Prospective Evaluation of a Clinical Practice Guideline for Diagnosis of Appendicitis in Children
Objectives:
The objective was to assess the performance of a clinical practice guideline for evaluation of possible appendicitis in children. The guideline incorporated risk stratification, staged imaging, and early surgical involvement in high-risk cases.
Thursday, October 18, 2012
Thursday, September 6, 2012
Patients With Rib Fractures Do Not Develop Delayed Pneumonia: A Prospective, Multicenter Cohort Study of Minor Thoracic Injury
Patients With Rib Fractures Do Not Develop Delayed Pneumonia: A Prospective, Multicenter Cohort Study of Minor Thoracic Injury
Background
In 2006, there were 119.2 million visits to hospital
emergency departments (EDs) in the United States, and
more than one third of them were injury-related. Thoracic
trauma frequency is estimated at 12 people per million per
day, representing more than 796,000 ED visits annually.
In the case of thoracic trauma, injuries of moderate
severity are most often sustained to the chest wall and thus
rarely require surgical intervention. Ziegler and Agarwal
reported a 10% incidence of rib fractures in trauma patients
treated at their site. In 2003, Liman et al observed that 2 of
3 patients could be safely discharged from EDs. As financial
pressures create more ambulatory care situations, minor
thoracic injury patients are rapidly discharged from EDs
without appropriate follow-up.
Background
In 2006, there were 119.2 million visits to hospital
emergency departments (EDs) in the United States, and
more than one third of them were injury-related. Thoracic
trauma frequency is estimated at 12 people per million per
day, representing more than 796,000 ED visits annually.
In the case of thoracic trauma, injuries of moderate
severity are most often sustained to the chest wall and thus
rarely require surgical intervention. Ziegler and Agarwal
reported a 10% incidence of rib fractures in trauma patients
treated at their site. In 2003, Liman et al observed that 2 of
3 patients could be safely discharged from EDs. As financial
pressures create more ambulatory care situations, minor
thoracic injury patients are rapidly discharged from EDs
without appropriate follow-up.
Thursday, February 9, 2012
Treating primary headaches in the ED: can droperidol regain its role?
Treating primary headaches in the ED: can droperidol regain its role?
OBJECTIVE:
The aim of this study was to describe the use and efficacy of low-dose (≤2 mg) droperidol for the treatment of primary headaches (ie, migraine, cluster, tension-type headache and trigeminal autonomic cephalalgias, and other primary headaches) in the emergency department (ED).
OBJECTIVE:
The aim of this study was to describe the use and efficacy of low-dose (≤2 mg) droperidol for the treatment of primary headaches (ie, migraine, cluster, tension-type headache and trigeminal autonomic cephalalgias, and other primary headaches) in the emergency department (ED).
Thursday, September 1, 2011
Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial
Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial
Background
Procedural sedation and analgesia is a technique of administering
sedatives (midazolam, propofol, etomidate) or dissociative agents
(ketamine) with or without opioid analgesics (fentanyl, morphine,
meperidine) to induce a state that allows the patient to tolerate
unpleasant procedures while maintaining cardiorespiratory function.
Ketamine, first described in 1965, has been administered extensively for procedural sedation and analgesia in children and is a safe and effective sedative analgesic for painful procedures not only in the emergency department (ED) but also in the out-of-hospital setting.
The widespread acceptance of ketamine as an agent for procedural
sedation and analgesia in adult ED patients may be limited by
physician apprehension about dreaming and hallucinations during
recovery, and unpleasant reactions and nightmares, collectively referred to as recovery agitation.
Background
Procedural sedation and analgesia is a technique of administering
sedatives (midazolam, propofol, etomidate) or dissociative agents
(ketamine) with or without opioid analgesics (fentanyl, morphine,
meperidine) to induce a state that allows the patient to tolerate
unpleasant procedures while maintaining cardiorespiratory function.
