The American journal of emergency medicine
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We investigated the impact of anemia based on admission hemoglobin (Hb) level as a prognostic risk factor for severe outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). ⋯ Anemia on admission was independently associated with increased odds of all-cause mortality in patients hospitalized with COVID-19. Furthermore, moderate-severe anemia (Hb <11 g/dL) was an independent risk factor for severe COVID-19 outcomes. Moving forward, COVID-19 patient management and risk stratification may benefit from addressing anemia on admission.
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Observational Study
Clinical predictors of delayed neurological sequelae in charcoal-burning carbon monoxide poisoning.
The main objective of the treatment of acute carbon monoxide (CO) poisoning is to prevent delayed neurological sequelae (DNS). However, today there is still no objective screening tool to identify patients at high risk of developing DNS. The aim of this study was to identify clinical factors that could predict DNS after acute charcoal-burning CO poisoning. ⋯ A low initial GCS score, longer exposure to CO and abnormal findings on diffusion-weighted magnetic resonance imaging can assist in the early identification of patients at high risk of DNS development.
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Observational Study
The role of emergency department computed tomography in early acute pancreatitis.
Computed tomography (CT) is often ordered for patients in whom the diagnosis of acute pancreatitis (AP) has already been established via elevated lipase levels and typical abdominal pain. We investigated whether early CT imaging performed in the ED altered the diagnosis or management. ⋯ Early CT may alter the diagnosis or management in up to 15% of patients presenting to the ED with AP, especially older patients with prior episodes of pancreatitis and biliary interventions, however abdominal US may be a more sensitive screening study for biliary etiologies and thereby better direct further management.
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Observational Study
Crowding is the strongest predictor of left without being seen risk in a pediatric emergency department.
Emergency Department (ED) patients who leave without being seen (LWBS) are associated with adverse safety and medico-legal consequences. While LWBS risk has been previously tied to demographic and acuity related factors, there is limited research examining crowding-related risk in the pediatric setting. The primary objective of this study was to determine the association between LWBS risk and crowding, using the National Emergency Department Overcrowding Score (NEDOCS) and occupancy rate as crowding metrics. ⋯ Not only was ED overcrowding positively and significantly associated with individual LWBS risk, but it was the single most important factor that determined a patient's likelihood of LWBS in the pediatric ED. Because occupancy rate and NEDOCS are available in real time, each could serve as a monitor for individual LWBS risk in the pediatric ED.
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Comparative Study
Text messages by wireless mesh network vs voice by two-way radio in disaster simulations: A crossover randomized-controlled trial.
Communication failures secondary to damaged infrastructure have caused difficulties in coordinating disaster responses. Two-way radios commonly serve as backup communication for hospitals. However, text messaging has become widely adopted in daily life and new technologies such as wireless mesh network (WMN) devices allow for text messaging independent of cellular towers, Wi-Fi networks, and electrical grids. ⋯ TEXT-WMN technology may be more effective and less burdensome than VOICE-TWR in facilitating accurate communication during disasters.