European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Presentation with acute chest pain is common, but the conventional 12-lead ECG has limitations in the detection of regional myocardial ischaemia. The previously described method of the body surface mapping system (BSM) Delta map, derived from an 80-electrode BSM, as well as a novel parameter total ischaemic burden (IB), may offer improved diagnostic sensitivity and specificity in patients with myocardial ischaemia. ⋯ This pilot study confirms the feasibility of using the Delta map for the diagnosis of ACS in patients presenting to the ED with cardiac-sounding chest pain and suggests that it has promising diagnostic accuracy and has superior sensitivity and specificity to the 12-lead ECG. The novel parameter of IB shows a significant correlation with troponin-I and is a promising tool for describing the extent of ischaemia. The use of the BSM Delta map in the ED setting could improve the diagnosis of clinically important ischaemic heart disease and furthermore presents the result in an intuitive manner, requiring little specialist experience. Further larger scale study is now warranted.
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There are no prospective data on which ischemic stroke patients require endotracheal intubation. This retrospective observational study describes the characteristics and outcomes of adult ischemic stroke patients admitted to two emergency department (ED)-ICU from January 2005 to October 2011 and who were intubated before imaging, either during the prehospital or the ED phase of care. Data were extracted from hospital charts and analyzed using descriptive statistics. ⋯ Twenty-six patients (84%) died during their hospital stay. The proportion of ED ischemic stroke patients intubated before imaging was very low. Almost all were severely ill and the majority died.