European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study
Accuracy of oxygen tissue saturation values in assessing severity in patients with sepsis admitted to emergency departments.
Near-infrared spectrometry assesses hemoglobin saturation of oxygen in tissues (StO2). Although it may provide additional information on local microcirculation function, the usefulness of near-infrared spectrometry in septic patients is debated. This study evaluated whether baseline StO2 value is useful in septic patients admitted to the emergency department with a diagnosis of severe sepsis. ⋯ This study fails to show any value of StO2 baseline at triage for early detection of severe sepsis in emergency patients.
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Does emergency ultrasound (EU) improve the speed of diagnosis of patients presenting to the emergency department (ED) with a ruptured abdominal aortic aneurysm (rAAA)? ⋯ There was a nonsignificant trend towards a faster time to diagnosis (51 min) in rAAA patients who underwent EU on presenting to the ED compared with those who did not undergo an ED EU (111 min). There was no improvement in survival or length of ICU unit stay.
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Out-of-hospital cardiac arrest (OHCA) is used to evaluate the performance of the emergency medical service (EMS) system. Our study examined the characteristics and outcomes of OHCA cases presenting to a tertiary care center in Beirut, Lebanon. ⋯ The OHCA survival rate in Beirut, Lebanon, is low. Bystander cardiopulmonary resuscitation and early defibrillation should be prioritized to achieve better outcomes.
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Blood gas analysers provide electrolyte and metabolic data. In the author's institution, these values were not used clinically because of the risk of inaccuracy. To discover whether this approach was warranted, we compared values from our Radiometer point-of-care (POC) analyser and the laboratory. ⋯ Thus, sodium and potassium showed negative bias on the Radiometer compared with the laboratory. Creatinine and haemoglobin agreed well. We advocate the clinical use of POC values when taken in clinical context.
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The use of point-of-care ultrasound in the emergency department has expanded considerably in recent years, allowing enhanced evaluation of the patient with an emergent eye or vision complaint. The technique is simple and quick to perform, and can yield clinical information that may not be readily obtainable through physical or slit-lamp exams. ⋯ Optic nerve sheath diameter can be measured in patients with a suspected intracranial process as a surrogate for intracranial pressure, and may aid emergency diagnosis and management. This article reviews common emergency ophthalmic pathologies diagnosed with ultrasound in the emergency setting and a mnemonic for the use of bedside ocular ultrasound is proposed to aid in thoroughly scanning the eye and its surrounding structures.