The American journal of emergency medicine
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Comparative Study
Prediction of en-route complications during interfacility transport by outcome predictive scores in ED.
The objective was to determine the accuracy of the outcome predictive scores (Modified Early Warning Score [MEWS]; Hypotension, Low Oxygen Saturation, Low Temperature, Abnormal ECG, Loss of Independence [HOTEL] score; and Simple Clinical Score [SCS]) in predicting en-route complications during interfacility transport (IFT) in emergency department. ⋯ None of the scores had good accuracy in prediction of en-route complications during IFT. MEWS at triage was among the best one already but was not ideal.
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Observational Study
Point-of-care ultrasonography for the management of shoulder dislocation in ED.
Point-of-care ultrasonography (POCUS) is an easily available and noninvasive tool without radiation exposure that is also gaining a broad range of use in emergency departments. The aim of this study is to evaluate the value of POCUS in the diagnosis of shoulder dislocation by comparing with plain radiography. ⋯ Point-of-care ultrasonography is an effective tool to either rule in or rule out shoulder dislocation in the emergency setting. Furthermore, it is a robust sensitive tool for excluding fractures but with false-positive results.
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Clinical Trial
A prehospital screening tool utilizing end-tidal carbon dioxide predicts sepsis and severe sepsis.
To determine the utility of a prehospital sepsis screening protocol utilizing systemic inflammatory response syndrome (SIRS) criteria and end-tidal carbon dioxide (ETCO2). ⋯ A prehospital screening protocol utilizing SIRS criteria and ETCO2 predicts sepsis and severe sepsis, which could potentially decrease time to therapeutic intervention.
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Case Reports
Acute hemorrhagic edema of infancy: report of 2 cases and review of common mimics for the emergency clinician.
Acute hemorrhagic edema of infancy (AHEI) is a rare acute benign cutaneous leukocytoclastic vasculitis affecting children younger than 24 months of age. Its presentation can be confused with those of urticaria, erythema multiforme, Henoch-Schönlein purpura, idiopathic thrombocytopenia,meningococcemia, Kawasaki disease, and drug rash. We present 2 cases of acute hemorrhagic edema of infancy, discuss the characteristics of AHEI, and compare and contrast AHEI with similar dermatologic presentations. ⋯ These 2 cases typify the presentation of AHEI. Acute hemorrhagic edema of infancy presents with characteristic purpuric lesions and extremity edema. The emergency physician's recognition of these presenting characteristics will help diagnose AHEI, avoid unnecessary procedures and tests, and aid in counseling the patient's parents.