The American journal of emergency medicine
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Multicenter Study Observational Study
Gestalt clinical severity score (GCSS) as a predictor of patient severity of illness or injury.
To determine if clinical judgement is accurate to predict the severity of injury or illness, and can be used at patient arrival when other formal scoring systems are not yet available. ⋯ Physicians can make accurate predictions of severity of injury and illness using a gestalt method and the scoring system we have developed as patient disposition correlates well with GCSS score. GCSS is most accurate with the 18-44 age group.
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Randomized Controlled Trial
Drones reduce the treatment-free interval in search and rescue operations with telemedical support - A randomized controlled trial.
Response to medical incidents in mountainous areas is delayed due to the remote and challenging terrain. Drones could assist in a quicker search for patients and can facilitate earlier treatment through delivery of medical equipment. We aim to assess the effects of using drones in search and rescue (SAR) operations in challenging terrain. We hypothesize that drones can reduce the search time and treatment-free interval of patients by delivering an emergency kit and telemedical support. ⋯ The successful use of drones in SAR operations leads to a reduction in search time and treatment-free interval of patients in challenging terrain, which could improve outcomes in patients suffering from traumatic injuries, the most commonly occurring incident requiring mountain rescue operations.
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Comparative Study Observational Study
Comparison of outcomes between observation and tube thoracostomy for small traumatic pneumothoraces.
Traumatic pneumothorax management has evolved to include the use of smaller caliber tube thoracostomy and even observation alone. Data is limited comparing tube thoracostomy to observation for small traumatic pneumothoraces. We aimed to investigate whether observing patients with a small traumatic pneumothorax on initial chest radiograph (CXR) is associated with improved outcomes compared to tube thoracostomy. ⋯ Select patients with small traumatic pneumothoraces on initial chest radiograph who were treated with observation experienced an average length of stay over two days shorter than those treated with tube thoracostomy. Outcomes were otherwise similar between the two groups suggesting that an observation-first strategy may be a superior treatment approach for these patients.
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Review Case Reports
The seven day itch: A delayed histamine reaction to stingray injury.
Stingray injuries are common presentations to emergency departments near warm coastal waters. Commonly reported injuries include puncture wounds, lacerations, and envenomations, the latter of which cause severe pain but are usually easily treated with warm water immersion. We report a case of delayed histamine reaction in a patient who sustained a stingray envenomation one week prior which we believe is the first such report in the medical literature but is found on discussion boards for those who have sustained stingray injuries. The literature on such envenomations is reviewed.
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COVID-19 had a significant impact on Emergency Departments (ED) with early data suggesting an initial decline in avoidable ED visits. However, the sustained impact over time is unclear. In this study, we analyzed ED discharges over a two-year time period after the COVID-19 pandemic began and compared it with a control time period pre-pandemic to evaluate the difference in ED visit categories, including total, avoidable, and unavoidable visits. ⋯ Our study identified a sustained decline in discharged avoidable ED visits during the two years following the beginning of the COVID-19 pandemic, which was partially offset by the increase in COVID-19 visits. This work can help inform ED and healthcare systems in resource allocation, hospital staffing, and financial planning during future COVID-19 resurgences and pandemics.