European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aim of our study was to determine the usefulness of pneumococcal urinary antigen (UA) collected in the emergency department (ED) for the microbiologic diagnosis of community-acquired pneumonia (CAP) in HIV patients and to compare it with other diagnostic tests. Prospective study from 1 January 2007 to 31 December 2008 included HIV-infected patients admitted at the ED with respiratory symptoms and who were diagnosed of CAP. UA, two blood cultures and sputum sample for culture determination were collected from every patient. ⋯ The statistical analysis showed that the test with best performance was the UA, both in relation to blood and sputum cultures (P<0.05). Two patients died during hospitalization (series mortality of 3%). In conclusion, given its good diagnostic performance, UA should be requested in the ED for the aetiological diagnosis of CAP.
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Comparative Study
How different are older people discharged from emergency departments compared with those admitted to hospital?
To compare the characteristics of older people presenting to the emergency department (ED) and admitted to hospital with those discharged directly from the ED and identify factors independently associated with hospital admission. ⋯ In this elderly population, health-related variables were the only independent factors associated with hospital admission. Approximately 30% of patients discharged home from ED had similar risk profiles to admitted patients.
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This study aimed to estimate the city-wide prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients (≥18 years old) presenting with skin and soft tissue infections (SSTIs) to the emergency departments (EDs) of a Canadian Academic Health Care Center. Secondary objectives were to identify demographic and clinical variables associated with MRSA, and determine MRSA antimicrobial susceptibilities and genotypes. ⋯ Community-acquired -MRSA is a significant pathogen of SSTIs in EDs of a Canadian teaching center. MRSA should be considered when initiating empiric antibiotic therapy, particularly in patients with risk factors.
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The epidemiology and optimal management of injury to the paediatric scaphoid (carpal navicular) is unknown.The objective of this study is to evaluate these parameters in the Emergency Department of a tertiary children's hospital. ⋯ Pain in the anatomical snuff box is a poor indicator of bone injury to the scaphoid of any sort. Scaphoid fracture is a rare injury in childhood and from this study, it is extremely unlikely to occur under the age of 9 years.The actual bone pathology of an injured paediatric scaphoid may not be clear, but these children have significant pain and tenderness. Further studies are warranted to improve the diagnostic process and the management of paediatric scaphoid injury.
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This study evaluates the effects of an educational intervention and the use of a preprinted form on the adequacy of documentation of procedural sedation in an adult emergency department. ⋯ Baseline documentation was poor and improved slightly after both the educational interventions. Use of a preprinted form was associated with no medical records being classified as having poor documentation; however, uptake of the form use was low. Emergency departments should develop and consider mandatory use of such an aid together with training staff in the use of the aid and the important implications of adequate procedural documentation.