Total body weight estimation by 3D camera systems: Potential high-tech solutions for emergency medicine applications? A scoping review.

Background: Weight estimation is required in adult patients when weight-based medication must be administered during emergency care, as measuring weight is often not possible. Inaccurate estimations may lead to inaccurate drug dosing, which may cause patient harm. High-tech 3D camera systems driven by artificial intelligence might be the solution to this problem.

Alcohol use is associated with intracranial hemorrhage in older emergency department head trauma patients.

Objectives: Falls are common in adults aged 65 years and older and are the leading cause of traumatic brain injuries in this age group. Alcohol use may increase the risk of falls as well as the severity of resultant injuries. The aim of this study was to examine the association between self-reported alcohol use and the prevalence of intracranial hemorrhage (ICH) in this patient group.

The Florida Geriatric Head Trauma CT Clinical Decision Rule.

Background: Several clinical decision rules have been devised to guide head computed tomography (CT) use in patients with minor head injuries, but none have been validated in patients 65 years or older. We aimed to derive and validate a head injury clinical decision rule for older adults.

Methods: We conducted a secondary analysis of an existing dataset of consecutive emergency department (ED) patients >65 years old with blunt head trauma.

The accuracy of total body weight estimation in adults - A systematic review and meta-analysis.

Background: Weight estimation is required in adult patients when weight-based medication must be administered during emergency care, as measuring weight is often impossible. Inaccurate estimations may lead to inaccurate drug doses, which may cause patient harm. Little is known about the relative accuracy of different methods of weight estimation that could be used during resuscitative care.

Lack of patient and primary care physician follow-up in geriatric emergency department patients with head trauma from a fall.

Study Objective: Falls are the leading cause of injuries in the US for older adults. Follow-up after an ED-related fall visit is essential to initiate preventive strategies in these patients who are at very high risk for recurrent falls. It is currently unclear how frequently follow-up occurs and whether preventive strategies are implemented.

Weight Estimation for Drug Dose Calculations in the Prehospital Setting - A Systematic Review.

Background: Weight estimation is required to enable dose calculations for weight-based drugs administered during emergency care. The accuracy of the estimation will determine the accuracy of the administered dose. This is an important matter of patient safety.

An observational simulation-based study of the accuracy of intercostal drain placement and factors influencing placement.

Introduction: South Africa's significant burden of trauma and respiratory disease requires the regular need for intercostal drain (ICD) insertion. ICD misplacement is associated with significant complications. The aim of this study was to assess ICD insertion site accuracy and the factors affecting accuracy by Emergency Department doctors.

Estimating Lean Body Weight in Adults With the PAWPER XL-MAC Tape Using Actual Measured Weight as an Input Variable.

Introduction Accurate drug dose calculation in obese patients requires an estimation of lean body weight (LBW) for dosing hydrophilic medications. Inaccurate weight estimates during the management of critically ill obese adults may contribute to inaccurate drug doses and consequential poor outcomes. Existing methods of LBW estimation or measurement may be very difficult or impossible to use during emergency care.

CT Utilization in a Level One Trauma Center in South Africa.

Introduction Computed tomography (CT) imaging forms an important component in the evaluation and management of patients with traumatic injuries. Many South African emergency departments (EDs) have a significant trauma-related workload, especially in the public sector, where there are limitations in resources relating to CT scanners. It is important to gauge the impact of traumatic injuries on CT utilization.

Development and Validation of a Length- and Habitus-Based Method of Ideal and Lean Body Weight Estimation for Adults Requiring Urgent Weight-Based Medical Intervention.

Background And Objective: Accurate drug dosing in obese patients requires an estimation of ideal body weight (IBW) or lean body weight (LBW) for dosing hydrophilic medications. Erroneous weight estimates during the management of adults requiring weight-based treatment may contribute to poor outcomes. Existing methods of IBW and LBW estimation or measurement are very difficult to use during emergency care.

