Robert Sapien | PubMed Health

PubMed2002

Introducing a simple, weight-based, color-coded, medication dosing device.

OBJECTIVE: To compare the time required to withdraw various pediatric resuscitation medications using traditional techniques and the Per-Kilo Doser (PKD), a new weight-based dosing device. METHODS: Seven emergency department nurses were each videotaped as they withdrew medications for four different pediatric resuscitation scenarios. In random order, each nurse performed a total of eight timing trials-four with traditional techniques and four with the PKD. The videotapes were later reviewed and timed by two reviewers who were unaware of the study purpose. The time to drug withdrawal (announcement of medication and dose to be withdrawn until the nurse completed medication withdrawal) was measured in seconds. Nonparametric and exact techniques were used to determine statistical significance. RESULTS: Using traditional techniques, the mean time to drug withdrawal was 71.8 seconds; using the PKD, the mean time to drug withdrawal was 43.1 seconds. The mean time difference between the PKD and traditional techniques was 29.2 seconds (95% CI, 16.7-41.7). CONCLUSION: The PKD decreases medication withdrawal time.

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PubMedDate not supplied

Characteristics of fire station walk-in patients.

OBJECTIVE: To characterize the use of fire stations for walk-in health care and compare utilization patterns of fire stations in lower-income areas with those in higher-income areas. METHODS: The study was a retrospective review of emergency medical services (EMS) medical forms of patients who presented directly to a fire station for medical care during a 12-month period. RESULTS: During the study period, there were a total of 56,600 EMS calls by the studied fire department, with 155 visits by persons presenting to 19 fire stations in the 12 zip code areas. Of these, 131 were eligible for inclusion in our study. Of the 131 visits, 76 of 131 (58%) occurred in zip codes where more than 20% of residents lived below poverty level. Patients presenting to the fire station for medical care were disproportionately male, 84 of 131 (64%), aged 31-50 years, 61 of 131 (47%). Leading chief complaints were abrasion/laceration/hematoma, 20 of 131 (15%), shortness of breath, 18 of 131 (14%), loss of consciousness/syncope/dizziness/weakness, 17 of 131 (13%), musculoskeletal pain, 17 of 131 (13%), and chest pain, 14 of 131 (11%). Suicide, assault, alcohol, or substance intoxication (SAAD) was associated with 47 of 131 (36%) visits. Following evaluation at the fire station, 97 of 131 (82%) were transported by EMS; few patients were transported by private vehicle (n = 11) or did not need transport (n = 12). CONCLUSIONS: In the authors' EMS system, the use of fire stations for walk-in health occurs disproportionately in areas of poverty. SAAD features are present in more than one third of the visits.

Adolescent↗