Articles: emergency-department.
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Patients with digitalis intoxication (DI) and hyperkalaemia are frequently encountered in the emergency department (ED). This alteration may require intravenous (iv) calcium, but its administration has been considered to increase cardiotoxicity and mortality in patients with DI. We studied the effect of iv calcium on mortality and 30-day readmission in patients with hyperkalaemia and DI. ⋯ Calcium administration in hyperkalaemia and ID is not associated with short-term mortality.
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Emerg Med Australas · Nov 2024
What they did next: Using follow-up phone calls to investigate health care access patterns of patients who take their own leave.
The purpose of the present study was to use telephone follow-up (TFU) to investigate the actions taken by patients after they took their own leave (TOL) from an ED, with a focus on priority groups who are at risk of experiencing health inequity. These included people experiencing homelessness (EH), people with a low socioeconomic status by index of relative socioeconomic disadvantage (IRSD) and First Nations people. The primary outcome was being seen by a general practitioner (GP) within 2 days of the TOL event. The utility of the TFU was also examined. ⋯ Patients EH were less likely to receive GP care within 2 days of TOL. Improving the access and acceptability of health care in these priority groups is important for achieving health equity.
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There have been important updates in the guidelines for the management of agitation in emergency room settings, including psychiatric emergency services. This manuscript provides a synthesis of current recommendations, combined with a detailed breakdown of the neurobiology of agitation, linking these neuroscientific dimensions with the pharmacological profiles of the drugs recommended by practice guidelines (as well as the profiles of other important agents). Since Project BETA (Best Practices in Evaluation and Treatment of Agitation) guidelines were published in 2012 (by the American Association for Emergency Psychiatry), there have been several developments in the standard of care, including an increase in use of ketamine and droperidol. Recommended treatment strategies for clinicians will be presented, including consideration of how to address specific causes of agitation.
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Early recognition of sepsis is essential for timely initiation of adequate care. However, this is challenging as signs and symptoms may be absent or nonspecific. The cascade of events leading to organ failure in sepsis is characterized by immune-metabolic alterations. Volatile organic compounds (VOCs) are metabolic byproducts released in expired air. We hypothesize that measuring the VOC profile using electronic nose technology (eNose) could improve early recognition of sepsis. ⋯ The study is embedded in the Acutelines data-biobank (www.acutelines.nl), registered in Clinicaltrials.gov (NCT04615065).