The American journal of emergency medicine
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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.
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Identifying patients at imminent risk of death is a paramount priority in combat casualty care. This study measures the vital sign values predictive of mortality among combat casualties in Iraq and Afghanistan. ⋯ Casualties with a systolic blood pressure <112 mmHg, are at high risk of mortality, a value significantly higher than the traditional 90 mmHg threshold. Our dataset highlights the need for better methods to guide resuscitation as vital sign measurements have limited accuracy in predicting mortality.
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Multicenter Study Comparative Study Observational Study
Comparison of 4 tests' utility for predicting need for emergency department care in patients with alcohol-related complaints.
Intoxication is a common presenting complaint in emergency departments (ED), but many patients with intoxication do not need emergency care. Three screens (BLINDED, Brown, and San Francisco) attempt to determine which intoxicated patients can be triaged to a lower level of care. ⋯ The three formal screens and provider gestalt performed similarly.
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Multicenter Study
Serum total carbon dioxide as a prognostic factor for 28-day mortality in patients with sepsis.
Metabolic acidosis is commonly associated with the disease severity in patients with sepsis or septic shock. This study was performed to investigate the association between serum total carbon dioxide (TCO2) concentration and 28-day mortality in patients with sepsis. ⋯ Serum TCO2 concentrations of 20 mmol/l or less were associated with 28-day mortality in patients with sepsis.