The American journal of emergency medicine
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Observational Study
Evaluation of proadrenomedullin as a diagnostic or prognostic biomarker of acute appendicitis in children.
A delay in the diagnosis of acute appendicitis (AA), with the added complication of symptoms that mimic other self-limited causes of abdominal pain, can lead to an increase in ruptured appendices and morbimortality. None of the serum biomarkers evaluated to date have shown a predictive value for early diagnosis. ⋯ Although MR-proADM values are higher in children with AA than in children with nonspecific abdominal pain, these values do not help in the early diagnosis of AA. The combination of low C-reactive protein and low MR-proADM levels is useful for the identification of children with a low risk of AA.
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Hyperglycemia and hyperosmolality are associated with poor outcomes among acute ischemic stroke (AIS) patients. ⋯ Hyperglycemia was associated with poor outcome, even after excluding the effect of hyperosmolality. However, hyperosmolality without hyperglycemia was not associated with poor outcome. An additive effect, likely reflecting severe hyperglycemia, was observed.
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Randomized Controlled Trial Comparative Study
Does practice make perfect? Prospectively comparing effects of 2 amounts of practice on tourniquet use performance.
Although a lifesaving skill, currently, there is no consensus for the required amount of practice in tourniquet use. We compared the effect of 2 amounts of practice on performance of tourniquet use by nonmedical personnel. ⋯ Three applications per monthly practice session were superior to one. This is the first prospective validation of a tourniquet practice program based on objective measurements.
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Randomized Controlled Trial
Is retrograde intubation more successful than direct laryngoscopic technique in difficult endotracheal intubation?
Difficult airway intubation is an emergency condition both at the emergency department (ED) and in out-of-hospital situations. Retrograde intubation (RI) is another option for difficult airway management. There are limited data regarding the successful rate of RI compared with direct laryngoscopy (DL) intubation, the commonly used method in the ED. ⋯ The RI technique had a higher success rate in difficult airway intubation than the DL technique, regardless of experience.
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Trauma patients sustaining blunt injuries are exposed to multiple radiologic studies. Evidence indicates that the risk of cancer from exposure to ionizing radiation rises in direct proportion to the cumulative effective dose (CED) received. The purpose of this study is to quantify the amount of ionizing radiation accumulated when arriving directly from point of injury to San Antonio Military Medical Center (SAMMC), a level I trauma center, compared with those transferred from other facilities. ⋯ III.