J Emerg Med
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Observational Study
Implementation of an Emergency Department Sign-Out Checklist Improves Transfer of Information at Shift Change.
Transitions of care are ubiquitous in the emergency department (ED) and inevitably introduce the opportunity for errors. Few emergency medicine residency programs provide formal training or a standard process for patient handoffs. Checklists have been shown to be effective quality-improvement measures in inpatient settings and may be a feasible method to improve ED handoffs. ⋯ Implementation of a checklist improved the transfer of information without increasing time to sign-out.
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Observational Study
Septic Shock and Adequacy of Early Empiric Antibiotics in the Emergency Department.
Antibiotic resistance is an increasing concern for Emergency Physicians. ⋯ In this population of ED patients with septic shock, empiric antibiotic coverage was inadequate in a small group of uroseptic patients with recent health care exposure. Current guidelines for UTI treatment do not consider health care setting exposure. A larger, prospective study is needed to further define this risk category and determine optimal empiric antibiotic therapy for patients.
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Concentrated laundry detergent packs are new products that may be more likely to cause adverse effects and serious medical outcomes among young children than traditional laundry detergent products. ⋯ Pediatric exposures to laundry detergent packs were more likely to be referred to health care facilities if the laundry detergent pack brand was Purex(TM), the exposure was ocular, or particular ocular, respiratory, dermal, or neurologic clinical effects were present.
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Acute coagulopathy associated with trauma has been recognized for decades and is a constituent of the "triad of death" together with hypothermia and acidosis. ⋯ Acute coagulopathy is present on admission to the ED and is associated with injury severity and significantly higher mortality.
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There are few studies researching the effect of fresh frozen plasma (FFP) transfusion on international normalized ratio (INR) in patients with coagulation abnormality. ⋯ A significant improvement in INR was observed in patients with higher pretransfusion INR. While determining FFP dose for patients admitted to the ED due to coagulation defect, pretransfusion INR value should be taken into account.