Objectives: The objective was to compare the effectiveness of intravenous (IV) procainamide and amiodarone for the termination of spontaneous stable sustained ventricular tachycardia (VT).
Methods: A historical cohort study of consecutive adult patients with stable sustained VT treated with IV amiodarone or procainamide was performed at four urban hospitals. Patients were identified for enrollment by admissions for VT and treatment with the study agents in the emergency department (ED) from 1993 to 2008.
Objectives: : To determine whether adenosine is useful and safe as a diagnostic and therapeutic agent for patients with undifferentiated wide QRS complex tachycardia. The etiology of sustained monomorphic wide QRS complex tachycardia is often uncertain acutely.
Design: : A retrospective observational study.
During an ongoing study of wireless vital signs monitoring of post-triage patients with SMART [1] in the waiting area of the emergency department (ED) at the Brigham and Women's Hospital in Boston, Massachusetts, USA, we observed that redundancy in vital signs monitoring can be advantageous.
View Article and Find Full Text PDFJ Am Med Inform Assoc
February 2008
Monitoring vital signs and locations of certain classes of ambulatory patients can be useful in overcrowded emergency departments and at disaster scenes, both on-site and during transportation. To be useful, such monitoring needs to be portable and low cost, and have minimal adverse impact on emergency personnel, e.g.
View Article and Find Full Text PDFStudy Objective: It is hypothesized that intravenous (IV) amiodarone is poorly effective for the acute termination of sustained monomorphic ventricular tachycardia because of the relatively slow onset of its Vaughn-Williams class III effect to prolong myocardial depolarization and the refractory period. This study is designed to determine the effectiveness and safety of IV amiodarone for the termination of sustained monomorphic ventricular tachycardia.
Methods: A retrospective case series was collected at 4 urban university-affiliated hospitals from September 1996 to April 2005 after institutional review board approval with waiver of informed consent.
As bacteria grow and proliferate, they release a variety of volatile compounds that can be profiled and used for speciation, providing an approach amenable to disease diagnosis through quick analysis of clinical cultures as well as patient breath analysis. As a practical alternative to mass spectrometry detection and whole cell pyrolysis approaches, we have developed methodology that involves detection via a sensitive, micromachined differential mobility spectrometer (microDMx), for sampling headspace gases produced by bacteria growing in liquid culture. We have applied pattern discovery/recognition algorithms (ProteomeQuest) to analyze headspace gas spectra generated by microDMx to reliably discern multiple species of bacteria in vitro: Escherichia coli, Bacillus subtilis, Bacillus thuringiensis, and Mycobacterium smegmatis.
View Article and Find Full Text PDFObjectives: The aims of this study were to compare rates of intimate partner violence (IPV) across different medical specialties and health care sites in one metropolitan area, describe demographic characteristics of women with abusive partners, characterize health care provider assessment of IPV, and describe patient characteristics associated with health care assessment for partner violence.
Methods: Women (N = 2,465) completed written surveys about partner violence and health care screening for violence in the waiting rooms of five types of health care settings (obstetrician/gynecologist office, emergency department, primary care office, pediatrics, and addiction recovery) across eight different hospitals in the greater Boston area.
Results: The overall survey response rate was 62%.
Study Objective: We determine whether a patient education intervention based on a previously validated model increases satisfaction with emergency department (ED) care.
Methods: A single-page patient education form was distributed on alternating 2-week time blocks for 8 weeks at the triage desk of a single academic ED. Alert, discharged patients were administered an exit interview assessing satisfaction on a 5-point ordinal scale.
This article reports progress since the original publication of the Frontlines of Medicine Project. This project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, other government agencies involved in health care and preparedness, law enforcement, and informatics to develop nonproprietary, standardized methods for reporting emergency department patient data. These data may be used for a variety of public health or clinical care initiatives, including syndromic surveillance for chemical and biological terrorism.
View Article and Find Full Text PDFObjectives: No single universal definition of emergency department (ED) overcrowding exists. The authors hypothesize that a previously developed site-sampling form for academic ED overcrowding is a valid model to quantify overcrowding in academic institutions and can be used to develop a validated short form that correlates with overcrowding.
Methods: A 23-question site-sampling form was designed based on input from academic physicians at eight medical schools representative of academic EDs nationwide.
Background: Because of concerns about masking important physical findings, there is controversy surrounding whether it is safe to provide analgesia to patients with undifferentiated abdominal pain. The purpose of this study was to address the effects of analgesia on the physical examination and diagnostic accuracy for patients with abdominal pain.
Study Design: The study was a prospective, double-blind clinical trial in which adult Emergency Department (ED) patients with undifferentiated abdominal pain were randomized to receive placebo (control group, n = 36) or morphine sulphate (MS group, n = 38).