Annals of emergency medicine
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Clinical Trial Controlled Clinical Trial
Incision and drainage of cutaneous abscesses is not associated with bacteremia in afebrile adults.
To determine the prevalence of bacteremia associated with incision and drainage (I&D) of cutaneous abscesses in afebrile adult emergency department patients. Such information has implications for the ED management of immunocompromised patients, patients with history of endocarditis, and patients with prosthetic appliances such as heart valves and artificial joints. ⋯ I&D of localized cutaneous abscesses in afebrile adults is unlikely to result in transient bacteremia. Larger studies are needed to determine whether routine antibiotic prophylaxis is necessary for afebrile patients undergoing I&D.
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Comparative Study
Effect of emergency physician-performed pelvic sonography on length of stay in the emergency department.
To evaluate the sensitivity and specificity of emergency physician-performed pelvic sonography (EPPPS) and its effect on length of stay (LOS) in the emergency department. ⋯ Pelvic ultrasound performed by emergency physicians after a brief period of training shortens ED LOS in women in early pregnancy, particularly in those with viable IUPs. This practice appears to be sensitive, specific, and safe.
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To determine whether abdominal ultrasound can be used routinely as the primary screening test to identify the need for laparotomy in trauma patients. ⋯ Ultrasound is a sensitive and specific test with which to evaluate trauma patients for abdominal injury requiring surgery. Routine abdominal ultrasound can be performed at the bedside in the emergency department as a timely, noninvasive diagnostic test. This use of a screening abdominal ultrasound examination can improve clinical decision-making for the use of emergency laparotomy. Ultrasound may be a better alternative to CT or diagnostic peritoneal lavage for the initial screening evaluation of abdominal trauma.