External monitoring-induced pacemaker-driven tachycardia: a case report.

A 55-year-old African-American woman with a history of end-stage renal disease secondary to systemic lupus erythematosus, dual-chamber pacemaker placement secondary to sick sinus syndrome, and a previous subarachnoid hemorrhage presented via ambulance to our Emergency Department (ED) from an outside hospital with the report of altered mental status, hyperkalemia, and hypoglycemia. In the ED, the patient's initial physical examination revealed a stable, normal heart rate. Reassessment after placement of external monitoring devices found the patient to be tachycardic at approximately 132-135 beats/min, with minimal variation in rate.

Ketamine-propofol combination sedation for fracture reduction in the pediatric emergency department.

Objectives: To evaluate the time of onset and recovery from and the efficacy and safety of intravenous ketamine-propofol sedation for reduction of forearm fractures in the pediatric emergency department setting.

Study Design: Prospective, observational pilot study.

Methods: Children presenting to an urban pediatric emergency department requiring sedation for closed reduction of forearm fractures received ketamine 0.

Improved documentation of wound care with a structured encounter form in the pediatric emergency department.

Objective: Accurate and complete documentation may enhance reimbursement and compliance with financial intermediary regulations, protect against litigation, and improve patient care. We measured the effect of introduction of a structured encounter form on the completeness of documentation of pediatric wound management in a teaching hospital.

Methods: The Children's Hospital Emergency Department introduced a structured encounter form for use in the documentation of wound care in place of the existing free-text dictation method.

The use of pulse oximetry to exclude pneumonia in children.

The objective of this study was to determine whether pulse oximetry alone or in conjunction with the clinical examination is predictive of pneumonia in children who present to the emergency department with respiratory complaints. A retrospective comparison of children with radiographic pneumonia with children with respiratory complaints and negative chest radiography was used. The study took place in an emergency department of a large academic, tertiary care hospital.