Emergencias
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Multicenter Study Observational Study
Derivation and validation of new prehospital phenotypes for adults with COVID-19.
To characterize phenotypes of prehospital patients with COVID-19 to facilitate early identification of at-risk groups. ⋯ Patients with COVID-19 evaluated by emergency medical responders and transferred to hospital emergency departments can be classified into 4 phenotypes with different clinical, therapeutic, and prognostic characteristics. The phenotypes can help health care professionals to quickly assess a patient's future risk, thus informing clinical decisions.
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To analyze the association between blood pressure during vasopressor weaning and in-hospital mortality in patients admitted to an intensive care unit (ICU). ⋯ Higher blood pressures during vasopressor weaning are associated with longer in-hospital survival in ICU patients. The optimum pressure ranges are SBP, 110-150 mmHg; DBP, 60-85 mmHg; and MAP, 75-110 mmHg. Blood pressures may behave differently according to diagnosis.
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Observational Study
Safety of ketamine for reducing fractures in a pediatric emergency department.
Ketamine is one of the most widely used drugs for analgesia and sedation when reducing fractures in pediatric emergency departments (EDs). We aimed to analyze the safety of intravenous (IV) ketamine when administered by physicians who are not anesthesiologists. ⋯ Pediatric emergency physicians who are not anesthesiologists can safely administer IV ketamine for reducing fractures. Prior use of opioids is not associated with greater risk for respiratory AEs after ketamine use.
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To determine whether symptoms and levels of severity of intoxication from street drugs differ between adolescents and young adults who come to hospital emergency departments for treatment. ⋯ Adolescents requiring emergency care for street drug intoxication had co-ingested alcohol or taken multiple drugs less often than young adults. Cannabis was the drug most often used by adolescents, who presented more often with diminished consciousness but less often with anxiety. We detected no differences related to event severity.
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To define quality of care indicators and care process standards for treating patients with COVID-19 in hospital emergency departments (EDs), to determine the level of adherence to standards during the first wave in 2020, and to detect factors associated with different levels of adherence. ⋯ Adherence to certain quality indicators deteriorated during ED treatment of patients with COVID-19 during the first wave of the pandemic. Pressure from high caseloads may have exacerbated this deterioration. A learning effect led to improvement. No differences related to patient age were detected.