Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the significance of a low out-of-hospital systolic blood pressure (SBP) reading in blunt trauma patients who have a normal SBP upon ED arrival. ⋯ The injured patients who were hypotensive in the out-of-hospital setting but normotensive upon ED arrival were more severely injured and had more potential for blood loss than were the patients who were normotensive both in the out-of-hospital setting and in the ED. Out-of-hospital hypotension may be a clinical predictor of severe injury, even in the face of normal ED SBP. Prospective studies are indicated to validate this hypothesis.
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Emergency Management of Trauma, Edited by Thomas A. Scaletta and Jeffrey J. ⋯ Paris House Calls, Rounds, and Healings: A Poetry Casebook By David L. Schiedermayer Tucson Airway Cam Video Series, Volume I: Orotracheal Intubation Produced by Richard Levjtan and Michael Higgins, with Ahmed Badr and Steven Blanks (assistant producers).
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To determine how often the results of urine and blood cultures led to changes in antibiotic therapy for patients discharged from the hospital with the diagnosis of pyelonephritis. ⋯ Urine cultures are useful in directing antibiotic therapy in patients with the discharge diagnosis of acute pyelonephritis and support a change in therapy in 5% of cases. Among the patients in this study, blood cultures results did not lead to changes in antibiotic therapy. These findings warrant prospective, multicenter evaluation.