The American journal of emergency medicine
-
Clinical Trial
Initial accuracy of bedside ultrasound performed by emergency physicians for multiple indications after a short training period.
Emergency physician-performed ultrasonography holds promise as a rapid and accurate method to diagnose multiple diseases in the emergency department (ED). Our objective was to assess the initial diagnostic accuracy (first 55 explorations) of emergency physician-performed ultrasonography for multiple categories of ultrasound use after a short training period. ⋯ Emergency physicians in our institution attained reasonably high initial accuracy in the performance of ultrasonography for a variety of clinical problems after a 10-hour training period.
-
The aim of the study was to determine whether C-reactive protein (CRP), procalcitonin (PCT), and d-dimer (DD) are markers of mortality in patients admitted to the emergency department (ED) with suspected infection and sepsis. ⋯ Our results suggest that high levels of DD are associated with 28-day mortality in patients with infection or sepsis identified in the emergency department.
-
Thirty-year-old woman with history of AIDS and anxiety presented with palpitations. Although clinically euvolemic, she was aggressively fluid resuscitated in lieu of sinus tachycardia. ⋯ Given her normal cardiac, renal, and liver status, she spontaneously cleared the extra fluid, and the pulmonary edema resolved. This case highlights the importance of recognizing transient unilateral pulmonary edema and need for early radiographs to document clearance and prevent unnecessary testing.
-
Symptoms are compared among patients with coronary artery disease (CAD) admitted to the emergency department with or without acute coronary syndrome (ACS). Sex and age are also assessed. ⋯ In patients with CAD, shortness of breath and dizziness are more common in non-ACS, whereas prior percutaneous coronary intervention and chest or arm pain are important factors to include during ACS triage.
-
Knee dislocations are rare injuries typically associated with severe traumatic mechanisms. We report 2 cases of morbidly obese patients who had complete knee dislocations after falls from standing height. Both cases resulted in significant morbidity secondary to popliteal artery injury. Emergency physicians need to maintain a high index of suspicion for knee dislocations and should be aware of atypical presentations from minor trauma in the obese population.