European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena.
Gastrointestinal (GI) bleeding is a common surgical problem. The aim of this study was to evaluate how insertion of the nasogastric tube may enable differentiation between upper and lower GI bleeding in patients with melena. A retrospective study involving patients admitted to our surgery division with a melena was carried out between the years 2010 and 2012. ⋯ The sensitivity of examination of nasogastric aspirate to establish the upper GI as the source of bleeding was only 28% and the negative predictive value of a negative nasogastric aspirate was less than 1%. Most patients who initially presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate. Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.
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Comparative Study Observational Study
Urgent carotid duplex and head computed tomography versus ABCD2 score for risk stratification of patients with transient ischemic attack.
The aim of the study was to prospectively compare the prognostic value of ABCD score, urgent carotid ultrasound (CUS), and unenhanced head computed tomography (UHCT) in patients presenting to the emergency department with transient ischemic attack (TIA). ⋯ Simple imaging tests showed added prognostic value to ABCD score in TIA patients. Urgent CUS together with UHCT should be performed in all TIA patients regardless of ABCD score.
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Observational Study
The predictive validity of RETTS-HEV as an acuity triage tool in the emergency department of a Danish Regional Hospital.
The Rapid Emergency Triage and Treatment System - Hospital Unit West (RETTS-HEV) is a triage system used in the emergency department (ED) in Herning, Denmark, since 2010. It categorizes patients according to priority and defines a time limit on how long patients can wait before being seen by a doctor depending on the severity of their condition. The purpose of this study was to determine the predictive validity of RETTS-HEV by measuring the association between triage scores and outcomes such as the admission rate, the length of stay (LOS), and mortality. ⋯ RETTS-HEV was found to be closely related to all examined outcomes, and therefore useful in the risk stratification of ED patients.
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Observational Study
Analysis of a data-fusion system for continuous vital sign monitoring in an emergency department.
The aim of the study was to evaluate the ability of a data-fusion patient status index (PSI) to detect patient deterioration in the emergency department (ED) in comparison with track-and-trigger (T&T). ⋯ Electronic data capture offers opportunities for increased detection of deteriorating patients in a busy clinical environment compared with paper charts. Sample size in this study is insufficient to determine which electronic method (eT&T or PSI) offers superior detection of the need for escalation.