The American journal of emergency medicine
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Clinical Trial
Derivation of a clinical prediction rule to predict hospitalization for influenza in EDs.
Early, rapid, and accurate identification of those patients who have severe influenza is important for emergency physicians. Influenza viral load, which has been proposed as a predictor of severe influenza, could be useful in facilitating decision making of resource use. We aimed to derive a clinical prediction rule to indicate probability for inpatient hospitalization for patients with influenza, which includes influenza viral load in addition to other clinical information commonly collected in the emergency department (ED). ⋯ The clinical prediction rule incorporating influenza viral load into the clinical information was indicative of hospitalization and merits further evaluation for determination of ED resource use for patients with influenza.
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Community-acquired pneumonia (CAP) is a major health problem in the United States and is associated with substantial morbidity, mortality, and health care costs. Patients with CAP commonly present to emergency departments where physicians must make critical decisions regarding diagnosis and management of pneumonia in a timely fashion, with emphasis on efficient and cost-effective diagnostic choices, consideration of emerging antimicrobial resistance, timely initiation of antibiotics, and appropriate site-of-care decisions. ⋯ These new data and additional guidelines pertaining to the treatment of CAP further our knowledge and understanding of this challenging infection. Furthermore, appreciation of the availability of new diagnostic testing and therapeutic options will help meet the demand for improved management of CAP.
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Chest compressions are pivotal determinants of successful resuscitation. The aim of our study was to identify the variations of the anatomical structures underneath the sternum and to investigate possible implications for chest compressions. ⋯ The occurrence of cardiac chambers under the lower part of the sternum is very high, making it a reasonable position for hand placement during chest compressions. However, optimal hand position may differ with age and among healthy individuals owing to variations in thoracic anatomy.
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This study was performed to determine the effects of sodium bicarbonate injection during prolonged cardiopulmonary resuscitation (for >15 minutes). ⋯ The administration of sodium bicarbonate during prolonged CPR did not significantly improve the rate of ROSC in out-of-hospital cardiac arrest.