The American journal of emergency medicine
-
The COVID19 crisis has provided a portal to revisit and understand qualities of screening tests and the importance of Bayes' theorem in understanding how to interpret results and implications of next actions.
-
Injury results in more deaths in children than all other causes combined, but there is little data regarding the association of early coagulopathy on outcomes in pediatric patients with traumatic injuries. The aim of this study was to determine the optimal cut-off value for the Prothrombin Time ratio (PTr) and to show the diagnostic characteristics of the PTr to predict mortality. ⋯ Trauma-induced coagulopathy defined only by a PTr ≥1.24 could be used as a severity predictive marker and as a sensitive, specific, quick, and easy to use tool for admission triage of pediatric patients.
-
Socioeconomic disparities are engrained in the US healthcare system and may extend to the prehospital cardiac arrest setting where mortality is high. ⋯ Low income individuals in cardiac arrest have a statistically significant lower probability of achieving ROSC and a higher chance of delayed ROSC.
-
Emergency department management of hypoxemia in the setting of COVID-19 is riddled with uncertainty. The lack of high-quality research has translated to an absence of clarity at the bedside. ⋯ Well known pharmacologic properties of the drug, namely the lack of respiratory depression and its anti-delirium effects, as well as other possible physiologic effects, suggest potential benefit for patients being managed with a delayed intubation approach. If dexmedetomidine can improve compliance with non-invasive oxygen support (the current recommended first-line therapy) while promoting better oxygenation, it may also decrease the need for mechanical ventilation and thus improve mortality.
-
We evaluated whether combining the serum albumin level and the Prediction Rule for Admission policy in Complicated urinary Tract InfeCtion LEiden (PRACTICE) class could be a prognostic predictor in elderly patients with urinary tract infection (UTI). ⋯ The modified PRACTICE score can be a useful prognostic predictor in elderly patients with UTI.