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The authors set out to compare arterial and central venous blood gases (ABG and VBG, respectively), to evaluate the utility and accuracy of a predefined algorithm for adjusting VBG pH and pCO2 to approximate that of ABG, and to define clinical scenarios where a VBG may not be a useful substitute for an ABG.
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While some publications have focused on the restriction of Propofol use by ED physicians and nurses under new rules issued in December 2009 by the Centers for Medicare and Medicaid Services (CMS), many observers say the issue is much larger, and that it deals with who can administer what ED providers consider procedural sedation and what CMS considers anesthesia.
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The bad news: Most ED experts believe that health care reform will only exacerbate the steady growth of volume in the nation's EDs. The good news: ED managers have several weapons in their arsenals to help keep patients flowing through and out of their departments.
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The management team in the ED at in St. Clair Hospital in Pittsburgh, PA, calls it "managing by walking around." They say it has been one of the keys to their continual improvement in patient satisfaction.
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Citing anticipated benefits for patient care, for caregiver health, and for the bottom line, Emory Healthcare in Atlanta has put a limit on overtime hours for its nurses, including those in its two EDs.
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The use of a cardiac MRI in the observation unit at Wake Forest University Baptist Medical Center in Winston-Salem, NC, resulted in lower cost at the hospital of about $588 per patient because 79% were managed without admission, according to a study published online in the Annals of Emergency Medicine.
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All emergency physicians are comfortable caring for the patient in acute pulmonary edema. Initial treatment of this emergency condition has changed little in the past decade. However the treatment of less acute patients with congestive heart failure (CHF) has changed dramatically in the recent past.
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Pediatric head trauma is a common presenting complaint to the emergency department (ED) and is a major cause of pediatric death and disability. This article will address the epidemiology, pathophysiology, diagnosis, and management of moderate to severe pediatric traumatic brain injury (TBI), with a focus on strategies to improve outcome.