Emergencias
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Observational Study
Predictors of noninvasive mechanical ventilation weaning failure in the emergency department.
To analyze factors related to the failure of noninvasive mechanical ventilation (NIV) weaning in a hospital emergency department (ED). ⋯ Weaning failure occurs in 17% of ED patients on NIV. Time on NIV, HCO3 concentration, and a pH less than 7.35 before weaning are independently associated with failure to wean from the respirator.
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Randomized Controlled Trial
Efficacy of a fast-track pathway for managing uncomplicated renal or ureteral colic in a hospital emergency department: the STONE randomized clinical trial of Sonography and Testing of a Nephrolithiasis Episode.
To evaluate a fast-track pathway utilizing point-of-care (POC) testing and sonography as soon as uncomplicated renal or ureteral colic is suspected and to compare the POC clinical pathway to a standard one. ⋯ The use of a fast-track POC pathway to manage uncomplicated colic in the ED is effective and safe. It also reduces the amount of time spent in the ED.
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Practice Guideline
Key issues in emergency department management of COVID-19: proposals for improving care for patients in Latin America.
The incidence of the coronavirus disease 2019 (COVID-19) in Latin America and Spain and its impact particularly on hospital emergency departments have been great, sustained, and unpredictable. Unfortunately, this situation will continue in the medium term, regardless of the diverse concepts and definitions used to identify cases or hypotheses about the role of staff. ⋯ Experts from the Spanish Society of Emergency Medicine (SEMES) also participated. The present consensus statement offers protocols and recommendations to facilitate the work of hospital emergency departments with regard to key issues the group identified, namely, the need for reorganization, triage, and routine test availability. Additional issues discussed include biomarkers; clinical, laboratory, radiologic, and microbiologic criteria for identifying patients with COVID-19; and risk and prognostic factors for mortality that emergency staff can use to quickly detect severe cases in our settings.
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Observational Study
Prehospital and hospital shock indices as predictors of massive blood transfusion during the initial treatment of polytrauma patients.
To explore a possible association between the shock index and a need for massive blood transfusion, duration of hospital stay in the critical care unit, and mortality. ⋯ The shock index is a useful, easy-to-obtain predictor to identify polytrauma patients who need early blood transfusion for optimal treatment. Hospital stay and mortality might be better predicted by other indicators.