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If a patient came to your ED complaining of fever, anxiety, or coughing, would you suspect a pulmonary embolism?
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Do you often encounter frightened, squirming children when attempting to start intravenous lines or care for lacerations? Their fright and movement can make care difficult to deliver, says Teri Howick, RN, nurse educator for the ED at McKay Dee Hospital in Ogden, UT.
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Patients with both psychiatric disorders and substance abuse are linked to significantly increased use of the ED, says this study from Central Arkansas Veterans Healthcare System and University of Arkansas for Medical Sciences, both based in Little Rock, and Baylor College of Medicine and Ben Taub General Hospital, both based in Houston.
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The FDA has approved the first nasally administered flu vaccine to be marketed in this country. Medimmunes FluMist is also the first influenza vaccine to use live virus.
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Although noninvasive positive-pressure ventilation (NPPV) has become a standard of care for acute-on-chronic ventilatory failure in patients with chronic obstructive pulmonary disease (COPD), the numerous reported studies have left uncertain how the clinician should select patients who should receive this therapy.
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A time lapse of > 4 hours in ICU transfer after the development of 1 or more physiologic threshold criteria was associated with greater mortality, longer hospital length of stay, and higher costs.
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Patients who were transferred directly to the authors medical ICU from other hospitals were sicker and had worse outcomes than those who were directly admitted. Benchmarking data generated without taking referral source into account erroneously indicated an excessive death rate and other adverse outcomes.
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The randomized, controlled trial (RCT) is believed to provide the strongest evidence for verifying both effectiveness and ineffectiveness of a given treatment. Once the RCT judges the proposed treatment as ineffective, it is rare that the treatment is ever evaluated again.
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Good ED/ICU networks are becoming more important as more rural hospitals close due to lack of funding, says Janet Williams, MD, FACEP, director of the Center for Rural Emergency Medicine and Professor of Emergency Medicine at West Virginia University in Morgantown.
