BMC emergency medicine
-
BMC emergency medicine · Nov 2018
Utility and effectiveness of the Scandinavian guidelines to exclude computerized tomography scanning in mild traumatic brain injury - a prospective cohort study.
In 2013 the Scandinavian Neurotrauma Committee (SNC) published updated guidelines for the initial management of minimal, mild and moderate traumatic head injuries (MTHI) that included serum analysis of protein S100B as a marker for brain tissue damage. This study reviews the effectiveness of the new guidelines in a clinical setting. ⋯ The implementation of the updated SNC guidelines resulted in direct discharge of more than one third of the MTHI cases without further observation or CT examinations. One in five of these discharges was a direct result of S100B testing. However, compliance to the guidelines were poor and the guidelines were only followed in 40%. While this study showed benefits of implementing SNC guidelines to reduce the number of CT scans, additional training is needed for optimal use.
-
BMC emergency medicine · Nov 2018
Observational StudyComparison of the use of comprehensive point-of-care test panel to conventional laboratory process in emergency department.
In this study, we hypothesized that point of care testing (POCT) would reduce length of stay (LOS) in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination. ⋯ POCT shortened the laboratory process and made results available faster than the central lab. This allowed patients to be discharged home quicker. Thus, with proper training and education of the ED care team, POCT can be used as an effective tool for improving patient flow.
-
BMC emergency medicine · Nov 2018
Comparative StudyReduction in the IL-6 level at 24 h after admission to the intensive care unit is a survival predictor for Vietnamese patients with sepsis and septic shock: a prospective study.
Sepsis and septic shock are common problems in intensive care units (ICUs). The mortality of patients with sepsis or septic shock is high. We investigated if reduction in the serum concentration of the cytokines tumor necrosis factor α, interleukin (IL)-6 and IL-10, and the rate of change in the IL-6 level at 24 h after ICU admission were survival predictors for patients with sepsis and septic shock in a Vietnamese population. ⋯ Our findings suggested that a reduction in the IL-6 level of ≥86% at 24 h from ICU admission is a survival predictor for patients with sepsis and septic shock in our population.
-
BMC emergency medicine · Oct 2018
Multicenter StudyPrior CT imaging history for patients who undergo whole-body CT for acute traumatic injury and are discharged home from the emergency department.
Recurrent CT imaging is believed to significantly increase lifetime malignancy risk. We previously reported that high acuity, admitted trauma patients who received a whole-body CT in the emergency department (ED) had a history of prior CT imaging in 14% of cases. The primary objective of this study was to determine the CT imaging history for trauma patients who received a whole-body CT but were ultimately deemed safe for discharge directly home from the ED. ⋯ We found a positive history for prior CT for 25% of trauma patients who received whole-body CT scan but were discharged from the ED to home.
-
BMC emergency medicine · Sep 2018
Observational StudyEpidemiological and clinical profiles of acute poisoning in patients admitted to the intensive care unit in eastern Iran (2010 to 2017).
Acute poisoning is a common chief complaint leading to emergency department visits and hospital admissions in developing countries such as Iran. Data describing the epidemiology of different poisonings, characteristics of the clinical presentations, and the predictors of outcome are lacking. Such data can help develop more efficient preventative and management strategies to decrease morbidity and mortality related to these poisonings. This manuscript describes the epidemiology of acute poisoning among patients admitted to the intensive care unit (ICU) in Birjand, Iran. ⋯ Opioids and pesticides were the most common exposures. The mortality rate of the poisoned patients in the ICU was proportionately high. The mortality rate due to opioid poisoning is a major concern and the most significant cause death due to poisoning in the region. Further monitoring and characterization of acute poisoning in Birjand, Iran is needed. These data can help develop educational and preventative programs to reduce these exposures and improve management of exposures in the prehospital and hospital settings.