Development and validation of a length- and habitus-based method of total body weight estimation in adults.

Background: Erroneous weight estimation during the management of emergency presentations in adults may contribute to patient harm and poor outcomes. Patients can often not be weighed during emergencies and a weight estimation is required to facilitate weight-based therapies. Many existing methods of weight estimation are either unacceptably inaccurate or very difficult to use during the provision of emergency care.

Human Factor Errors in the use of the PAWPER Tape Systems: An Analysis of Inter-Rater Reliability.

Background International guidelines have promoted the use of length-based tapes for emergency weight estimation in children. This is primarily because of a perception that more modern methods might require more training than can practically be achieved. This study aimed to evaluate the inter-rater reliability of novice users of the PAWPER XL (paediatric advanced weight-prediction in the emergency room) tape as an indicator of the ability to use the device effectively with limited training.

The utility of pediatric age-based weight estimation formulas for emergency drug dose calculations in obese children.

Objectives: In obese children, when drug therapy is required during emergency care, an estimation of ideal body weight is required for certain drug dose calculations. Some experts have previously speculated that age-based weight estimation formulas could be used to predict ideal body weight. The objectives of this study were to evaluate how accurately age-based formulas could predict ideal body weight and total body weight in obese children.

Drug dosing errors in simulated paediatric emergencies - Comprehensive dosing guides outperform length-based tapes with precalculated drug doses.

Background: The accuracy of drug dosing calculations during medical emergencies in children has not been evaluated extensively. The objectives of this study were to evaluate the accuracy of drug dose calculations using the Broselow tape, the PAWPER XL tape plus its companion drug-dosing guide, a custom-designed mobile phone app and no drug-dosing aid (control group).

Methods: This was a prospective study in which 32 emergency medicine volunteers participated in eight simulations of common paediatric emergency conditions, using children models.

Using the Mercy Method to Estimate Ideal Body Weight in Children: A Description and Validation of a New Methodology.

Background In obese children, lipophilic medications should be dosed to total body weight (TBW) and hydrophilic medications to ideal body weight (IBW). During emergencies, these weights need to be estimated to ensure that urgent drug therapy is accurate and safe. The Mercy method is a well-established weight estimation system that has recently been adapted to provide estimations of body length in children.

How and Why Paediatric Weight Estimation Systems Fail - A Body Composition Study.

Background Weight estimation during medical emergencies in children is essential, but fraught with errors if the wrong techniques are used, which may result in critical drug dosing errors. Individualised weight estimation is required to allow for accurate dosing in underweight and obese children in particular. This study was designed to evaluate the associations between weight estimations from different systems and body composition in order to establish how and why they may perform well or poorly.

Smart watch-detected tachycardia: a case of atrial flutter.

The use of smart watches like the Apple watch and other wearable electronic devices by the general public has been increasing dramatically. Until their accuracy for detecting dysrhythmias has been well-established, however, it would not be appropriate to rely on them solely to rule-in or rule-out pathology. Nonetheless, unusual findings from these devices should be followed up with more conventional investigations, and this approach may prove highly beneficial to patients and treating clinicians alike.

Nervous breakdown! A registry of nerve blocks from a South African emergency centre.

Introduction: Nerve blocks are commonplace in the operating theatre and have recently made their way into emergency centres as a viable alternative to traditional methods of analgesia. Their use and safety has been documented for a variety of pathologies and it has been shown that they spare opioids and shorten time to discharge. No data exists on their use in South Africa.

The cost-effectiveness of upfront point-of-care testing in the emergency department: a secondary analysis of a randomised, controlled trial.

Background: Time-saving is constantly sought after in the Emergency Department (ED), and Point-of-Care (POC) testing has been shown to be an effective time-saving intervention. However, when direct costs are compared, these tests commonly appear to be cost-prohibitive. Economic viability may become apparent when the time-saving is translated into financial benefits from staffing, time- and cost-saving.