Trending peripheral venous PCO in patients with respiratory failure using mathematically arterialised venous blood gas samples.

Background: Trending venous blood gases (VBGs) has been suggested as an alternative to arterial blood gases (ABGs) in patients with respiratory failure, but there are limits to its utility. The aim of this study was to compare the trending of venous carbon dioxide partial pressure (pCO) (pCOv) with mathematically arterialised pCO (pCOca) and to further evaluate whether pCOca follows change in arterial pCO (pCOa) more accurately.

Methods: We analysed two data sets.

Introducing a Clinical Practice Guideline Using Early CT in the Diagnosis of Scaphoid and Other Fractures.

Objective: We developed and implemented clinical practice guideline (CPG) using computerized tomography (CT) as the initial imaging method in the emergency department management of scaphoid fractures. We hypothesized that this CPG would decrease unnecessary immobilization and lead to earlier return to work.

Methods: This observational study evaluated implementation of our CPG, which incorporated early wrist CT in patients with "clinical scaphoid fracture": a mechanism of injury consistent with scaphoid fracture, anatomical snuff box tenderness, and normal initial plain x-rays.