European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The objective of this study is to determine the incidence of emergency department (ED) visits for acute allergic reactions, identify the triggers, assess the severity, evaluate the management practices, and examine patient outcomes at a single-center ED in Lebanon. ⋯ The incidence of ED visits for acute allergic reaction was high compared with other studies, although the majority of cases were mild. Deviations from published guidelines on the treatment of anaphylaxis are common, with rare use of epinephrine and heavy reliance on H1-antihistamines both in the ED and at discharge. This did not seem to result in any measurable impact on mortality.
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There is interest in health service reform and efficiencies; health service providers collect statistics, set targets and compare institutions. In January 2009, in Ireland, a national waiting time target of 6 h was set from registration in the emergency department (ED) to admission or discharge. The aim of this study was to assess the consequences of the introduction of this target on our institution and the Acute Medical Admission Unit. ⋯ Target setting may result in unintended consequences in other areas in addition to its stated goal. These unintentional consequences of targets should be borne in mind by those planning and instituting healthcare reform.
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Despite now being rarely used in the prehospital and emergency department arena because of their excessive length and low inner diameter, narrow-bore central venous catheters (CVC) are sometime used to perform fluid resuscitation using a rapid infusion pump to enhance delivered flow. In this bench study, we tested the hypothesis that the delivered flow rate downstream from the catheter connected to a rapid infusion pump would be significantly lower than the preset flow rate, and this difference would be affected by the catheter size. ⋯ Using a rapid infusion device, the delivered flow rate was lower than the preset flow rate. Even PVCs are better than narrow-bore CVC, neither is the most suitable cannula for patients requiring massive resuscitation.