The American journal of emergency medicine
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Cardiac point-of-care ultrasound (POCUS) can evaluate for systolic and diastolic dysfunction to inform care in the Emergency Department (ED). However, accurate assessment can be limited by user experience. Artificial intelligence (AI) has been proposed as a model to increase the accuracy of cardiac POCUS. However, there is limited evidence of the accuracy of AI in the clinical environment. The objective of this study was to determine the diagnostic accuracy of AI for identifying systolic and diastolic dysfunction compared with expert reviewers. ⋯ When compared with expert assessment, AI had high sensitivity and specificity for diagnosing both systolic and diastolic dysfunction.
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This study investigated the feasibility of using the Roth score in the emergency setting to make hospitalization or discharge decisions for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). ⋯ The Roth score (only counts) increased in discharged patients after AECOPD treatment. It appears to be a viable method for predicting hospitalization or discharge decisions in patients with AECOPD who present to the emergency department.
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Case Reports
Rectus sheath nerve block for analgesia & incarcerated hernia reduction in the emergency department.
Patients who present to the emergency department (ED) with incarcerated or strangulated ventral hernias are often in significant pain. Furthermore, even with procedural sedation, reduction itself also causes substantial pain. Hernias that cannot be reduced at the bedside with intravenous opioids or procedural sedation will require emergent surgery, which contributes to morbidity and mortality, especially in high-risk populations. ⋯ Ultrasound can visualize and diagnose an incarcerated hernia, and a bilateral rectus sheath block can be performed in the ED to anesthetize the peritoneal wall, paralyze abdominal musculature, and achieve nearly painless hernia reduction.