Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Observational Study
High Prevalence of Fluoroquinolone-Resistant UTI Among US Emergency Department Patients Diagnosed with Urinary Tract Infection, 2018-2020.
Uropathogen resistance, fluoroquinolone-resistance (FQR), and extended spectrum beta-lactamase (ESBL), has been observed to be emerging worldwide with prevalences above recommended thresholds for routine empirical treatment. The primary aim of our study was to determine the prevalence of FQR from a geographically diverse sample of United States emergency departments (EDs). ⋯ FQ-resistant E. coli is widely prevalent across US sites highlighting the need for ongoing monitoring of antimicrobial resistance and, at some locations, modification of empirical treatments.
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Review Meta Analysis
Efficacy of ketorolac in the treatment of acute migraine attack: a systematic review and meta-analysis.
This review was designated to evaluate the efficacy of parenteral ketorolac in treating acute migraine headache. ⋯ Ketorolac may have similar efficacy to phenothiazines and metoclopramide in treating acute migraine headache. Ketorolac may also offer better pain control than sumatriptan, dexamethasone, and sodium valproate. However, given the lack of evidence due to inadequate number of trials available, future studies are warranted.
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Review
Mechanism of Injury and Special Considerations as Predictive of Serious Injury: A Systematic Review.
The Centers for Disease Control and Prevention's field triage guidelines (FTG) are routinely used by emergency medical services personnel for triaging injured patients. The most recent (2011) FTG contains physiologic, anatomic, mechanism, and special consideration steps. Our objective was to systematically review the criteria in the mechanism and special consideration steps that might be predictive of serious injury or need for a trauma center. ⋯ Select mechanism and special consideration criteria contribute positively to appropriate field triage of potentially injured patients.
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Observational Study
Physician Gestalt for Emergency Department Triage: A Prospective Videotaped Study.
Appropriate triage in patients presenting to the emergency department (ED) is often challenging. Little is known about the role of physician gestalt in ED triage. We aimed to compare the accuracy of emergency physician gestalt against the currently used computerized triage process. ⋯ Emergency physician gestalt for triage showed similar performance to a computerized system; however, physicians redistributed patients to lower triage levels. Physician gestalt has advantages for identifying low-risk patients. This approach may avoid undue time pressure for health care providers and promote rapid discharge.