The American journal of emergency medicine
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Multicenter Study
Time for a prehospital-modified sequential organ failure assessment score: An ambulance-Based cohort study.
To adapt the Sequential Organ Failure Assessment (SOFA) score to fit the prehospital care needs; to do that, the SOFA was modified by replacing platelets and bilirubin, by lactate, and tested this modified SOFA (mSOFA) score in its prognostic capacity to assess the mortality-risk at 2 days since the first Emergency Medical Service (EMS) contact. ⋯ Scoring systems are now a reality in prehospital care, and the mSOFA score assesses multiorgan dysfunction in a simple and agile manner either bedside or en route. Patients with acute disease and an mSOFA score greater than 6 points transferred with high priority by EMS represent a high early mortality group.
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Multicenter Study Observational Study
Association between patients' body mass index and emergency department wait times: A multicenter observational cohort investigation by the reducing disparities increasing equity in emergency medicine (REDEEM) study group.
Numerous studies have demonstrated evidence of obesity bias in healthcare settings, however, little is known about obesity bias in the Emergency Department (ED). The objective of this study was to investigate obesity bias in an ED setting by assessing the association between body mass index (BMI) and door-to-room (DTR) or door-to-provider (DTP) times among ED patients. ⋯ We did not find evidence of longer wait times experienced by people with obesity. Rather, patients with obesity often experienced wait times that were shorter than patients of normal weight.
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Multicenter Study
Flattening the other curve: Reducing emergency department STEMI delays during the COVID-19 pandemic.
The COVID-19 pandemic has been associated with ST-Elevation Myocardial Infarction (STEMI) reperfusion delays despite reduced emergency department (ED) volumes. However, little is known about ED contributions to these delays. We sought to measure STEMI delays and ED quality benchmarks over the course of the first two waves of the pandemic. ⋯ Both DTE and ETA metrics worsened during the first wave of the pandemic, revealing how it negatively impacted the triage and diagnosis of STEMI patients. But these normalized after the first wave and were unaffected by the second wave, indicating that nurses and physicians adapted to the pandemic to maintain STEMI quality of care. DTE and ETA metrics can help EDs identify delays to reperfusion during the pandemic and beyond.
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Multicenter Study
Forecast modeling to identify changes in pediatric emergency department utilization during the COVID-19 pandemic.
To identify trends in pediatric emergency department (ED) utilization following the COVID-19 pandemic. ⋯ Pediatric ED utilization has remained low following the COVID-19 pandemic, and below forecasted utilization for most diagnoses. Nearly all conditions demonstrated substantial declines below forecasted rates from the prior decade and which persisted through the end of the year. Some declines in non-communicable diseases may represent unmet healthcare needs among children. Further study is warranted to understand the impact of policies aimed at curbing pandemic disease on children.
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Multicenter Study Observational Study
Pneumothorax diagnosis with lung sliding quantification by speckle tracking: A prospective multicentric observational study.
Lung ultrasound is commonly used for the diagnosis of pneumothorax. However, recognition of pleural sliding is subjective and can be difficult for novice. The primary objective was to compare a novices physician's performance in diagnosing pneumothorax from ultrasound (US) scans either with visual evaluation or with maximum longitudinal pleural strain (MLPS). The secondary objective was to compare the diagnostic relevance of US with visual evaluation or MLPS to diagnose pneumothorax with an intermediately experienced and an expert physician. ⋯ In our study, speckle tracking analysis improved the accuracy of US for the novice and the intermediate but not the expert sonographer in the diagnosis of pneumothorax.