European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Identifying predictors of an abnormal computed tomographic scan among patients with a head injury and a Glasgow Coma Scale of 15.
The aim of this study was to determine the proportions of patients with a head injury and a Glasgow Coma Scale of 15 with an abnormal computed tomographic (CT) head scan and to explore its predictors. ⋯ Abnormal CT and NS interventions were infrequent in patients with a head injury and a Glasgow Coma Scale of 15. We identified three predictors of abnormal head CTs.
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Comparative Study
Operating characteristics of a qualitative troponin assay for the diagnosis of acute coronary syndrome.
The troponin I serum level is widely used in acute coronary syndrome patients for their classification. The qualitative assay is faster and more available than the quantitative assay. The objective was to determine the operating characteristics of a qualitative troponin I assay compared with a quantitative method. ⋯ The degree of agreement between the second rapid qualitative and quantitative troponin I was excellent (κ=0.946; 95% confidence interval, 0.903-0.989). The sensitivity, specificity, negative predictive value, and positive predictive value of the rapid qualitative troponin I test were 92.6, 100, 96.8, and 100%, respectively. In conclusion, this study reveals an excellent agreement between quantitative and qualitative bedside assays 6 h after admission in a sample of Iranian patients in the emergency department.
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To determine if ultrasound guided measurement of the optic nerve sheath diameter accurately predicted elevated intracranial pressure (ICP) as demonstrated by cranial computed tomography (CT) in at-risk emergency department patients. ⋯ This study shows that the ultrasound guided optic nerve sheath diameter is a sensitive and specific test for predicting elevated ICP. A prospective validation study across emergency departments would test applicability of this test. We propose an algorithm for incorporating ultrasound for the management of suspected intracranial hypertension in emergency departments.
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Paediatric emergency medicine (PEM) currently faces many competing educational challenges. Recent changes to the working patterns have made the delivery of effective teaching to trainees extremely difficult. We developed a virtual learning environment, on the basis of socioconstructivist principles, which allows learning to take place regardless of time or location. The aim was to evaluate the effectiveness of a blended e-learning approach for PEM training. ⋯ A blended approach to e-learning in basic PEM is effective and enjoyable to trainees.
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Letter Multicenter Study Comparative Study
Positive computed tomography rate for lone acute severe headache: a potential quality marker for emergency care?