The American journal of emergency medicine
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Rhabdomyolysis is a medical condition caused by muscle breakdown leading to potential renal damage. This can result in significant morbidity and mortality if not rapidly identified and treated. ⋯ Rhabdomyolysis is a potentially dangerous medical condition requiring rapid diagnosis and management that may result in significant complications if not appropriately identified and treated. Emergency clinician knowledge of this condition is essential for appropriate management.
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We sought to evaluate the effectiveness of the "Timed Up and Go" (TUG) and the Chair test as screening tools in the Emergency Department (ED), stratified by sex. ⋯ There were no sex specific significant differences in TUG or Chair test screening performance. Neither test performed well as a screening tool for future falls in the elderly in the ED setting.
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Observational Study
Respiratory adjusted shock index for identifying occult shock and level of Care in Sepsis Patients.
Early identification of shock allows for timely resuscitation. Previous studies note the utility of bedside calculations such as the shock index (SI) and quick sepsis-related organ failure assessment (qSOFA) to detect occult shock. Respiratory rate may also be an important marker of occult shock. The goal of our study was to evaluate whether using a modified SI with respiratory rate would improve identification of emergency department sepsis patients admitted to an ICU or stepdown unit. ⋯ RASI may have utility as a rapid bedside tool for predicting critical illness in sepsis patients.
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Unintentional non-fire-related (UNFR) carbon monoxide (CO) poisoning is a leading cause of poisoning in the US and a preventable cause of death. We generated national estimates of accidental CO poisoning and characterized the populations most at risk. UNFR CO poisoning cases were assessed using hospitalization and emergency department (ED) data from the Healthcare Costs and Utilization Project National Inpatient Sample and Nationwide Emergency Department Sample databases. ⋯ Unintentional CO poisoning is preventable and these cases represent the most recent national estimates. ED visits declined over the study period, but the hospitalization rates did not change. This emphasizes the need for prevention efforts, such as education in the ED setting, increased use of CO alarms, and proper use and maintenance of fuel-powered household appliances.
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The definition of myocardial infarction (MI) is based on the detection of high-sensitive cardiac troponin (hs-cTn) levels above the 99th percentile of upper reference limit (URL) value for a healthy reference population. In the era of hs-cTn assay and the 4th definition for MI, the distinction between the injury and infarction is crucial for the clinician. Measurable troponin is present in the blood of healthy adult subjects. ⋯ Professional societies have published their recommendations to solve the pre-analytic and analytic contraversies in hs-cTn assay. In conclusion, hs-cTn assays have revolutionized the practice of cardiology. Universal healthy normal pool and consideration of different cut off levels for different populations (i.e. elderly) can potentially help to standardize the interpretation of the hs-cTn test.