The American journal of emergency medicine
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A Glasgow Coma Scale (GCS) score of 3 on presentation in patients with traumatic brain injury (TBI) portends a poor prognosis. Consequently, there is often a tendency to treat these patients less aggressively because of low expectations for a good outcome. ⋯ 14.5% of patients with TBI and a GCS of 3 at presentation achieved a good outcome at 6months, and 6.9% of patients with GCS of 3 and bilateral fixed pupils on presentation to the ED achieved a good outcome at 6months.
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Gross hematuria is a very common complaint in emergency departments and outpatient clinics. Globally, the incidence of hematuria is 4 per 1000 patients per year. ⋯ However, hematuria rarely causes hypovolemic shock or an emergent, life-threatening condition at the initial presentation. In this report, we describe the case of a 64-year-old man who suffered a life-threatening gross hematuria in a very short time due to ruptured renal arteriovenous malformations (AVMs).
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Little is known about the outcomes of deliberate non-surgical management for hemodynamically unstable patients with blunt traumatic pericardial effusion. We evaluated the efficacy of management with pericardiocentesis or subxiphoid pericardial window in hemodynamically unstable patients who reach the hospital alive with blunt traumatic pericardial effusion. ⋯ The results of the present study suggested that non-surgical management of hemodynamically unstable patients who reach hospital alive with blunt pericardial effusion may be a feasible option for treatment.
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Letter Randomized Controlled Trial Comparative Study
A randomized, cross-over, pilot study comparing the standard cricothyrotomy to a novel trochar-based cricothyrotomy device.
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To address emergency department overcrowding operational research seeks to identify efficient processes to optimize flow of patients through the emergency department. Vertical flow refers to the concept of utilizing and assigning patients virtual beds rather than to an actual physical space within the emergency department to care of low acuity patients. The aim of this study is to evaluate the impact of vertical flow upon emergency department efficiency and patient satisfaction. ⋯ Initiation of a vertical split flow model was associated with improved ED efficiency.