Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Effect of two different FDA-approved D-dimer assays on resource utilization in the emergency department.
The D-dimer assay has been shown to be an appropriate test to rule out pulmonary embolism (PE) in low-risk patients in the emergency department (ED). Multiple assays now are approved to measure D-dimer levels. Studies have shown a newer assay, Tina-quant, to have similar diagnostic accuracy to the VIDAS assay. ⋯ Switching D-dimer assays reduced both LOS and number of imaging studies in our patient population.
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Early surface cooling of burns reduces pain and depth of injury and improves healing. However, there are concerns that cooling of large burns may result in hypothermia and worsen outcomes. In contrast, controlled mild hypothermia improves outcomes after cardiac arrest and traumatic brain injury. The authors hypothesized that controlled mild hypothermia would prolong survival in a rat model of large scald burns. ⋯ Induction of brief, mild hypothermia prolongs survival and increases the survival rate in nonresuscitated rats with large scald burns.
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The authors sought to determine the diagnostic test characteristics of bedside emergency physician (EP)-performed ultrasound (US) for cholelithiasis in symptomatic emergency department (ED) patients. ⋯ This study suggests that in patients presenting to the ED with pain consistent with biliary colic, a positive EUS scan may be used to arrange for appropriate outpatient follow-up if symptoms have resolved. In patients with a low pretest probability, a negative EUS scan should prompt the clinician to consider an alternative diagnosis.
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Multicenter Study
Preliminary investigation of the Panic Screening Score for emergency department patients with unexplained chest pain.
The objective was to demonstrate the derivation and the preliminary validation of a brief screening score to improve recognition of panic-like anxiety in emergency department (ED) patients with unexplained chest pain. ⋯ The PSS may be useful to identify patients with unexplained chest pain who could benefit from referral to mental health professionals or their primary care providers for evaluation of panic attack and panic disorder. Prospective studies to improve and validate the PSS, followed by impact analysis, are mandatory before clinical implementation.