A comparison of the effects of etomidate and midazolam on hospital length of stay in patients with suspected sepsis: a prospective, randomized study.

Study Objective: Etomidate, a widely used induction agent for rapid sequence intubation in the emergency department (ED), causes measurable adrenal suppression after a single bolus dose. The clinical significance of this adrenal suppression in patients with sepsis remains controversial. We seek to determine the difference in hospital length of stay between patients with suspected sepsis who receive either etomidate or midazolam during intubation in our ED.

ED overcrowding is associated with an increased frequency of medication errors.

Objectives: Despite the growing problems of emergency department (ED) crowding, the potential impact on the frequency of medication errors occurring in the ED is uncertain. Using a metric to measure ED crowding in real time (the Emergency Department Work Index, or EDWIN, score), we sought to prospectively measure the correlation between the degree of crowding and the frequency of medication errors occurring in our ED as detected by our ED pharmacists.

Methods: We performed a prospective, observational study in a large, community hospital ED of all patients whose medication orders were evaluated by our ED pharmacists for a 3-month period.

The effect of single-bolus etomidate on septic patient mortality: a retrospective review.

Background: Because of its many desirable properties, etomidate is widely used as an induction agent for endotracheal intubation. However, some have recently called into question the safety of etomidate for even single-bolus use due to its known effects on adrenal suppression.

Objectives: We sought to compare the in-hospital mortality between septic patients given etomidate and those given alternative induction agents for intubation.

The effect of alpha-blockade in emergency department patients with ureterolithiasis.

Background: Recent studies suggest that alpha-blockade with tamsulosin may be useful in the treatment of ureterolithiasis by increasing the success of, and decreasing the time to, stone passage.

Objectives: We sought to determine stone passage success rates in patients diagnosed with ureterolithiasis and discharged from our Emergency Department (ED) with tamsulosin.

Methods: We conducted a non-randomized retrospective cohort study over a 1-year period during which we made monthly follow-up telephone calls to patients discharged from our ED with a diagnosis of ureterolithiasis determined by computed tomography (CT) scan.

A prospective observational study of the effect of etomidate on septic patient mortality and length of stay.

Objectives: Etomidate is known to cause adrenal suppression after single-bolus administration. Some studies suggest that when etomidate is used as an induction agent for intubation of septic patients in the emergency department (ED), this adrenal suppression leads to increased mortality, vasopressor requirements, and length of hospital stay. The authors sought to determine differences in the in-hospital mortality and hospital length of stay (LOS) between septic patients given etomidate and patients given alternative or no induction agents for rapid-sequence intubation in our ED.

Correlation between impedance cardiography and B-type natriuretic peptide levels in dyspneic patients.

Background: Both serum measurements of B-type natriuretic peptide (BNP) and impedance cardiography (ICG) are used to evaluate patients for congestive heart failure (CHF) in the Emergency Department (ED), but the agreement between the data obtained by these two methods remains uncertain.

Study Objectives: We sought to measure the correlation between BNP levels and ICG measurements in patients presenting to the ED with dyspnea, and compare the diagnostic accuracy of each method in diagnosing CHF.

Methods: We performed a prospective observational study of a convenience sample of patients presenting to the ED with dyspnea and being evaluated for CHF as a cause of their symptoms.