Ketamine, first described in 1965, has been administered extensively for procedural sedation and analgesia in children and is a safe and effective sedative analgesic for painful procedures not only in the emergency department (ED) but also in the out-of-hospital setting.
The widespread acceptance of ketamine as an agent for procedural
sedation and analgesia in adult ED patients may be limited by
physician apprehension about dreaming and hallucinations during
recovery, and unpleasant reactions and nightmares, collectively referred to as recovery agitation.
Tuesday, June 14, 2011
Vasopression / Epinephrine / Dabigatran / Warfarin and Cardiopulmonary
UF EM Journal Club 06/14/2011
* Vasopressin and Epinephrine vs. Epinephrine Alone in Cardiopulmonary Resuscitation
BACKGROUND: During the administration of advanced cardiac life support for resuscitation from cardiac arrest, a combination of vasopressin and epinephrine may be more effective
than epinephrine or vasopressin alone, but evidence is insufficient to make clinical
recommendations.
* Dabigatran versus Warfarin in Patients with Atrial Fibrillation
BACKGROUND: Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin
inhibitor.
* Vasopressin and Epinephrine vs. Epinephrine Alone in Cardiopulmonary Resuscitation
BACKGROUND: During the administration of advanced cardiac life support for resuscitation from cardiac arrest, a combination of vasopressin and epinephrine may be more effective
than epinephrine or vasopressin alone, but evidence is insufficient to make clinical
recommendations.
* Dabigatran versus Warfarin in Patients with Atrial Fibrillation
BACKGROUND: Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin
inhibitor.
Tuesday, January 18, 2011
Do Emergency Department Blood Cultures Change Practice in Patients With Pneumonia?
UF EM Journal Club - 01/20/2011
Do Emergency Department Blood Cultures Change Practice in Patients With Pneumonia?
Study objective: Although it is considered standard of care to obtain blood cultures on patients hospitalized for pneumonia, several studies have questioned the utility and cost-effectiveness of this practice. The objective of this study is to determine the impact of emergency department (ED) blood cultures on antimicrobial therapy for patients with pneumonia.
Please print and have this article ready for conference.
Do Emergency Department Blood Cultures Change Practice in Patients With Pneumonia?
Study objective: Although it is considered standard of care to obtain blood cultures on patients hospitalized for pneumonia, several studies have questioned the utility and cost-effectiveness of this practice. The objective of this study is to determine the impact of emergency department (ED) blood cultures on antimicrobial therapy for patients with pneumonia.
Please print and have this article ready for conference.
Tuesday, January 11, 2011
Traumatic Pedatric Lacerations Repair / Gut vs Nylon Sutures
UF EM Journal Club - 01/25/11
Hi all
This is my article for our journal club on Jan 25th:
CLINICAL INVESTIGATIONS ARTICLE - LINK
A Randomized, Controlled Trial Comparing Long-term
Cosmetic Outcomes of Traumatic Pediatric
Lacerations Repaired with Absorbable Plain Gut
versus Nonabsorbable Nylon Sutures
AbstractObjectives: To show that the use of absorbable sutures in
pediatric traumatic lacerations affords good long-term
cosmesis and no increase in complications (infection, dehiscence
rates, and need for surgical scar revision) when
compared with wounds sutured with nonabsorbable sutures.
Please print article, and have on hand at meeting.
Hi all
This is my article for our journal club on Jan 25th:
CLINICAL INVESTIGATIONS ARTICLE - LINK
A Randomized, Controlled Trial Comparing Long-term
Cosmetic Outcomes of Traumatic Pediatric
Lacerations Repaired with Absorbable Plain Gut
versus Nonabsorbable Nylon Sutures
AbstractObjectives: To show that the use of absorbable sutures in
pediatric traumatic lacerations affords good long-term
cosmesis and no increase in complications (infection, dehiscence
rates, and need for surgical scar revision) when
compared with wounds sutured with nonabsorbable sutures.
Please print article, and have on hand at meeting.
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