The American journal of emergency medicine
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Clinical Trial
Assessment of using fingerstick blood sample with i-STAT point-of-care device for cardiac troponin I assay.
The purpose of this study is to compare fingerstick point-of-care (POC) testing for cardiac troponin I to conventional venipuncture POC testing using the i-STAT device. ⋯ Fingerstick cTnI testing using the i-STAT device is not accurate enough to determine the exact troponin level without the application of a corrective term. Fingerstick testing is, however, accurate in qualifying troponin levels as negative, borderline, or positive and is, therefore, capable of providing clinical information that may guide diagnostic and therapeutic decision making.
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We aimed to develop a risk score incorporating heart rate variability (HRV) and traditional vital signs for the prediction of early mortality and complications in patients during the initial presentation to the emergency department (ED) with chest pain. ⋯ A risk score incorporating heart rate variability and vital signs performed well in predicting mortality and other complications within 72 hours after arrival at ED in patients with chest pain.
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The cardiac dipolar field is represented by the measured 12-lead electrocardiogram (ECG) and 3-lead vectorcardiogram (VCG). The objective is to derive the 12-lead ECG and 3-lead VCG from 3 measured leads acquired from only 5 electrodes. ⋯ The 12-lead ECG and 3-lead VCG can be derived accurately from 3 measured leads with high quantitative and qualitative correlations. These derived tracings can be acquired instantaneously and displayed in real time from a cardiac rhythm monitor. This will allow for immediate, on-demand, convenient, and cost-effective acquisition and analysis of the 12-lead ECG and 3-lead VCG in areas of acute patient care.
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The prevalence and impact of prehospital neurologic deterioration (PhND) in patients with traumatic brain injury (TBI) have not been investigated. We aimed to determine the prevalence of PhND during emergency medical service (EMS) transportation among patients with TBI and its impact on patient's outcome. ⋯ Prehospital neurologic deterioration occurs in 9% of patients with TBI. It is more prevalent in men and associated with lower EMS GCS level and higher ED ISS. Prehospital neurologic deterioration is an independent predictor of worse hospital outcome and higher resource use in patients with TBI.