Annals of emergency medicine
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We sought to determine whether knowledge of vital signs changes nurse triage designations (TDs). We also sought to determine whether patient age and ability to communicate modify the effect of vital signs on triage decisions. ⋯ In this sample, 92.1% of the nurses' TDs were not affected by the knowledge of patient vital signs. For the other 7.9%, including many patients from vulnerable populations, the vital signs changed the nurses' assessments of the patients' triage designation. Methods of triage that do not determine vital signs may not adequately reflect the urgency of the patient's presentation.
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We sought to synthesize the literature on patterns of use of emergency services among older adults, risk factors associated with adverse health outcomes, and effectiveness of intervention strategies targeting this population. ⋯ Older ED patients have distinct patterns of service use and care needs. The current disease-oriented and episodic models of emergency care do not adequately respond to the complex care needs of frail older patients. More research is needed to determine the effectiveness of screening and intervention strategies targeting at-risk older ED patients.
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Vital sign measurements, specifically heart rate, respiratory rate, and blood pressure, play a fundamental role in many medical evaluations, yet little is known about the reliability of noninvasive vital sign measurements. We sought to determine whether trained observers can reproducibly assess vital signs in the clinical setting. ⋯ The reproducibility of vital sign measurements may be limited by significant interobserver variability. Clinicians should recognize this inherent variability and interpret vital signs with caution.
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Letter Case Reports
Two cases of rattlesnake envenomation with delayed coagulopathy.