Articles: emergency-department.
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Urethral catheterization is a technique frequently used in the pediatric emergency department. Intravesicular knotting of the catheter is a rare but potentially preventable complication that can involve significant morbidity. ⋯ The risk of intravesicular catheter knotting can be reduced with proper technique and the correct choice of catheters. We present a case report and list recommendations to minimize the risk of occurrence.
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To determine the inter-observer agreement on triage assignment by first-time users with diverse training and background using the Canadian Emergency Department Triage and Acuity Scale (CTAS). ⋯ Despite minimal experience with the CTAS, inter-observer agreement among emergency care providers with different backgrounds was significant.
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To determine if peripheral venous blood gas values for pH, partial pressure of carbon dioxide (Pco(2)) and the resultant calculated bicarbonate (HCO(3)) predict arterial values accurately enough to replace them in a clinical setting. ⋯ Arterial and venous blood gas samples were strongly correlated, and there were only small differences between them. A survey of emergency physicians suggested that the differences are too large to allow for interchangeability of results; however, venous values may be valid if used in conjunction with a correction factor or for trending purposes.
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Most emergency departments (EDs) have deficiencies in the type and quantity of antidotes readily available to treat severely poisoned patients. Undue emphasis on the purchase price of several expensive antidotes such as anti-digoxin F(ab) fragments and fomepizole may contribute to this problem by creating the perception that comprehensive antidote stocking is too costly for smaller centres. For rarely used medications, however, purchase price alone is an insufficient estimate of cost. ⋯ While other factors (antidote efficacy, safety and available alternate therapy) need to be considered, the cost of maintaining antidote availability is not determined primarily by purchase price. A change in supplier policy to free replacement on expiry for fomepizole and cyanide antidotes would have a considerable effect on making these antidotes less costly for smaller Canadian EDs.