Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Discriminatory Value of the Ascending Aorta Diameter in Suspected Acute Type A Aortic Dissection.
The objective was to determine if ascending aorta (AscAo) diameters measured by noncontrast computed tomography (CT) allow for meaningful discrimination between patients with and without type A aortic dissection (TAAD), ideally with 100% sensitivity. ⋯ Nearly all patients with TAAD appear to have enlarged AscAo diameters as measured by noncontrast CT, whereas most patients with suspected but absent TAAD have relatively normal AscAo diameters. Both raw and normalized AscAo measures provided relatively comparable discriminatory value. If validated, these data may be useful in adjudicating risk among patients with suspected TAAD in whom a criterion standard test is unavailable, nondiagnostic, or contraindicated.
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Rising rates of opioid overdose deaths require innovative programs to prevent and reduce opioid-related morbidity and mortality. This study evaluates adoption, utilization, and maintenance of an emergency department (ED) take-home naloxone and peer recovery coach consultation program for ED patients at risk of opioid overdose. ⋯ ED naloxone distribution and consultation of a community-based peer recovery coach are feasible and acceptable and can be maintained over time.
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This is a validation of a preplanned secondary analysis of the NEXUS II Head computed tomography (CT) decision instrument, focusing on the pediatric population. A total of 1,018 patients less than 18 years old, who underwent head CT imaging for blunt head trauma, were included. The decision instrument correctly identified all patient (27/27) who required neurosurgical intervention and 48 of 49 patients who had clinically significant head injury on CT imaging.