European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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We sought to identify the impact of whole-body computed tomography (WBCT) on working and suspected diagnoses in Emergency Department (ED) trauma patients and to determine the rate of WBCT scans with no detectable traumatic injuries. We performed a retrospective database analysis of all trauma patients who underwent WBCT in 2009, comparing pretest suspicion of specific injury to WBCT findings, looking for the rates of unexpected findings and the absence of traumatic injury in WBCT studies. ⋯ Overall, WBCT results differed from clinical findings in 130 (72.6%) patients, a statistically significant difference (P<0.0001). In conclusion, WBCT identifies previously unexpected injuries in almost 66% of ED trauma patients, supporting its continued use in the initial assessment of trauma patients.
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Despite the severity of pneumonia in patients with pandemic influenza A infection (H1N1), no validated risk scores associated with H1N1 pneumonia were tested. In this prospective observational study, we analyzed data of consecutive patients in our emergency room, hospitalized because of pneumonia between July and August 2009 in a public hospital in Brazil. The following pneumonia scoring systems were applied: the SMART-COP rule; the Pneumonia Severity Index; and the CURB-65 rule. ⋯ Among them, only 9.5% that had a low risk according to SMART-COP were admitted to ICU, compared with 36.8% of those with the Pneumonia Severity Index score of 1-2 and 49% of those with CURB-65 score of 0-1. The SMART-COP had an accuracy of 83% to predict ICU admission. The SMART-COP rule presented the best performance to indicate ICU admission in patients with H1N1 pneumonia.
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Comparative Study
Invasive bacterial infections in a paediatric emergency department in the era of the heptavalent pneumococcal conjugate vaccine.
To describe the characteristics of patients diagnosed with invasive bacterial infections (IBIs) in a Paediatric Emergency Department (PED) following the introduction of the heptavalent pneumococcal conjugated vaccine (PCV7). ⋯ In the era of PCV7, pneumococcus is the leading cause of IBI in PED. The introduction of PCV13 may lead to a very significant decrease in the IBI rate and meningococcus may become the leading cause of IBI.