Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department

Article Abstract:

Beta-adrenergic agents (epinephrine-stimulating substances) which have been used to treat acute bronchial asthma in emergency departments for more than 50 years are ineffective for up to 30 percent of persons treated. Magnesium sulfate, an anti-convulsant and topical anti-inflammatory agent, seems to be of benefit as a therapeutic agent in the treatment of acute bronchial asthma. A study evaluating the use of this substance on 38 patients admitted to emergency departments suffering from moderate to severe asthma demonstrated the effectiveness of magnesium sulfate in treating patients who did not respond to beta-adrenergic agents. The means by which magnesium sulfate reduces the symptoms of asthma is not known, but it may modulate the movement of calcium ions associated with the activity of smooth vascular muscles which control blood vessel vasodilation. Further studies involving larger numbers of patients are needed to ascertain that magnesium sulfate is a safe, effective and reliable treatment for patients suffering from acute episodes of moderate to severe asthma.

Care and treatment, Evaluation, Practice, Physiological aspects, Emergency medicine, Magnesium sulphate, Sympathomimetic agents

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Requesting consent for an invasive procedure in newly deceased adults

Article Abstract:

Family members of newly deceased adults may frequently grant consent allowing the performance of invasive procedures on the deceased. These procedures are performed by medical professionals to aid in the teaching and practice of medicine. Researchers approached 44 families of newly deceased patients and requested family consent to perform retrograde tracheal intubation on the deceased. Fifty-nine percent of families granted permission for the procedure. Families of patients who had died unexpectedly were more likely to grant permission than families of patients whose deaths were expected. Families of patients who died in the emergency room granted permission more often than families of those who died during their hospital stay. Spouses of the deceased granted consent more often than the decedents' children. The two physicians who were part of the investigating team felt comfortable requesting family consent in 96% of cases and the student nurse anesthetist investigator felt comfortable soliciting consent in 11% of cases.

Research, Usage, Informed consent (Medical law), Informed consent, Cadaver, Cadavers

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The influence of age and sex on asthma admissions

Article Abstract:

Adult women are much more likely to be admitted to a hospital for asthma than adult men. A review of 33,269 asthma admissions at 67 hospitals in five Pennsylvania counties between 1986 and 1989 found that children under the age of two had the highest admission rates, and twice as many boys were admitted as girls. However, this ratio began to change when adult admissions were reviewed. After the age of 20, almost three times as many women were admitted as men. Older patients remained in the hospital longer than younger patients. It is possible that asthma is affected by female hormones, but the increase in admissions was seen even in postmenopausal women. Other researchers have found that 80% of female asthmatics studied had abnormal blood levels of one or more female hormones. Women may be more likely to be diagnosed with asthma. There is no evidence that physicians treat female asthmatics differently than male asthmatics.

Demographic aspects, Hospitals, Hospital admission and discharge

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