PURPOSE: The resuscitation room is the hub of intensive care and focused management within the emergency department (ED). For patients with life-threatening conditions, immediate triage and proper treatment using the resuscitation room is important. This study was conducted to assess the epidemiology of patients using the resuscitation room in an emergency department. METHODS:This was a retrospective observational study. Eligible subjects were enrolled through the National Emergency Department Information System from July 2007 to September 2008. All subjects came through a single regional emergency center that logs more than 45,000 patients annually. Pediatric patients less than 15 years of age and those who were dead on arrival at the ED were excluded. The Emergency Severity Index (ESI) version IV was used as a triage tool, and characteristics and ESI levels of patients using or not using resuscitation rooms were compared. RESULTS: The total number of eligible subjects was 40,926 and the male-female ratio was 1:0.92. The numbers of patients using the resuscitation room was 1,050 (2.99%). Patients using the resuscitation room were older than the patients not using the resuscitation room, were more likely to have used an ambulance to visit the ED, and had a higher mortality rate and a higher admission rate. A majority of staff members had the authority to put patients in the resuscitation room. Among them were professors 18.19%, emergency residents 11.43%, certified emergency nurses 40.57%, emergency nurses 19.43%, emergency medical technicians 2.86%, and paramedics 6.19%. Critical care was done in the resuscitation room for cardiopulmonary resuscitation 11.66%, intubation 26.33%, ventilation 1.71%, defibrillation 5.73%, and other 54.57%. The most frequent ESI levels of patients using the resuscitation room was 1 (57.89%); an ESI score of 3 (72.01%) was the most frequent value for patients not using the resuscitation room. CONCLUSION: Patient using the resuscitation room were older, more likely to have used an ambulance, and had a higher mortality rate, admission rate and ESI level.
Allied Health Personnel ; Ambulances ; Cardiopulmonary Resuscitation ; Critical Care ; Emergencies ; Emergency Medical Technicians ; Humans ; Information Systems ; Critical Care ; Intubation ; Porphyrins ; Resuscitation ; Retrospective Studies ; Severity of Illness Index ; Triage ; Ventilation

Emphysematous pyelitis is uniquely characterized by gas-forming infection restricted to the renal collecting system. This disease entity is uncommon, and shows preferred occurrence in patients with diabetes mellitus or urinary tract obstruction. We report a case of bilateral emphysematous pyelitis in a diabetic end-stage renal disease patient undergoing peritoneal dialysis therapy. The patient was treated by medical treatment only and then recovered from infection, and she has maintained peritoneal dialysis until today. The authors report this case as a successful medical treatment for emphysematous pyelitis accompanying multiple risk factors, such as diabetes mellitus, amorphous medullary kidney stones, and even underlying maintaining peritoneal dialysis.
Diabetes Mellitus ; Humans ; Kidney Calculi ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Pyelitis ; Risk Factors ; Urinary Tract

PURPOSE: To determine the utility of HRCT in the diagnosis of chronic airflow obstruction and to correlate the morphologic abnormalities revealed by this modality with functional impairment in patients with chronic air-flow obstruction. MATERIALS AND METHODS:This study involved 80 patients with chronic airflow obstruction who underwent HRCT and a pulmonary function test. Final clinical diagnosis in these patients was determined by a chest physician on the basis of clinical features, bronchoscopy, pulmonary function test, and HRCT. In order to diagnose and determine the extent of areas of decreased attenuation revealed by HRCT (the CT score), the find-ings of HRCT were retrospectively reviewed by two radiologists, who reached a consensus. Clinical and HRCT diagnoses were then compared, and the rate of agreement between them was calculated. The relation-ship between the extent of areas of decreased attenuation revealed by HRCT and by FEV1/FVC was evaluated using Correl 's account and Student 's unpaired t-test. RESULTS: The agreement rate between clinical and HRCT diagnoses was 77.5% (62/80). The rates for bronchiec-tasis (88.9%, 24/27), emphysema (93.9%, 31/33), and bronchiolitis obliterans (100%, 6/6) were considerably higher than those for chronic bronchitis and bronchial asthma. The correlation rate between CT score and FEV1/FVC was significant in bronchiectasis (p<0.05; r: -0.76) and bronchiolitis obliterans (p<0.01; r:-0.66), but not in cases involving emphysema, bronchial asthma, or chronic bronchitis (p>0.05). CONCLUSION: HRCT is valuable in the diagnosis and prediction of physiologic impairment in patients with bronchiectasis and bronchiolitis obliterans, but has limited value in those with emphysema, chronic bronchitis or asthma.
Asthma ; Bronchiectasis ; Bronchiolitis Obliterans ; Bronchitis, Chronic ; Bronchoscopy ; Consensus ; Diagnosis* ; Emphysema ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Pulmonary Emphysema ; Respiratory Function Tests* ; Retrospective Studies ; Thorax