Kathleen H. Rzechula

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OBJECTIVES The study aimed to determine mortality in septic patients 2 years after introduction of a modified early goal-directed therapy (EGDT) protocol and to measure compliance with the protocol. DESIGN This was an observational study of prospectively identified patients treated with EGDT in our emergency department (ED) from May 2007 through May 2008(More)
OBJECTIVES 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(More)
BACKGROUND Because of its many desirable properties, etomidate is widely used as an induction agent for endotracheal intubation. However, some have recently called into question the safety of etomidate for even single-bolus use due to its known effects on adrenal suppression. OBJECTIVES We sought to compare the in-hospital mortality between septic(More)
BACKGROUND Both serum measurements of B-type natriuretic peptide (BNP) and impedance cardiography (ICG) are used to evaluate patients for congestive heart failure (CHF) in the Emergency Department (ED), but the agreement between the data obtained by these two methods remains uncertain. STUDY OBJECTIVES We sought to measure the correlation between BNP(More)
BACKGROUND Recent studies suggest that alpha-blockade with tamsulosin may be useful in the treatment of ureterolithiasis by increasing the success of, and decreasing the time to, stone passage. OBJECTIVES We sought to determine stone passage success rates in patients diagnosed with ureterolithiasis and discharged from our Emergency Department (ED) with(More)
INTRODUCTION Simulation scenarios provide a realistic, stressful environment in which participants can gain new clinical knowledge. It is unclear whether the role a participant plays in a scenario affects these goals. We measured heart rate, self-perceived stress and learning value, and objective written test results of participants in two simulation(More)
STUDY OBJECTIVE 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(More)
OBJECTIVES 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(More)
BACKGROUND High fidelity (HF) simulators have become more common in residency training programs. AIMS We hypothesized that high fidelity (HF) simulation-based assessment of patient care competency could differentiate novice from experienced residents. METHODS Prospective study of 44 emergency medicine residents. A simulated case of anaphylactic shock(More)
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