Emergency
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Tranexamic Acid in Trauma
Tranexamic acid or TXA is a potent antifibrinolytic that has the potential to decrease clot breakdown and reduce bleeding in trauma patients. Studies have shown that the use of TXA in trauma patients improves overall survival, although these studies have been discounted as not being relevant to trauma care as practiced in well-resourced countries. Thus, the adoption of TXA into trauma protocols in U.S. centers has been slow and controversial. Further studies are needed to answer questions about which patient populations can benefit most from TXA and how it should be used in highly developed and well-resourced trauma systems and centers.
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Pediatric Oncology
Many emergency department (ED) visits for children are driven by parental fears of serious illness, including concerns that a child may have cancer. Some presenting symptoms are high-risk and require serious inquiry, while others are less concerning and may be managed by reassurance alone. Additionally, children with established cancer diagnoses may present to the ED with complications of their cancer, an unexpected recurrence after a period of remission, or issues related to treatment. The authors review the presentations for the most common pediatric cancers and the complications associated with pediatric cancers and their treatment.
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Surviving Sepsis Campaign Guidelines Bundle: Studying How Improved Compliance Might Affect Outcomes
Improved compliance with the Surviving Sepsis Campaign guidelines bundle was associated with a non-statistically significant decrease in the in-hospital mortality of severe sepsis patients.
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The ABCs of In-hospital Cardiac Arrest
In this large, propensity-matched cohort study of patients who experienced an in-hospital cardiac arrest, patients who underwent endotracheal intubation had worse survival to hospital discharge than patients who were not intubated.
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The Clinical Utility of Measuring Dead Space Ventilation in Critical Illness
Here are some of the technologic and physiologic aspects of capnography as they relate to dead space ventilation and their application in the management of critically ill patients.
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Lack of Training on Psych Patients Exposes ED to Liability
EDs are obligated to provide a safe, protective environment for all patients.
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Does ED Visitor Arrive With a Gun and a Carry Permit?
Policy needed to determine next step.
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Legal Risks Are ‘Huge’ if Violence Occurs in ED
“Even meek people can be dangerous,” says one expert.
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What Are Legal Considerations if ED Security Guards Are Armed?
Should ED security be armed with guns, Tasers, or pepper spray?
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ED Staff in Crossfire of Violence Can Lead to Negligence Claims
Assaults occur disproportionately in EDs.