Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The electrocardiograph (ECG) is an essential tool in initial management and risk stratification of patients with suspected acute coronary syndrome (ACS). A six-point reporting criterion has been proposed to facilitate standardized clinical assessment of patients presenting to the emergency department (ED) with suspected ACS. We set out to evaluate the efficacy of these criteria in identifying patients with major adverse cardiac events (MACE), Type 1 myocardial infarction (T1MI), Type 2 myocardial infarction (T2MI), and 1-year mortality in a cohort of emergency patients with chest pain. ⋯ The rates of MACE, T1MI, and 1-year death can be stratified according to standardized ECG criteria in patients presenting to the ED with chest pain. The ECG findings in patients with T2MI are variable, and the ECG is less helpful in defining risk in this group.
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Comparative Study
Assessment of Right Ventricular Strain by Computed Tomography versus Echocardiography in Acute Pulmonary Embolism.
Right ventricular strain (RVS) identifies patients at risk of hemodynamic deterioration from pulmonary embolism (PE). Our hypothesis was that chest computed tomography (CT) can provide information about RVS analogous to transthoracic echocardiography (TTE) and that RVS on CT is associated with adverse outcomes after PE. ⋯ In acute PE, CT is highly sensitive but only moderately specific for RVS compared to TTE. RVS on both CT and TTE predicts more events than either modality alone. TTE confers additional positive prognostic value compared to CT in predicting post-PE clinical deterioration.
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Multicenter Study Observational Study
Diagnostic performance of Wells score combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism.
Lung and venous ultrasound are bedside diagnostic tools increasingly used in the early diagnostic approach of suspected pulmonary embolism (PE). However, the possibility of improving the conventional prediction rule for PE by integrating ultrasound has never been investigated. ⋯ A pretest risk stratification enhanced by ultrasound of lung and venous performs better than Ws in the early diagnostic process of PE.
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Observational Study
The effect of frailty on 30-day mortality risk in older patients with acute heart failure attended in the Emergency Department.
The objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs). ⋯ The presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.
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Mentoring is considered a fundamental component of career success and satisfaction in academic medicine. However, there is no national standard for faculty mentoring in academic emergency medicine (EM) and a paucity of literature on the subject. ⋯ Our findings help to characterize the variability of faculty mentoring in EM, identify opportunities for improvement, and underscore the need to learn from other successful mentoring programs. This study can serve as a basis to share mentoring practices and stimulate conversation around strategies to improve faculty mentoring in EM.