The American journal of emergency medicine
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Randomized Controlled Trial Multicenter Study
High early phase hemoglobin level is associated with favorable neurological outcome in patients with severe traumatic brain injury.
The appropriate hemoglobin (Hb) level threshold for the early phase (i.e. from Emergency Department to ICU admission) in patients with severe traumatic brain injury (TBI) is still unknown. Therefore, we aimed to examine the association between Hb levels during the early phase and neurological outcomes in patients with severe TBI using data from the Brain Hypothermia (B-HYPO) Study Group. ⋯ High early phase Hb levels are associated with favorable neurological outcomes after severe TBI.
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Multicenter Study Comparative Study
Time to antibiotic administration: Sepsis alerts called in emergency department versus in the field via emergency medical services.
The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) identifies patients with "severe sepsis" and mandates antibiotics within a specific time window. Rapid time to administration of antibiotics may improve patient outcomes. The goal of this investigation was to compare time to antibiotic administration when sepsis alerts are called in the emergency department (ED) with those called in the field by emergency medical services (EMS). ⋯ Sepsis alerts called in the field via EMS may decrease time to antibiotics and increase the likelihood of antibiotic administration occurring within 60 min of arrival when compared to those called in the ED.
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Meta Analysis
Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis.
In this systematic review and meta-analysis, we aimed to explore the association between cardiac injury and mortality, the need for intensive care unit (ICU) care, acute respiratory distress syndrome (ARDS), and severe coronavirus disease 2019 (COVID-19) in patients with COVID-19 pneumonia. ⋯ Cardiac injury is associated with mortality, need for ICU care, and severity of disease in patients with COVID-19.
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Rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic. ⋯ This narrative review provides clinicians with an updated approach to the evaluation and management of patients presenting to the emergency department with suspected COVID-19.
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Multicenter Study
Diagnostic accuracy of combined WBC, ANC and CRP in adult emergency department patients suspected of acute appendicitis.
To assess the sensitivity, specificity, and negative predictive value (NPV) of normal total white blood cell count (WBC) and normal absolute neutrophil count (ANC) combined with a normal proprietary C-reactive protein (pCRP) level in adult emergency department (ED) patients with abdominal pain suspected of possible acute appendicitis. ⋯ The combination of normal WBC and ANC with normal pCRP levels exhibited high sensitivity and negative predictive value for acute appendicitis in this prospective adult patient cohort. Confirmation and validation of these findings with further study using commercially available CRP assays is needed.