Preferences for resuscitation and intubation among patients with do-not-resuscitate/do-not-intubate orders.

Objective: To determine the accuracy of do-not-resuscitate/do-not-intubate (DNR/DNI) orders in representing patient preferences regarding cardiopulmonary resuscitation (CPR) and intubation.

Patients And Methods: We conducted a prospective survey study of patients with documented DNR/DNI code status at an urban academic tertiary care center that serves approximately 250,000 patients per year. From October 1, 2010, to October 1, 2011, research staff enrolled a convenience sample of patients from the inpatient medical service, providing them with a series of emergency scenarios for which they related their treatment preference.

Treatment of potential organ donors in the emergency department: a review.

The expanding role of emergency medicine in the care of potential organ donors presents unique ethical challenges. This article introduces emergency providers to the ethical challenges of organ donation, including issues of patient autonomy and consent, public perception and trust, goals of care, and the determination of death.

The diagnosis and management of seizures and status epilepticus in the prehospital setting.

Seizure is one of the most common complaints encountered in the prehospital setting. In this review the authors discuss the prehospital management of seizures and review the evidence for specific treatment approaches. Specific attention is devoted to prehospital care of the pediatric seizure patient.

The importance of emergency medicine in organ donation: successful donation is more likely when potential donors are referred from the emergency department.

Objectives: This study sought to identify factors that are associated with successful organ retrieval among patients referred to organ procurement services for potential organ donation. Particular attention was paid to the frequency, patient characteristics, and outcomes of patients referred for donation from the emergency department (ED).

Methods: For this retrospective cohort study, data were collected on all solid-organ donor referrals made to a single organ procurement organization serving 78 hospitals over a 45-month period.

Ethical considerations of research in disaster-stricken populations.

Recently, emphasis has been placed on improving and expanding research in disaster response and the treatment of disaster-stricken populations. However, research in these settings presents unique ethical challenges with which the scientific and biomedical ethics communities continue to struggle. At the core of the controversy is the question of how best to balance the critical need for research with the equally important obligation to respect and protect the interests of research participants within the unique stress of a disaster.

When are prehospital intravenous catheters used for treatment?

Prior studies have found that > 50% of prehospital intravenous catheters (i.v.s) were unutilized for treatment; however, few data are available regarding which patients benefit.

Women are less likely than men to receive prehospital analgesia for isolated extremity injuries.

Objectives: The goal of this study was to examine the effect of socioeconomic factors, such as ethnicity, income, age, and sex, on the administration of analgesia for isolated extremity injuries in the prehospital setting.

Methods: For this retrospective study, the electronic medical record of a large ground-based emergency medical services agency was reviewed and all isolated extremity injuries occurring during the year 2005 were extracted. A total of 1009 cases met the inclusion criteria.

Validation of low-acuity emergency medical services dispatch codes.

Background: Computer-aided dispatch systems are used to assess the severity of a 9-1-1 caller's complaint and then assign an appropriate level of emergency medical services (EMS) response.

Objective: To evaluate a group of low-acuity codes (defined as requiring advanced life support [ALS] intervention in fewer than 10% of cases) that has been derived and validated in one community.

Methods: All of the 9-1-1 medical calls assigned to these predetermined emergency medical dispatch codes between January 1, 2004, and July 1, 2004, were analyzed.