International journal of emergency medicine
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One of the highest rates of illicit cocaine consumption in Europe is in Spain. Our objective was to study the incidence and impact of undisclosed cocaine consumption in patients attending the emergency department (ED) for trauma or chest pain. ⋯ Thirty percent of eligible patients participated. Of 75 cases, 61.3% had trauma and 38.7% chest pain; 25% presented a positive test for drugs. Cocaine was present in 13.3% and cannabis in the same proportion. No differences were found regarding positive cocaine test and chief complaint, ED or hospital stay, or additional tests. Cocaine-positive patients were significantly younger.
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Skin and soft tissue infections are a common admission diagnosis to emergency department (ED) observation units (OU). Little is known about which patients fail OU treatment. ⋯ Among OU patients treated for skin and soft tissue infections, women were twice as likely to require hospitalization and patients with a WBC > 15,000 on presentation to the ED, regardless of gender, were 4 times more likely to require hospitalization.
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In 2003, the King Laryngeal Tube (LT) received FDA approval for US sales. Prehospital systems in urban setting have begun evaluating and adopting the LT for clinical airway management. However, it is not routinely approved by State EMS Boards for use by all prehospital providers. Given the LT's simple design there may be benefit to using this tool for airway management in all levels of prehospital providers. This pilot study reviews cases where the King LT was used in a rural Iowa county EMS system. ⋯ This small pilot project emphasizes the need for additional rapid airway management tools given the demonstrated ETI failures. The authors believe the King LT has significant potential to impact prehospital airway management as a primary airway device or backup to other failed strategies. Further study is necessary to evaluate the LT's efficacy compared to current strategies.
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The purpose of this study is to identify the rate of emergency department (ED) intubation and the mortality associated with ED intubation. ⋯ The mortality after an ED intubation in our study population was relatively high. Further studies need to confirm these findings and help identify predictors of mortality.
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The patient with difficult airways is a common challenge for emergency physicians. ⋯ Emergency physicians manage most of the difficult airways successfully (68.8%). However, the success rate can be further improved through the more frequent use of the bougie or other rescue device. A possible suggestion would be for the emergency physician to use the bougie after the second or third attempt at direct orotracheal intubation.