Despite a range of therapeutic options for treating acute migraine headaches, the use of opioids is still reported to be common practice. This study describes treatment practices in regards to migraines in the ED. It characterizes the prevalence of opioid orders during visits in three different settings, an academic medical center, a non-academic urban ED, and a community ED. Fourteen months of consecutive migraine visits were identified. All medications ordered were separated into first-line and rescue medications. Number of visits, length of stay, door to provider time, and total provider time were compared. A total of 1222 visits were identified. Opioids were ordered in 35.8% of these visits. By facility, opioids were ordered in 12.3% of academic medical center visits, 40.9% of urban ED visits, and 68.6% of community ED visits. This ranged from 6.9% of first-line therapies in the academic center to 69.9% of rescue therapies in the community ED. Of those who received opioids, 36.0% versus 25.1% required rescue medications. Patients who received opioids had more repeat visits, 1.79 versus 1.30. The academic center and urban ED both found greater than 30% decrease in length of stay in visits where opioids were not given. In the face of evidence against opioids for migraines, over one third of patients received them. There was a higher prevalence in the community setting. There were no significant benefits in overall throughput time, however, opioid visits required more rescue medications, increased length of stay, and resulted in more repeat visits.
Men's Health (7), Pain Management (3) Migraine Disorders (5), more mentions
AbstractText: Patients in the intensivecare unit (ICU), may be placed in contact isolation (CI) for meticillin-resistant ... PCR assay and sedation within 24 and 48 hours of ICU admission, respectively. Endpoints included rate of inappropriate sedation, length of ICU stay, length of time on MV, and incidence of ventilator ... Keyword: criticalcare.
... considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes ... and disadvantages and clinical pearls of these therapies, providing practitioners with essential drug information to optimize pharmacotherapy in acutely ill neurocritical care patients.
Previous studies of emergencydepartment (ED) rate-control have been limited by relatively small sample ... probability of hospital admission after propensity score matching patients by medication class AbstractText: Of the 1639 patients who received either a ... of a CCB, a higher presenting heart rate, a successful pharmacological cardioversion (versus no attempt), or who were seen at the ...
Cardiovascular Diseases (2), Men's Health (2) Atrial Fibrillation (2), Heart Failure (1), Hypotension (1), more mentions
... Devices and Radiological Health (CDRH) at the US Food and Drug Administration is to facilitate medical device innovation... for innovative physiological closed-loop controlled (PCLC) devices used in criticalcare environments, such as intensivecare units, emergency settings, and battlefield environments ... implementation, and evaluation considerations associated with PCLC devices used in criticalcare environments.
Abstract: Monitoring fungal ecology and resistance to antifungal agents within intensivecare units (ICU) is essential for the management of invasive fungal infections ... As the majority of invasive fungal infections in ICU are caused by Candida species, the study objectives were to ... distribution, to assess candidaemia incidence and to monitor the antifungal drug susceptibility of Candida isolates and the consumption of antifungal agents.
Infectious Diseases (1) Infections (4), Candidiasis (1), more mentions
Evaluation of the 2016 Infectious Diseases Society of America/American Thoracic Society Guideline Criteria for Risk of Multi-drug Resistant Pathogens in Hospital-acquired and Ventilator-associated Pneumonia Patients in the IntensiveCare Unit..
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used analgesic and anti-inflammatory adjuncts. Nonsteroidal anti-inflammatory drug administration may potentially increase the risk of postoperative gastrointestinal anastomotic failure (AF... Nonsteroidal anti-inflammatory drug administration should be used cautiously in EGS patients with colon or rectal anastomoses. Future randomized trials should validate the effects of perioperative NSAIDs use on AF.Therapeutic ...