Emergencias
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Multicenter Study Comparative Study
Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment.
Paracetamol poisoning can be serious and require treatment with N-acetylcysteine (NAC). A dose of 300 mg/kg is usually given in 3 fractions over 21 hours. An alternative regimen, the Scottish and Newcastle Acetylcysteine Protocol (SNAP), specifies the same total dose given in 2 intravenous injections over 12 hours. This study aimed to compare the 2 regimens in terms of effectiveness, adverse events, and lengths of emergency department (ED) and hospital stays. ⋯ Fewer adverse events occurred with the SNAP approach. The 2 protocols were similarly effective. The SNAP-treated patients spent less time in the ED, and those who were admitted to hospital had shorter stays.
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To analyze the possible association between a finding of plasma alkalosis in patients diagnosed with acute heart failure (AHF) in the emergency department (ED) and in-hospital mortality. ⋯ This retrospective analysis of cases in the EAHFE registry found no association between alkalosis and higher in-hospital mortality after AHF. Nor were significant associations found when we analyzed mortality related to probable metabolic vs respiratory alkalosis.
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To identify clinical and sociodemographic characteristics of frequent use of emergency departments by persons of advanced age. ⋯ Frail elderly patients with more comorbid conditions are at higher risk for frequent use of emergency departments. These patients should be identified early so that management of their conditions can be adjusted.