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Police Transport More Patients with Mental Health Needs to ED
Annual rates of adults transported to EDs by law enforcement increased by almost 50% from 2009 to 2016, according to the authors of a recent study. Of the 136,240 patients brought to EDs by law enforcement during the study period, 43.1% had a mental health diagnosis; 22% of all visits were for involuntary commitments.
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For Some Patients with Valid DNRs, Confusion Results in Unwanted CPR
Some DNR orders were not documented anywhere in the medical record. ED staff sometimes failed to recognize DNR orders that were documented. Other patients had advance directives, but no valid DNR order.
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SPADE Method Quantifies Potential Harm of Misdiagnosis
Methodology improves accuracy of diagnostics for sepsis and acute myocardial infarction, lowers malpractice risk.
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Certain Patients Might Meet Criteria, Still Do Not Receive Formal Sepsis Diagnosis
This study highlights two competing risks: The risk of undertreating sepsis and the risk overresuscitating a patient with another cause of their symptoms.
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Two Similar Studies, Two Different Conclusions: What Is the Best Way to Treat Sepsis?
The authors of two recent studies of the performance of the Epic Sepsis Model (ESM), a commonly used early warning tool for sepsis, reached different conclusions: One research group found ESM fails to predict many sepsis cases beyond what clinicians detect on their own, but another research group reported the tool enhances care.
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Acknowledge Pandemic-Driven Moral Distress, Mitigate Harmful Effects
Clinicians experience a high level of moral distress when they know they are not providing optimal care to patients. However, investigators have found leaders can mitigate the effects of moral distress. Such information could not arrive at a better time as hospitals in many regions cope with surging COVID-19 case volumes amid a shortage of skilled nurses.
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In Addition to the Rhythm
The ECG in the figure was obtained from a middle-aged woman who presented with a febrile illness and shortness of breath. She reported no chest pain. In addition to the rhythm, what else is going on?
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Dihydroergotamine Nasal Spray (Trudhesa)
DHE nasal spray can be prescribed to treat migraine in adults with or without aura.
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Iron Therapy for Acute Heart Failure
Giving intravenous ferric carboxymaltose to stabilized post-acute heart failure patients with iron deficiency improved quality of life vs. placebo-treated patients within four weeks, which persisted during subsequent therapy for up to 24 weeks.
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Proton-Pump Inhibitors and Community-Associated Clostridioides difficile Infection
A nationwide cohort study of adults in Denmark found that proton-pump inhibitor (PPI) use was associated with a moderately increased risk of community-associated Clostridioides difficile infection, and the risk remained elevated up to one year after PPI treatment had ended.