Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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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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Comparative Study
Reappraisal of criteria used to predict serious bacterial illness in febrile infants less than 8 weeks of age.
To re-evaluate the Philadelphia protocol and the Rochester criteria for identifying infants at low risk for serious bacterial illness (SBI) in a new population. ⋯ The Philadelphia protocol and the Rochester criteria maintained their previously reported NPVs when applied to a new population of febrile infants. These data illustrate the usefulness of retesting clinical decision rules in new populations prior to their universal acceptance.
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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.
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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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Emergency department (ED) patients with disaster-related experiences may present with vague symptoms not clearly linked to the event. In 2001, two disasters in New York City, the World Trade Center disaster (WTCD) and the subsequent American Airlines Flight 587 crash, presented an opportunity to study long-term consequences of cumulative disaster exposure (CDE) on health-related quality of life (HRQOL) among ED patients. ⋯ In the year following mass traumatic events, persons with CDE had lower overall health status than those with one or no disaster exposure. Clinicians should consider the impact that traumatic events have on the overall health status of ED patients in the wake of consecutive disasters.