Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Obese patients with abdominal pain presenting to the emergency department do not require more time or resources for evaluation than nonobese patients.
The authors describe the evaluation of obese and nonobese adult patients with abdominal pain presenting to an emergency department (ED). The hypothesis was that more ED and hospital resources are used to evaluate and treat obese patients. ⋯ In contradiction to the hypothesis, the results suggest that LOS and ED resource use in obese patients with abdominal pain are not increased when compared with nonobese patients.
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To evaluate the utility of routine abdominal computed tomographic (CT) scanning for abdominal evaluation of blunt trauma patients before urgent extra-abdominal surgery. ⋯ Abdominal CT scanning has a low yield in trauma patients whose sole indication for diagnostic abdominal evaluation is the need for general anesthesia for urgent extra-abdominal surgery. A small percentage of these patients, however, will have important intra-abdominal injuries such that further refinement of the recommendations for diagnostic study in this select population is needed.
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Comparative Study
Precise formulation and evidence-based application of resource-constrained triage.
To develop a precise mathematical formulation of resource-constrained triage, denoted the Sacco triage method (STM), to develop an evidence-based application to blunt trauma, and to compare the STM with the simple triage and rapid treatment (START) method. ⋯ Resource-constrained triage is modeled precisely as an evidence-based, outcome-driven method that maximizes expected survivors in consideration of resources. The lifesaving potential and operational advantages over current methods warrant scrutiny and further research.
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Closed traumatic brain injury (cTBI) is a significant cause of mortality and morbidity in children. The natural course and extent of recovery from cTBI in children are poorly understood. Neuron-specific enolase (NSE), an enzyme detected in serum following structural damage of neuronal brain cells, appears to be a good marker for intracranial injury. However, to the best of the authors' knowledge, the usefulness of NSE as a predictor of disability in children with cTBI has not been reported. ⋯ It appears that the serum NSE level can be used as a predictor of global short-term physical disability in children following cTBI.