Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Performance of the pediatric glasgow coma scale in children with blunt head trauma.
To compare the accuracy of a pediatric Glasgow Coma Scale (GCS) score in preverbal children with blunt head trauma with the standard GCS score in older children. ⋯ This pediatric GCS for children 2 years and younger compares favorably with the standard GCS in the evaluation of children with blunt head trauma. The pediatric GCS is particularly accurate in evaluating preverbal children with blunt head trauma with regard to the need for acute intervention.
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To determine the sensitivity and specificity of a brief two-question depression screen for the detection of depression in older emergency department (ED) patients, and to determine the prevalence of depression in this population. ⋯ Depression is fairly prevalent in older ED patients. The brief two-question depression screen, using a cutoff score of at least one positive response, is promising for ED use. However, given lower specificity, patients scoring positive for depression should be followed up with a more specific tool such as the self-administered SFGDS prior to referral for further evaluation and treatment.
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Prior evidence suggests that physicians may alter process of care based on race/ethnicity. The objective of this study was to determine whether race/ethnicity predicts whether a patient receives computed tomography of the head (head CT) during evaluation of blunt head injury. ⋯ Minority and non-Hispanic white patients may not have significantly different rates of receiving head CT during evaluation of blunt head injury. A multicenter prospective study is necessary to confirm these preliminary findings.
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Acute decompensated heart failure (adHF) is the cause of approximately 1 million annual hospital admissions. In some of these, the use of a short-stay emergency department observation unit (EDOU) decreases 90-day ED revisits and 90-day rehospitalizations and, if subsequent hospitalization is required, results in shorter stays. ⋯ These results demonstrate that a BUN level >30 mg/dL is associated with an increased likelihood of admission in patients with adHF. This provides the emergency physician with a practical prognostic tool for disposition planning in congestive heart failure patients.
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There has been little systematic study of emergency department (ED) patients with elevated blood pressure (BP) values. The authors sought to characterize ED patients with elevated BP values, assess presenting symptoms, and determine the prevalence of elevated BP after discharge. ⋯ Elevated BP is common among ED patients. African American patients are more likely than those of other ethnic groups to have greater BP values. The ED visit may be a good opportunity to identify patients with unrecognized or poorly controlled hypertension.