Emergency medicine journal : EMJ
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Multicenter Study
Comparison of Glasgow Admission Prediction Score and Amb Score in predicting need for inpatient care.
We compared the abilities of two established clinical scores to predict emergency department (ED) disposition: the Glasgow Admission Prediction Score (GAPS) and the Ambulatory Score (Ambs). ⋯ The GAPS is a significantly better predictor of need for hospital admission than Ambs in an unselected ED population.
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Orthostasis is a frequent trigger for (pre)syncope but some forms of orthostatic (pre)syncope have a worse prognosis than others. Routine assessment of orthostatic BP in the ED can detect classic orthostatic hypotension, but often misses these other forms of orthostatic (pre)syncope. This study aimed to determine the frequency of abnormal orthostatic BP recovery patterns in patients with (pre)syncope by using continuous non-invasive BP monitoring. ⋯ Continuous non-invasive BP measurement can potentially identify more specific and concerning causes of orthostatic (pre)syncope. Correct classification is important because of different short-term and long-term clinical implications.
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We describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED. ⋯ In this series of ketamine sedations in an urban, resource-limited ED, there were no serious adverse events attributable to ketamine.
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CLINICAL INTRODUCTION: A 44-year-old woman presents pain free to our ED after experiencing 45 min of tightening of the chest with radiation to her left arm, diaphoresis and nausea. Her vital signs are normal except for her high BP, which is 180/110. ⋯ She visited a general practitioner who prescribed pain medication and treated her new-onset hypertension. Besides the recently found hypertension, heavy smoking is her only other traditional risk factor for cardiovascular disease.