The American journal of emergency medicine
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High-risk pulmonary embolism (PE) is a complex, life-threatening condition, and emergency clinicians must be ready to resuscitate and rapidly pursue primary reperfusion therapy. The first-line reperfusion therapy for patients with high-risk PE is systemic thrombolytics (ST). Despite consensus guidelines, only a fraction of eligible patients receive ST for high-risk PE. ⋯ Emergency clinicians must possess an understanding of high-risk PE including the clinical assessment, pathophysiology, management of hemodynamic instability and respiratory failure, and primary reperfusion therapies.
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Multicenter Study Observational Study
Impact of time to revascularization on outcomes in patients after out-of-hospital cardiac arrest with STEMI.
International guidelines recommend emergency coronary angiography in patients after out-of-hospital cardiac arrest (OHCA) with ST-segment elevation on 12‑lead electrocardiography. However, the association between time to revascularization and outcomes remains unknown. This study aimed to evaluate the association between time to revascularization and outcomes in patients with OHCA due to ST-segment-elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI). ⋯ Shorter time to revascularization was significantly associated with 1-month favorable neurological outcomes in patients with OHCA due to STEMI who underwent PCI.
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Human intelligence versus Chat-GPT: who performs better in correctly classifying patients in triage?
Chat-GPT is rapidly emerging as a promising and potentially revolutionary tool in medicine. One of its possible applications is the stratification of patients according to the severity of clinical conditions and prognosis during the triage evaluation in the emergency department (ED). ⋯ The current level of Chat-GPT reliability is insufficient to make it a valid substitute for the expertise of triage nurses in prioritizing ED patients. Further developments are required to enhance the safety and effectiveness of AI for risk stratification of ED patients.
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Observational Study
Diagnostic accuracy of apple watch ECG outputs in identifying dysrhythmias: A comparison with 12-Lead ECG in emergency department.
Wearable devices, particularly smartwatches like the Apple Watch (AW), can record important cardiac information, such as single‑lead electrocardiograms (ECGs). Although they are increasingly used to detect conditions such as atrial fibrillation (AF), research on their effectiveness in detecting a wider range of dysrhythmias and abnormal ECG findings remains limited. The primary objective of this study is to evaluate the accuracy of the AW in detecting various cardiac rhythms by comparing it with standard ECG's lead-I. ⋯ Our study indicates that the AW has the potential to detect cardiac rhythms beyond AF. ECG tracings obtained from the AW may help evaluate cardiac rhythms prior to the patient's arrival in the ED. However, further research with a larger patient cohort is essential, especially for specific diagnoses.
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Foam tape is commonly used in the emergency department as a dressing over chest tubes owing to its occlusive and compressible properties. There is a paucity of data regarding the incidence of significant cutaneous reactions to this material. We conducted a prospective trial to evaluate the incidence of dermatitis following application of foam tape to the upper arm of a cohort of healthy volunteers. ⋯ #NCT06059417.