articles that meet our objective. Articles were then organized into the different subheadings used within the article and reviewed. The most up-to-date articles or those that were in the opinion of the authors the most appropriate to convey our objective were included in our review.
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The aim of this study is to analyze the impact of the actions carried out by the Intoxications Working Group (IWG) of Spanish Society of Pediatric Emergencies in the management of acute pediatric intoxications in Spain, specifically the publishing of a Handbook in 2004 or the creation of the Toxicologic Surveillance System in 2009. ⋯ Recommendations developed and spread by a Working Group have approached the management of acute pediatric intoxications in Spain to international guidelines on the basis of scientific evidence.
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Multicenter Study Observational Study
The utility of copeptin in the emergency department for non-ST-elevation myocardial infarction rapid rule out: COPED-MIRRO study.
To evaluate whether the addition of copeptin measurement to the first troponin determination allows non-ST-elevation acute myocardial infarction to be ruled out in patients consulting the emergency department (ED) for nontraumatic chest pain (NTCP) suggestive of acute coronary syndrome (ACS) whose first electrocardiogram and troponin determination are nondiagnostic, thereby avoiding a second determination of troponin and shortening ED stay. ⋯ The determination of copeptin on arrival to the ED in patients with NTCP suggestive of ACS, in addition to routine troponin determination, does not allow the presence of myocardial infarction to be ruled out quickly and safely and does not avoid ED stay for a second determination of troponin.