ACEP News, August 2009

August 2009 ACEP News in full digital format
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Treatment of acute-onset atrial fibrillation or flutter using the Ottawa Aggressive Protocol for rapid emergency department rhythm control yielded a 91% conversion rate in a large consecutive patient series.

Many new strategies are being tested to improve identification and treatment of people who are suicidal when they come to emergency departments, where most suicidality currently falls through the cracks.

Health care payers, legislators, and the general public limit the ability of emergency medical service professionals to use the best resuscitation practices, which are outlined in national guidelines, according to the results of a qualitative study published online in Circulation: Cardiovascular Quality and Outcomes.

I predict that the treatment of the superobese will be the next fertile ground for trial lawyers.

The Centers for Disease Control and Prevention's vaccine advisory panel voted to drop the recommended number of postexposure doses of rabies vaccine from 5 to 4, based on data suggesting that doing so would not adversely affect outcomes for exposed individuals.

The American Medical Association has launched its online ePrescribing Learning Center to provide physicians with the tools they need to make informed decisions about electronic prescribing

A simple predictive instrument may improve emergency department disposition decisions regarding asymptomatic elderly patients who present with syncope.

A substantial proportion of older adults or their proxies did not understand key portions of their emergency department discharge information, according to a survey of 92 patients aged 65 years or more.

Tweaking the widely utilized San Francisco Syncope Rule by tightening up its ECG criteria boosts the test's sensitivity and specificity for emergency department prediction of 30-day cardiac events, according to Canadian researchers.

Empiric treatment for sexually transmitted infections among adolescent girls presenting to a pediatric emergency department is high, but many patients are unreachable for follow-up and some remain unaware that they are infected, according to a 3-month baseline study.

The newly formed American Board of Addiction Medicine has certified more than 1,600 physicians as specialists in addiction medicine so far this year--and doctors from multiple disciplines who meet expertise criteria are taking advantage of the opportunity to be "grandfathered in" to the nascent specialty.

European studies conducted in health care systems with comprehensive patient tracking indicate that two-thirds to three-quarters of all patients with acute HIV infection seek treatment because they feel ill.

Corticosteroid therapy has no significant effect on 28-day mortality, ICU mortality, or hospital mortality overall in patients with severe sepsis or septic shock, according to a meta-analysis.

Having the right mix of physicians, nurses, midlevel providers, and support staff in the emergency department can help ensure emergency department efficiency, patient satisfaction, cost-effective care, and medical-legal safety.

The health care reform discussion taking place on Capitol Hill is broad and all-encompassing, and trying to solve all that ails our country's health care system will not be easy. Ensuring that all sides of each issue are heard will be even tougher.

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