The American journal of emergency medicine
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Observational Study
Diagnosis and disposition are changed when board-certified emergency physicians use CT for non-traumatic abdominal pain.
To determine the effect of abdominal computed tomographic (CT) scan results on diagnosis and disposition of patients with non-traumatic abdominal pain who were evaluated by board-certified emergency physicians (EPs). ⋯ Abdominal CT use by board certified EPs for nontraumatic abdominal pain changed diagnosis and disposition, with more sent home in lieu of admission. Diagnostic accuracy did not appear to be related to years of clinical experience.
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The inferior vena cava (IVC) parameters, including its diameter and collapsibility index have been evaluated for fluid status for over 30 years, but little is known about the impacts of patient characteristics on IVC parameters. The purpose of this study was to explore the relationships between individual patient characteristics and IVC parameters in healthy Chinese adult volunteers. ⋯ The percentage collapse of IVC and the IVCmax are not substantially influenced by patient characteristics. In contrast, the IVC/Ao index is more susceptible to patient characteristics than IVC.
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Observational Study
Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED.
Despite pediatric stroke awareness and pediatric stroke activation systems, recognition and imaging delays along with activation inconsistency still occur. Reliable objective pediatric stroke detection tools are needed to improve detection and activations. Regional cerebral oxygen saturation (rcso2) with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology. ⋯ Cerebral oximetry and CBVI detected abnormal cerebral physiology, stroke location, and type (hemorrhagic or ischemic). Rcso2 side differences greater than 10 or rcso2 readings less than 50% had a 100% positive predictive value for stroke. Cerebral oximetry has shown potential as a detection tool for stroke location and type in a pediatric stroke alert and nonalert stroke patients. Using cerebral oximetry by the nonneurologist, we found that the patient's rcso2 side difference greater than 10 or one or both sides having less than 50% rcso2 readings suggests abnormal hemispheric pathology and expedites the patient's diagnosis, neuroresuscitation, and radiologic imaging.