The American journal of emergency medicine
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To document the level of interobserver agreement and compare the diagnostic performances of emergency physicians and radiologists at interpreting low radiation CT images of acute appendicitis in adolescents and young adults. ⋯ The emergency physicians and radiologists showed good interobserver agreement and comparable diagnostic performances for appendicitis in adolescents and adults using low-dose CT images. Low-dose CT could be a useful tool for the diagnosis of appendicitis by emergency physicians.
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Coronary artery bypass graft (CABG) surgery remains a high-risk procedure, and many patients require emergency department (ED) management for complications after surgery. ⋯ Postoperative complications of CABG surgery can result in significant morbidity and mortality. Physicians must rapidly diagnose these conditions while evaluating for other diseases. Early surgical consultation is imperative, as is optimizing the patient's hemodynamics, including preload, heart rate, cardiac rhythm, contractility, and afterload.
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Observational Study
Hypertensive ED patients: Missed opportunities for addressing hypertension and facilitating outpatient follow-up.
Hypertension is a leading cause of morbidity and mortality. The emergency department (ED) frequently serves populations with unmet health needs and could have a greater and more systematic role in secondary prevention for hypertension. This study sought to determine, among hypertensive patients discharged from the ED, the frequency that patients 1) received hypertension-specific education, and 2) followed-up with a primary care provider. We secondarily assessed participant beliefs about hypertension. ⋯ Over half of markedly hypertensive patients discharged from the ED followed up with primary care within four weeks. Nonetheless, missed opportunities for improved secondary prevention among ED patients with hypertension are common. There is an urgent need for evidence-based interventions to assist emergency departments in addressing this health threat.
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We aim to evaluate the effectiveness of a broadly inclusive, comparatively low intensity intervention linking ED patients to a primary care home. ⋯ Low intensity, broadly inclusive, ED care coordination linked nearly 50% of patients referred for intervention, and two-thirds of willing participants, with a primary care home.
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Peri-mortem caesarean section (PMCS) is a very rare procedure performed to improve the chances of survival for both mother and fetus following cardiorespiratory arrest. Non-obstetricians including Emergency Physicians (EPs) are often called upon to perform this procedure under challenging and suboptimal circumstances. We reported a case of PMCS performed timely after traumatic cardiorespiratory arrest that resulted in fetal survival. ⋯ She survived and is currently one year old. The mother, however, did not respond to our resuscitation and succumbed to her multiple injuries. We reviewed the limited literature regarding this potentially life-saving emergency procedure and highlighted the challenges facing our resuscitation team.