Isopropyl Alcohol Nasal Inhalation for Nausea in the Emergency Department: A Randomized Controlled Trial

Beadle, Kenneth Lee; Helbling, Antonia R.; Love, Sue L.; April, Michael D.; Hunter, Christopher L.

doi:10.1016/j.annemergmed.2015.09.031

Cited by 31 publications

(23 citation statements)

References 18 publications

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“…In addition, our finding suggested that higher mortality might be mainly due to a higher incidence of cardiac arrest. We found that the patients who experienced IHCA had higher ICU admission and mortality rates, a finding consistent with results showing poor outcomes in patients who experienced IHCA [ 24 ]. In addition, most EDs are designed to care for at-risk patients upon arrival, not for patients awaiting test results or admission.…”

Section: Discussionsupporting

confidence: 90%

Prolonged Length of Stay in the Emergency Department and Increased Risk of In-Hospital Cardiac Arrest: A nationwide Population-Based Study in South Korea, 2016–2017

Kim

Seo

Jeong

et al. 2020

JCM

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This study was to determine whether prolonged emergency department (ED) length of stay (LOS) is associated with increased risk of in-hospital cardiac arrest (IHCA). A retrospective cohort with a nationwide database of all adult patients who visited the EDs in South Korea between January 2016 and December 2017 was performed. A total of 18,217,034 patients visited an ED during the study period. The median ED LOS was 2.5 h. IHCA occurred in 9,180 patients (0.2%). IHCA was associated with longer ED LOS (4.2 vs. 2.5 h), and higher rates of intensive care unit (ICU) admission (58.6% vs. 4.7%) and in-hospital mortality (35.7% vs. 1.5%). The ED LOS correlated positively with the development of IHCA (Spearman ρ = 0.91; p < 0.01) and was an independent risk factor for IHCA (odds ratio (OR) 1.10; 95% confidence interval (CI), 1.10–1.10). The development of IHCA increased in a stepwise fashion across increasing quartiles of ED LOS, with ORs for the second, third, and fourth relative to the first being 3.35 (95% CI, 3.26–3.44), 3.974 (95% CI, 3.89–4.06), and 4.97 (95% CI, 4.89–5.05), respectively. ED LOS should be reduced to prevent adverse events in patients visiting the ED.

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Section: Discussionsupporting

confidence: 90%

Prolonged Length of Stay in the Emergency Department and Increased Risk of In-Hospital Cardiac Arrest: A nationwide Population-Based Study in South Korea, 2016–2017

Kim

Seo

Jeong

et al. 2020

JCM

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“…19 It has been used in emergency departments to increase nausea relief. 20,21 There is inadequate evidence to classify it as a carcinogen in humans or animals. 19 Isopropyl alcohol is used in the post processing of SLA printed models.…”

Section: Figure 2 Temporal Bone Printed Using Photoreactive Acrylic Resinmentioning

confidence: 99%

Safety of Drilling 3-Dimensional–Printed Temporal Bones

Freiser

Ghodadra

Hart

et al. 2018

JAMA Otolaryngol Head Neck Surg

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n the past 10 years, great advances in 3-dimensional (3-D)printing technology have been made. Increasingly, otolaryngologists are investigating new ways to use the technology, from implantable stents to surgical simulation tools. 1 One such application that has been explored by several studies in the literature is 3-D printing temporal bones. A number of models have been described and evaluated with generally positive feedback. [2][3][4][5][6][7][8][9] What has not been described in the literature, however, is the safety of drilling 3-D-printed temporal bones. When surgical drills are used on the printed models, they will cut the material into pieces, which may be small enough to aerosolize, and the heat from the drill may volatilize components. Much like bone dust, particles from the material can be seen spraying off of the model during drilling. This raises the question of whether there may be harmful chemicals being produced that the surgeon may inhale and whether additional protection is necessary, such as is the case for asbestos and certain chemicals. The objective of the present study was to investigate whether the surgeon may be exposed to airborne contaminants when conducting high-speed drilling on 3-D-printed models and to determine whether there is a need for exposure control measures beyond standard personal protective equipment. MethodsInstitutional review board approval is not required for occupational safety testing at our institution. Three separate IMPORTANCE Three-dimensional (3-D) printing of temporal bones is becoming more prevalent. However, there has been no measure of the safety of drilling these models to date. It is unknown whether the heat and sheer from the drill may create harmful volatile organic compounds (VOCs).OBJECTIVE To determine the level of exposure to airborne contaminants when conducting high-speed drilling on 3-D-printed models and to explore whether there is a need for exposure control measures. DESIGN, SETTING, AND PARTICIPANTSIn this occupational safety assessment carried out in a temporal bone laboratory, 3 individual 3-D-printed temporal bones were made using 3 different materials commonly cited in the literature: polylactic acid (PLA), photoreactive acrylic resin (PAR), and acrylonitrile butadiene styrene (ABS). Each model was drilled for 40 minutes while the surgeon wore a sampling badge. Sampling was conducted for airborne concentrations of VOCs and total particulate (TP). Monitoring for VOCs was conducted using Assay Technology 521-25 organic vapor badge worn at the surgeon's neckline. Monitoring for TP was conducted using a polyvinyl chloride filter housed inside a cassette and coupled with an SKC AirChek 52 personal air-sampling pump. Samples were collected and analyzed in accordance with NIOSH Method 500. MAIN OUTCOMES AND MEASURES Presence of VOCs and TP count exposures at OccupationalSafety and Health Administration (OSHA) actionable levels.RESULTS Results of the VOC sample were less than detection limits except for isopropyl alcohol at 0.24 ppm for PAR. The T...

