The American journal of emergency medicine
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We describe the case of a 75-year-old man affected by a chronic obstructive pulmonary disease and chronic renal failure admitted to our emergency department for dyspnea and interscapular stabbing pain. Chest radiography showed diffuse parenchymal consolidation in the lower right lung with bronchiectasis, but the treatment for infection disease did not improve the clinical conditions of the patient. ⋯ Because the presence of chronic renal failure limited the execution of a helical computed tomographic pulmonary angiography, a pulmonary scintigraphy was performed confirming the diagnosis of pulmonary embolism. Our case suggested that chest ultrasonography can be a valuable tool for early detection of pulmonary embolism and to establish immediately an appropriate therapy.
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The presence of the sonographic sliding lung sign (SLS) is a sensitive indicator for the absence of a pneumothorax. The addition of M-mode ultrasound (US) can be a useful adjunct in detecting the SLS. ⋯ M-mode US may be used successfully to detect the SLS during helicopter transport.
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There is a lack of data on the effect(s) of suboptimal human immunodeficiency virus (HIV) care on subsequent health care utilization among emergency department (ED) patients with HIV. Findings on their ED and inpatient care utilization patterns will provide information on service provision for those who have suboptimal access to HIV-related care. ⋯ In our setting, IHC does not appear to be associated with earlier or more frequent ED visits but may lead to earlier hospitalization, particularly among those without other chronic diseases.
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Clinical Trial
A before- and after-intervention trial for reducing unexpected events during the intrahospital transport of emergency patients.
This study was aimed to explore the effect of intervention in safe intrahospital transport on the incidence of unexpected events (UEs) occurring during the transport of emergency patients. ⋯ A significant reduction in the rate of total and serious UEs during intrahospital transport from the ED was found through using transport checklists.
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This study was undertaken to validate the diagnostic values of 9 different physical tests in emergency department patients with primary anterior shoulder dislocation (PASD) to select the best screening test for full-thickness rotator cuff tear (FTRCT) after PASD. ⋯ The prevalence of FTRCT after PASD is 37% (95% CI, 24%-52%). Jobe test has the highest sensitivity (89% CI, 64%-98%) among the tests.