The American journal of emergency medicine
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Per the American Heart Association guidelines, blood pressure (BP) should be less than 185/110 to be eligible for stroke thrombolysis. No studies have focused on prehospital BP and its impact on door to needle (DTN) times. We hypothesized that DTN times would be longer for patients with higher prehospital BP. ⋯ Higher prehospital BP is associated with prolonged DTN times and DTN time remains prolonged if prehospital BP greater than or equal to 185/110 is untreated before ED arrival. Prehospital BP control could be a potential area for improvement to reduce DTN times in patients with acute ischemic stroke.
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Observational Study
Prevalence of strangulation in survivors of sexual assault and domestic violence.
Both sexual assault (SA) survivors and domestic violence (DV) survivors are populations at risk of strangulation injury. Our goal was to identify the prevalence of strangulation in patients who are survivors of SA and DV, identify presence of lethality risk factors in intimate partner violence, and assess differences in strangulation between SA and DV populations. ⋯ Patients presenting to our forensic nurse examiner program who were survivors of DV were more likely than SA patients to sustain strangulation. Lethality risk factors were common.
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We conducted a pilot study to test the interrater reliability of emergency department (ED) physician assessments of 3 ED visit attributes-severity, immediacy, and ideal setting, with the long-term goal of developing a novel ED categorization system. ⋯ Rater agreement among ED physicians when assessing clinical data on specific ED visits was fair for severity and immediacy ratings. Raters agreed on ideal treatment settings half the time. In general, there was greater agreement when a specific diagnosis was found rather than negative workups for symptoms. This demonstrates a validity issue when it comes to developing and using categorization systems for ED visits and assessing setting appropriateness.