We all probably already know and we don't need that kind of negativity in our Safe Space.ġ3. No "X celebrity/politician is a transphobe" threads If you have less than 0 karma, you won't be allowed to submit here. Submissions or comments from users with 0 or less karma will be removed These are dangerous medications, not toys.ġ1. Posts that ask for or give advice on how to obtain or use DIY hormones will be removed, as will comments that explicitly state where to get black-market drugs. We're not doctors and we can't vouch for the safety or validity of any medical information. What may seem like tough love to one person may come across as hatred or abuse to another. It's hard to convey inflection and intent via text. If you got a cool tattoo or something else that's incidentally NSFW, please tag it as such. Users who are here to post porn or advertise will be removed. There are places online which cater to that particular fetish, but this is not one of them. Maliciously reporting someone who doesn't break our rules spams the report system, and it's against the site-wide rules. Treating a person like they're lesser or somehow inferior because they're non-binary is immoral, and shows a clear lack of understanding.Īsking for, or posting, a person's personal information can be dangerous, and it's also against the site-wide rules. Non-op, genderqueer, agender or any other denomination of transgender is still transgender. There is no such thing as "valid discrimination," and this sub will remove any post or comment that demonstrates racism, sexism, body shaming or any other bigotry you care to name. Be respectful, and we'll all be happier for it.Ībuse is absolutely banned here, and is treated extremely seriously. We're better than the trolls and haters, and we can show that by not rising to take the bait. Even when those users show disrespect themselves. © 2023 Society for Academic Emergency Medicine. In this single-center study at an academic ED, treatment of patients with MTM-severity DKA with a SQ insulin protocol was effective, demonstrated equivalent safety, and reduced ED length of stay.ĭiabetic ketoacidosis emergency subcutaneous insulin. We observed significant reductions in median EDLOS for the SQuID cohort compared to the traditional cohort during the study period (-3.0, 95% CI -8.5 to -1.4), the preintervention period (-1.4, 95% CI -3.1 to -0.1), and the pre-COVID control period (-3.6, 95% CI -7.5 to -1.8). We found no difference in the proportion of rescue dextrose administration compared to the traditional pathway. Fidelity to the SQuID pathway was good, with glucose checks exceeding the q2-h requirement. We identified 177 MTM-severity DKA patients in the study period (78 SQuID, 99 traditional cohort) and 163 preintervention and 161 pre-COVID historical control patients. We used Mann-Whitney U to test for differences in EDLOS distributions, bootstrapped (n = 1000) confidence intervals (CIs) for EDLOS median differences, and the two-sample z-test for differences in ICU admissions. We also examined ICU admission rate among MTM-severity DKA patients after introduction of SQuID to two historical control periods (pre-intervention and pre-COVID). We examined fidelity (frequency of required q2h glucose checks), safety (proportion of patients administered rescue dextrose for hypoglycemia), and ED length of stay (EDLOS) for the SQuID cohort compared to patients (non-ICU) treated with a traditional insulin infusion. We implemented the SQuID (Subcutaneous Insulin in Diabetic Ketoacidosis) protocol for adults with MTM-severity DKA in an urban academic ED, collecting data from August 1, 2021, to February 28, 2022. However, emergency department (ED)-based studies are few, with limited exploration of impacts on operational metrics. Studies using fast-acting subcutaneous (SQ) insulin analogs in diabetic ketoacidosis (DKA) have demonstrated efficacy, safety, and cost-effectiveness, allowing treatment of mild-to-moderate (MTM)-severity DKA patients in non-intensive care unit (ICU) settings.
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