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“… 7 Simultaneously, interest continues to grow in the emergency medicine literature with regard to investigations of interventions to improve patient satisfaction. 1 – 3 To our knowledge, ours is the first and only study to examine the impact of heated gel on patient satisfaction. Our results indicate that heated US gel has no material impact on the satisfaction of ED patients undergoing bedside US studies.…”

Section: Discussionmentioning

confidence: 99%

“…Patient satisfaction is an increasing outcome of interest for emergency department (ED) providers. 1 – 4 Hospital administrators increasingly scrutinize satisfaction scores and link results with physician reimbursement. 5 Moreover, there exists a correlation between ED visit satisfaction scores and the likelihood of patients filing complaints related to their care.…”

Section: Introductionmentioning

confidence: 99%

Heated Ultrasound Gel and Patient Satisfaction with Bedside Ultrasound Studies: The HUGS Trial

Krainin

Thaut

April

et al. 2017

WestJEM

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IntroductionOur goal was to determine if heated gel for emergency department (ED) bedside ultrasonography improves patient satisfaction compared to room-temperature gel.MethodsWe randomized a convenience sample of ED patients determined by their treating physician to require a bedside ultrasound (US) study to either heated gel (102.0° F) or room-temperature gel (82.3° F). Investigators performed all US examinations. We informed all subjects that the study entailed investigation into various measures to improve patient satisfaction with ED US examinations but did not inform them of our specific focus on gel temperature. Investigators wore heat-resistant gloves while performing the examinations to blind themselves to the gel temperature. After completion of the US, subjects completed a survey including the primary outcome measure of patient satisfaction as measured on a 100-mm visual analogue scale (VAS). A secondary outcome was patient perceptions of sonographer professionalism measured by an ordinal scale (1–5).ResultsWe enrolled 124 subjects; 120 completed all outcome measures. Of these, 59 underwent randomization to US studies with room-temperature gel and 61 underwent randomization to heated US gel. Patient 100-mm VAS satisfaction scores were 83.9 among patients undergoing studies with room-temperature gel versus 87.6 among subjects undergoing studies with heated gel (effect size 3.7, 95% confidence interval −1.3–8.6). There were similarly no differences between the two arms with regard to patient perceptions of sonographer professionalism.ConclusionThe use of heated ultrasound gel appears to have no material impact on the satisfaction of ED patients undergoing bedside ultrasound studies.

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Isopropyl Alcohol Nasal Inhalation for Nausea in the Emergency Department: A Randomized Controlled Trial

Cited by 31 publications

References 18 publications

Prolonged Length of Stay in the Emergency Department and Increased Risk of In-Hospital Cardiac Arrest: A nationwide Population-Based Study in South Korea, 2016–2017

Prolonged Length of Stay in the Emergency Department and Increased Risk of In-Hospital Cardiac Arrest: A nationwide Population-Based Study in South Korea, 2016–2017

Safety of Drilling 3-Dimensional–Printed Temporal Bones

Heated Ultrasound Gel and Patient Satisfaction with Bedside Ultrasound Studies: The HUGS Trial

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