The American journal of emergency medicine
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The ability to identify wall motion abnormalities may be useful for emergency clinicians, but is not typically evaluated in point-of-care echocardiograms. We sought to determine if emergency physicians with basic training in emergency echocardiography could identify regional wall motion abnormalities (RWMA) in patients admitted with ST-elevation myocardial infarction (STEMI). ⋯ Emergency physicians with core training in point-of-care echocardiography can accurately identify RMWA.
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Evaluate nine different models, the interaction of three flow models (ESI, intake attending physician, and no split flow) and three physical design typologies (zero, one, and two internal-waiting areas), on Emergency Department (ED) flow and patient-centered metrics. ⋯ Based on a DES model with empirical data from a single institution, combining flow split by an intake attending physician and multiple internal-waiting areas resulted in improved ED operational and patient-centered metrics.
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Patients with massive pulmonary embolism (PE) have poor outcomes and their management remains challenging. An interventional radiology (IVR)-computed tomography (CT) system available in our emergency room (ER) allows immediate access to CT and extracorporeal membrane oxygenation (ECMO) with safe cannulation under fluoroscopy. We aimed to determine if initial treatment in this "hybrid ER" is helpful in patients with PE requiring extracorporeal cardiopulmonary resuscitation (ECPR). ⋯ A hybrid ER may be useful for initial management of massive PE requiring ECPR and may help to improve outcomes.
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To evaluate the occurrence of renal injury in hospitalized patients with the diagnosis of rhabdomyolysis among a series of patients presenting to an urban emergency department. ⋯ Patients in our data set that presented to the Emergency Department with a CPK of >1000 U/L and a Cr of <1.3 mg/dL that were hospitalized with a diagnosis of rhabdomyolysis are not at risk for developing renal insufficiency or failure if treated promptly with fluid rehydration, regardless of their initial CPK values.