The American journal of emergency medicine
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In this study, we aimed to investigate the relationship between blood lactate levels and lactate kinetics (lactate clearance and Δ lactate) for predicting mortality in patients with COVID-19 admitted to the emergency department. ⋯ In COVID-19, 2nd highest blood lactate and lactate kinetics were found to be prognostic indicators of the disease. High 2nd highest lactate levels and low lactate kinetics in patients with high clinical severity were guiding physicians regarding the outcome of the disease.
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Observational Study
Palliative care patient emergency department visits at tertiary university-based emergency department in Ireland.
Palliative care patients often present to the emergency department (ED) for various reasons e.g., acute illness, pain, altered mental status, and complications of therapy. Many visits involve less severe etiologies e.g., dyspnea, constipation, fear as patients approach the end of life, which may be more effectively and efficiently managed outside of the ED. The objective of this study is to identify and assess the frequency of presenting complaints, primary diagnosis, triage acuity, need for admission, in an Irish setting. ⋯ Palliative care patients utilize ED services not uncommonly. Though many of these patients presented with higher acuity triage scores, 42% had lower ESI scores and may be effectively managed outside of the ED. These data suggest developing mechanisms for these patients to be urgently evaluated in their homes or facilities obviating the need for an ED evaluation.
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The Roth score is an alternative strategy to estimate oxygen saturation by using a simple verbal test. We designed this clinical study to assess the validity of the Roth score (Spanish version) as a screening test for hypoxemia. A secondary objective was to evaluate the agreement and consistency between the oxygen saturation obtained via pulse oximetry (SpO2) and arterial blood gas test (SaO2). ⋯ The Roth score performed in Spanish is not a valid test for hypoxemia screening. There is sufficient agreement and consistency between SaO2 and SpO2 measurements.
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We report a case of atorvastatin-induced hypersensitivity reaction in a 58-year-old male following first exposure to the drug. The patient took one dose of atorvastatin 40 mg and presented to the emergency department (ED) within 24 h with a chief complaint of throat swelling, trouble swallowing, and throat pain. The patient did not have pruritis or skin manifestations. ⋯ Statin-induced hypersensitivity reactions could be explained by statins' effects on bradykinin 2 receptors that potentiate vasodilation and leading to angioedema. In the literature, cases of hypersensitivity associated with atorvastatin present after months of cumulative exposure. Therefore, this case is unique in that a reaction developed within 24 h of that first dose.
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Testicular torsion is a serious condition that carries with it a high rate of morbidity. ⋯ An understanding of testicular torsion can assist emergency clinicians in diagnosing and managing this disease.