The American journal of emergency medicine
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The injuries caused by earthquakes are often complex and of various patterns. Our study included all fracture inpatients from the Yushu earthquake (1323 in total), to learn more about the incidence and distribution of fractures during earthquakes. ⋯ Analysis profiles of the injuries and clinical features of patients with earthquake-related fractures will positively impact rescue efforts and the treatment of fracture injuries caused by possible future natural disasters. We should assemble orthopedic-related medications and surgical equipment, and allocate them promptly after a major earthquake.
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Early repolarization (ER) and acute left anterior descending artery occlusion (LADO) may be difficult to distinguish. Terminal QRS distortion (TQRSD), defined by the absence of both an S wave and J wave in either of leads V2 or V3, is often present in anterior ST-segment elevation myocardial infarction. We hypothesized that this finding would always be absent in ER. ⋯ Terminal QRS distortion was never observed in benign ER. Based on previous studies indicating the presence of TQRSD in LADO, it was, thus, 100% specific to LADO when the differential diagnosis was acute myocardial infarction vs ER.
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To evaluate the feasibility and effectiveness of emergency endotracheal intubation (EEI) under fluoroscopy guidance for patients with acute dyspnea or asphyxia. ⋯ Fluoroscopy-guided EEI is a safe and feasible procedure, and may serve as an alternative treatment option for patients when traditional EEI is unsuccessful.
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The objective of this study was to develop a comparative diagnostic model for computed tomography (CT) and ultrasound (US) in the assessment of acute appendicitis using Alvarado risk score as a predictor of pretest probability and Bayesian statistical model as a tool to calculate posttest probabilities for both diagnostic test. Stratification was made by applying the Alvarado score for the prediction of acute appendicitis. Likelihood ratios were calculated using sensitivity and specificity of both CT and US from a Meta-analysis. ⋯ No statistical differences were found between Ultrasound and CT. This Bayesian analysis demonstrated slight superiority of CT scan over US low-risk patients, whereas no significant advantage was seen when evaluating intermediate and high risk patients. This study also favored elevated accuracy of the Alvarado score.
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The purpose was to determine if the physical presence of a clinical pharmacist in the emergency department (ED) would decrease antibiotic order to administration time in adult patients with sepsis, severe sepsis, or septic shock. ⋯ Physical presence of a clinical pharmacist in the ED decreased time to administration and increased appropriateness of intravenous antibiotics for adult patients with sepsis, severe sepsis, or septic shock.