Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine if there is an association between total out-of-hospital time and trauma patient mortality. ⋯ Provider-assigned CUPS status, patient age, Injury Severity Score, and Revised Trauma Score all were significant predictors of trauma patient mortality. Total out-of-hospital time was not associated with mortality.
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A multidisciplinary panel of experts is developing standardized reporting criteria for risk stratification studies of emergency department (ED) patients with potential acute coronary syndromes (ACS). The authors assessed the need for such criteria by reviewing published studies to determine whether these core criteria currently are being reported. ⋯ Many of the 47 items considered core criteria by the expert committee writing standardized reporting guidelines for risk stratification studies of potential ACS patients were not reported often in major cardiology and emergency medicine journals. There seems to be a need for standardized reporting guidelines because important information is not currently being reported.
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An 82-year-old women presented with altered mental status, seizure, and apnea after an accidental ingestion of concentrated hydrogen peroxide. Ingestion of concentrated peroxide can result in gas embolism of the cerebral vasculature. ⋯ To the best of the authors' knowledge, this is the first reported case of reversal of significant altered mental status associated with hydrogen peroxide ingestion in temporal relation with hyperbaric oxygen therapy. Emergency physicians need to be aware of the dangers of peroxide ingestion and may wish to consider hyperbaric oxygen as a potential additional treatment for severe cases.
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To test the hypothesis that arterial blood gas (ABG) results for patients with suspected diabetic ketoacidosis (DKA) do not influence emergency physicians' management decisions and to assess correlation and precision between venous pH and arterial pH. ⋯ ABG results rarely influenced emergency physicians' decisions on diagnosis, treatment, or disposition in suspected DKA patients. Venous pH correlated well and was precise enough with arterial pH to serve as a substitute.
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To assess the impact of an emergency department (ED) guideline employing selective use of helical computed tomography (CT) on clinical outcomes of female patients with suspected appendicitis. ⋯ Helical CT is highly accurate in detecting appendicitis in patients with equivocal ED presentations. The use of a guideline employing selective helical CT was associated with a decline in the time from ED presentation to operative intervention in females.