Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the effects of delaying fluid on the rate of hemorrhage and hemodynamic parameters in an injury involving the arterial system. ⋯ Rates of hemorrhage from an arterial injury are related to changes in mean arterial pressure. In this animal model, early aggressive fluid resuscitation in penetrating thoracic trauma exacerbates total hemorrhage volume. Despite resumption of hemorrhage from the site of injury, delaying fluid resuscitation results in the best hemodynamic parameters.
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Comparative Study Clinical Trial
Determination of left ventricular function by emergency physician echocardiography of hypotensive patients.
To determine whether emergency physicians (EPs) with goal-directed training can use echocardiography to accurately assess left ventricular function (LVF) in hypotensive emergency department (ED) patients. ⋯ Emergency physicians with focused training in echocardiography can accurately determine LVF in hypotensive patients.
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Comparative Study Clinical Trial
Assessment of clinically significant changes in acute pain in children.
To quantify, using two pain assessment scales, the amount of change in pain severity required to achieve a clinically significant improvement in pain in children presenting to a pediatric emergency department (ED) with pain. ⋯ The assessment and treatment of pain in children are an important component of pediatric practice, especially in the ED. This study provides health care professionals and clinical investigators the information necessary to assess whether their method of pain control in children is clinically relevant.
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With increasing availability and utilization of advanced technologic modalities in medicine, questions frequently arise regarding the appropriate use of recorded images of patients. While recorded images (photography, video, etc.) of patients may often be appropriate for documentation, medical record use, peer review, and teaching, the nonmedical use of recorded images for entertainment or commercial purposes is more problematic, both ethically and procedurally. Practices regarding filming of patients in academic emergency departments are reviewed, and suggested guidelines are provided regarding the appropriate and inappropriate filming of patients.
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Clinical Trial
How useful are clinical features in the diagnosis of acute, undifferentiated chest pain?
To measure the predictive value and diagnostic performance of clinical features used to diagnose coronary syndromes in patients presenting with acute, undifferentiated chest pain. ⋯ Important differences exist when clinical features are specifically investigated in patients with acute chest pain and a nondiagnostic electrocardiogram. Clinical features have a limited role to play in triage decision making.