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OBJECTIVE The objective of the study was to determine if balanced electrolyte solution (BES) prevents hyperchloremic metabolic acidosis in patients with diabetic ketoacidosis (DKA). METHODS This is a prospective, randomized, double-blind study. A convenience sample of DKA patients aged 18 to 65 years with serum bicarbonate less than or equal to 15 and(More)
BACKGROUND Patients with low-risk chest pain have high utilization of stress testing and cardiac imaging, but low rates of acute coronary syndrome (ACS). The objective of this study was to determine whether the HEART score could safely reduce objective cardiac testing in patients with low-risk chest pain. METHODS A cohort of chest pain patients was(More)
BACKGROUND Extracellular nucleotides mediate many cellular functions and are released in response to mechanical stress in vitro. It is unknown whether adenosine triphosphate (ATP) is released in vivo during mechanical ventilation (MV). We hypothesized that stress from high-pressure MV would increase airway ATP, contributing to MV-associated lung edema. (More)
BACKGROUND The utility of ultrasound-guided peripheral intravenous access (USGPIV) has been well described. However, few studies have investigated USGPIV techniques. OBJECTIVES To describe a modified Seldinger technique for USGPIV. METHODS Emergency Department patients with difficult i.v. access (three or more failed landmark attempts) were(More)
BACKGROUND The HEART score and North American Chest Pain Rule (NACPR) are decision rules designed to identify acute chest pain patients for early discharge without stress testing or cardiac imaging. This study compares the clinical utility of these decision rules combined with serial troponin determinations. METHODS AND RESULTS A secondary analysis was(More)
Emergency Medicine (EM) residency program web sites are an important tool that programs use to attract applicants. However, there are only a few studies examining the aspects of a program's web site that are most important to EM applicants. We conducted a cross-sectional study of 142 prospective residency applicants interviewing for an EM position at one of(More)
BACKGROUND Stable and reproducible large animal models of hepatic failure, which allow the assessment of liver-assist devices, are not available. Our objective was to develop a physiologically stable animal model of hepatic failure on which the safety and efficacy of an extracorporeal liver-assist device can be tested. We hypothesized that a surgical model(More)
BACKGROUND Alcohol use increases injury risk and severity. However, few studies have evaluated the ability of emergency physicians (EPs) to accurately determine sobriety. OBJECTIVES To determine the predictive value of clinical sobriety assessment by EPs in blunt trauma patients with acute alcohol use. MATERIALS AND METHODS Blunt trauma patients, aged(More)
OBJECTIVE The objective of the study was to determine if the short-axis approach and long-axis approach to ultrasound-guided peripheral intravenous access (USGPIV) differ in success rate, catheter insertion time, and number of needle sticks. METHODS A convenience sample of emergency department patients aged 18 to 65 years with difficult IV access (2 or(More)
OBJECTIVES The aim of this study was to determine the effect of stress cardiac magnetic resonance (CMR) imaging in an observation unit (OU) on revascularization, hospital readmission, and recurrent cardiac testing in intermediate-risk patients with possible acute coronary syndromes (ACS). BACKGROUND Intermediate-risk patients commonly undergo hospital(More)