The American journal of emergency medicine
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The most common presenting complaint to the emergency department (ED) is pain. Several studies have shown that a large proportion of ED patients either receive no or sub-optimal analgesia. Patient-controlled analgesia (PCA) pumps used in the post-operative setting has shown to decrease total opioid consumption and has increased patient and nurse satisfaction. ⋯ The quality, the differences in study methods and outcome measures used, and heterogeneity of the studies performed to date do not provide adequate evidence to support its widespread use in the ED. Well-designed studies conducted in the ED are still needed to evaluate the ideal patient population to whom these PCAs may provide the most benefit as well as a robust cost-analysis to ensure feasibility of use in the future.
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Acute aortic syndromes comprise a spectrum of diseases including aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcers. Early diagnosis, rapid intervention, and multidisciplinary team care are vital to efficiently manage time-sensitive aortic emergencies, mobilize appropriate resources, and optimize clinical outcomes. ⋯ A multidisciplinary team can help promptly diagnose and manage aortic syndromes.
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The present study aimed to perform a systematic review and meta-analysis on the prevalence of one-year hospital readmissions and post-discharge all-cause mortality in recovered COVID-19 patients. Moreover, the country-level prevalence of the outcomes was investigated. ⋯ 10.34% of recovered COVID-19 patients required hospital readmissions after discharge. Most cases of hospital readmissions and mortality appear to occur within 30 days after discharge. The one-year post-discharge all-cause mortality rate of COVID-19 patients is 7.87%, and the majority of patients' readmission and mortality happens within the first 30 days post-discharge. Therefore, a 30-day follow-up program and patient tracking system for discharged COVID-19 patients seems necessary.
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Emergency physicians (EP) are frequently interrupted to screen electrocardiograms (ECG) from Emergency Department (ED) patients undergoing triage. Our objective was to identify discrepancies between the computer ECG interpretation and the cardiologist ECG interpretation and if any patients with normal ECGs underwent emergent cardiac intervention. We hypothesized that computer-interpreted normal ECGs do not require immediate review by an EP. ⋯ Cardiologists frequently disagree with a computer-interpreted normal ECG. Patients with computer-interpreted normal ECGs, however, rarely had significant ischemic events. A rare number of patients will have important cardiac outcomes regardless of the computer-generated normal ECG interpretation. Immediate EP review of the ECG, however, would not have changed these patients' ED courses.
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Comparative Study
Comparison of out of hospital cardiac arrest due to acute brain injury vs other causes.
Acute brain injury (ABI) can cause out of hospital cardiac arrest (OHCA). The aim of this study was to compare clinical features, mortality and potential for organ donation in patients with OHCA due to ABI vs other causes. ⋯ ABI is the third cause of OHCA. Neurological prodromes, absence of chest pain and dyspnea before cardiac arrest, anisocoria and initial non-shockable rhythm might suggest a neurological etiology of the cardiac arrest. Patients with OHCA due to ABI has an unfavorable outcome, however, they could be candidate to organ donation.