Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
The contribution of the subjective component of the Canadian Pulmonary Embolism Score to the overall score in emergency department patients.
Clinicians frequently use their experience to determine the pretest probability of pulmonary embolism (PE), although scoring systems are promoted as being more reliable. The Canadian Pulmonary Embolism Score (CPES) combines six objective questions and one subjective question. The CPES has been validated and appears to be useful for risk-stratifying patients. However, research suggests that subjective gestalt performs similarly to the CPES, and the influence of the subjective question on the predictive value of the CPES is not clear. ⋯ The predictive value of the CPES appears to be derived primarily from its subjective component.
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To determine the availability of emergency contraception (EC) in Massachusetts emergency departments (EDs) and to identify patient, hospital, and system factors that could affect access to EC. ⋯ There was significant variability in access to EC in Massachusetts EDs and in services for sexual assault survivors. Hospital type and provider preference affected availability. This study suggests that access to EC is limited, and that there are not consistent services for women seeking EC, including for victims of sexual assault.
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Low-risk emergency department (ED) patients with chest pain (CP) are often transported by nurses to monitored beds on telemetry monitoring, diverting valuable resources from the ED and delaying transport. ⋯ Transportation of low-risk ED chest pain patients off telemetry monitoring by nonclinical personnel to the floor appears safe. This may reduce diversion of ED nurses from the ED, helping to alleviate nursing shortages.
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Socioeconomic status (SES) has been linked to heart disease, but its influence on outcome from out-of-hospital cardiac arrest (OHCA) is not well understood. ⋯ An individual-level, but not an area-level, measure of SES predicted survival following OHCA independent of demographic, circumstance, or care factors. Future research should continue to investigate mechanisms through which SES is associated with OHCA survival.
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Comparative Study
Prevalence of anemia in children presenting with apparent life-threatening events.
Anemia has been associated with apparent life-threatening events (ALTEs) in children. However, the nature of the association has not been well described. ⋯ Anemia is common in pediatric patients with recurrent ALTEs. Patients with recurrent ALTEs are older and have lower Hb, MCH, and MCV values than patients with a single ALTE and age-matched control patients. Significantly lower MCH and MCV values in patients with recurrent ALTEs suggest that iron deficiency may be associated with the recurrence of events.