Articles: emergency-department.
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Observational Study
Requirement for a structured algorithm in cardiac arrest following major trauma:Epidemiology, management errors, and preventability of traumatic deaths in Berlin.
Despite continuous innovation in trauma care, fatal trauma remains a significant medical and socioeconomic problem. Traumatic cardiac arrest (tCA) is still considered a hopeless situation, whereas management errors and preventability of death are neglected. We analyzed clinical and autopsy data from tCA patients in an emergency-physician-based rescue system in order to reveal epidemiologic data and current problems in the successful treatment of tCA. ⋯ Trauma CPR is beyond routine with the need for a tCPR-algorithm, including chest/pericardial decompression, external pelvic stabilization and external bleeding control. The prehospital trauma management has the highest potential to improve tCPR and survival. Therefore, we suggested a pilot prehospital tCPR-algorithm.
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Pediatric emergency care · Mar 2014
Review Case ReportsAlternative airways for the pediatric emergency department.
Securing the pediatric airway in the emergency setting is an uncommon event that is complicated by anatomic, physiologic, and environmental factors. Even more uncommonly, practitioners are faced with the added complication of a difficult airway, and the question of what alternatives to traditional endotracheal intubation are available and most useful may arise. Timely and effective intervention determines the patient's clinical outcome. The purpose of this review was to detail specific alternative airway management strategies and tools for use in the pediatric emergency department.
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Comparative Study Clinical Trial
Finger counting: an alternative method for estimating pediatric weights.
We compared the accuracy of a conceptually simple pediatric weight estimation technique, the finger counting method, with other commonly used methods. ⋯ The finger counting method is an acceptable alternative to the Broselow method for weight estimation in children aged 1 to 9 years. It outperforms the traditional APLS method but underestimates weights compared with parental estimate and the Luscombe formula.
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Pediatric emergency care · Mar 2014
ReviewThe use of alternate light sources in the clinical evaluation of child abuse and sexual assault.
Alternate light sources are devices that produce visible and invisible light at specific wavelengths to allow for enhanced visualization of fluorescent substances. These devices (which include Wood's lamp and blue light) are often used in forensics for evidence collection and can be quite useful to physicians in the medical evaluation of suspected physical or sexual assault. An understanding of the proper applications, as well as the limitations, of each alternate light source is imperative to correctly performing and interpreting medical evaluations in the emergency department. This review discusses the evidence from prospective trials in children and adults on the ability of specific alternate light sources to identify evidence of physical or sexual assault and also highlights some promising new technological adjuncts to alternate light sources that may allow for accurate dating of bruising.
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Infect. Dis. Clin. North Am. · Mar 2014
ReviewDiagnosis and management of urinary tract infection in the emergency department and outpatient settings.
Emergency physicians encounter urinary tract infections (UTIs) in a wide spectrum of disease severity and patient populations. The challenges of managing UTIs in an emergency department include limited history, lack of follow-up, and lack of culture and susceptibility results. Most patients do not require an extensive diagnostic evaluation and can be safely managed as outpatients with oral antibiotics. The diagnostic approach to and treatment of adults presenting to emergency departments with UTIs are reviewed.