a-novel-approach-for-administration-medications-fluids-emergency

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or ...

Advocate Christ Medical Center

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.

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

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.

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

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.

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

Angiotensin-converting enzyme inhibitor-related angioedema (ACEI-RA) is a well-described condition, yet isolated genital ACEI-RA is a little-known entity.

Penile angioedema developing after 3 years of ACEI therapy.

A Centers for Medicare & Medicaid Services (CMS) pneumonia quality measures with particular impact on the emergency department (ED) is blood cultures prior to antibiotic administration for patients admitted with pneumonia. A study was conducted to measure the impact of an automated dispensing cabinet (ADC) alert on improving compliance with the quality measure of obtaining blood cultures prior to giving antibiotics for patients admitted with pneumonia and who have blood cultures ordered.

Automated dispensing cabinet alert improves compliance with obtaining blood cultures before antibiotic administration for patients admitted with pneumonia.

Our prior analysis suggested that error frequency increases disproportionately with Emergency department (ED) crowding. To further characterize, we measured this association while controlling for the number of charts reviewed and the presence of ambulance diversion status. We hypothesized that errors would occur significantly more frequently as crowding increased, even after controlling for higher patient volumes.

Article	Year
A prospective observational study of the effect of etomidate on septic patient mortality and length of stay. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine\| PubMed ID: 19055676	2009
ED overcrowding is associated with an increased frequency of medication errors. The American journal of emergency medicine\| PubMed ID: 20223387	2010
A comparison of the effects of etomidate and midazolam on hospital length of stay in patients with suspected sepsis: a prospective, randomized study. Annals of emergency medicine\| PubMed ID: 20828877	2010
Penile angioedema developing after 3 years of ACEI therapy. The Journal of emergency medicine\| PubMed ID: 22560272	2012
Automated dispensing cabinet alert improves compliance with obtaining blood cultures before antibiotic administration for patients admitted with pneumonia. Joint Commission journal on quality and patient safety\| PubMed ID: 22649862	2012
Further characterization of the influence of crowding on medication errors. Journal of emergencies, trauma, and shock\| PubMed ID: 24339659	2013
Application of a scoring instrument to predict intracerebral hemorrhage and outcome after thrombolysis for acute ischemic stroke. Journal of emergencies, trauma, and shock\| PubMed ID: 26229304	2015

Rolla Sweis

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