The American journal of emergency medicine
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The objective of this study was to assess the predictive value of lactate and base deficit in determining outcomes in trauma patients who are positive for ethanol. ⋯ Previously established relationships between elevated lactate, base deficit, and outcome do not remain consistent in patients presenting with positive serum ethanol concentrations. Ethanol skews the relationship between lactate, base deficit, and mortality thus resetting the threshold in which lactate and base deficit are associated with increased mortality.
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The objective of this study was to determine whether prehospital trauma arrival notification was associated with more head computed tomography (CT) scans and image studies performed in patients with minor head trauma and discharged from emergency department (ED). ⋯ Prehospital trauma arrival notification was associated with significantly more head CT scans and more image studies in patients with minor head trauma and discharged from ED.
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Observational Study
Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community-acquired pneumonia.
This study aims to investigate whether mean platelet volume (MPV) is correlated with the CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, >65 years of age) score, and whether a combination of the CURB-65 score with MPV could better predict the 28-day mortality in patients with community-acquired pneumonia (CAP). ⋯ Mean platelet volume level is valuable for predicting mortality and the severity of disease among patients with CAP at ED admission. Furthermore, a combination of CURB-65 score and MPV can enhance the predictive accuracy of 28-day mortality.
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Use of extracorporeal membrane oxygenation in severe traumatic lung injury with respiratory failure.
The use of extracorporeal membrane oxygenation (ECMO) in managing acute respiratory distress syndrome had been accepted. Severe lung injury with respiratory failure is often encountered in trauma patients. We report our experience with the use of ECMO in severe traumatic lung injury. ⋯ The use of ECMO may offer an additional treatment modality in severe traumatic lung injury with respiratory failure that is unresponsive to optimal conventional ventilator support. Timely ECMO intervention is of value.
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Needle-based cricothyrotomy is a common procedure for emergency department patients requiring an emergent surgical airway. Percutaneous transtracheal jet ventilation is well studied to provide oxygenation. We propose to combine these procedures into a novel, single, and sequential procedure. ⋯ Percutaneous transtracheal jet ventilation and needle-based Seldinger cricothyrotomy can be performed by emergency medicine physicians, and a single, sequential procedure may significantly reduce time to oxygenation for patients already undergoing surgical cricothyrotomy.