Articles: hospital-emergency-service.
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Meta Analysis
Diagnostic performance of emergency physician-performed point-of-care ultrasonography for acute appendicitis: A meta-analysis.
To assess the sensitivity and specificity of emergency physician-performed point-of-care ultrasonography (EP-POCUS) for diagnosing acute appendicitis (AA). ⋯ The diagnostic performances of EP-POCUS and RADUS were excellent for AA, with EP-POCUS having even better performance for pediatric AA. Accurate diagnoses may be achieved when the attending EP is the initial POCUS operator and uses a 7-mm cut-off value.
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Recent literature advocates outpatient emergency department (ED) management of intussusception citing low recurrence rates and postreduction events after uncomplicated ileocolic reduction. However, few studies include both inpatient and outpatient cohorts. We performed a systematic review and meta-analysis to compare recurrence rates and length of hospital stay between the groups. ⋯ Management of intussusception in the ED after uncomplicated reduction appears acceptable. However, evidence levels are low, and RCT should be performed to adequately evaluate the safety of outpatient management of pediatric intussusception.
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Rapid tranquilization of agitated patients can prevent injuries and expedite care. Whereas antipsychotics and benzodiazepines are commonly used for this purpose, ketamine has been suggested as an alternative. ⋯ Ketamine provides rapid sedation for undifferentiated agitated patients and is associated with higher intubation rates when used by ground Emergency Medical Services paramedics, compared with ED or air medical transport patients. Other side effects are common but usually self-limiting.
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Meta Analysis
Lung ultrasound in diagnosing pneumonia in the emergency department: a systematic review and meta-analysis.
Community-acquired pneumonia (CAP) is one of the most widespread and severe infectious diseases worldwide. In the emergency department (ED), there is still a need for a rapid and accurate tool that can diagnose CAP. Lung ultrasound (LUS) is a recent tool that is increasingly being for this purpose. ⋯ The pooled area under the curve, sensitivity, and specificity were, respectively, 97, 92, and 93%. The LUS was found to be an accurate tool in diagnosing CAP in adult patients in the ED. More methodologically rigorous trials are needed.
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Scand J Trauma Resus · Jul 2018
Review Meta AnalysisHead-to-head comparison of qSOFA and SIRS criteria in predicting the mortality of infected patients in the emergency department: a meta-analysis.
Recently, the concept of sepsis was redefined by an international task force. This international task force of experts recommended using the quick Sequential Organ Failure Assessment (qSOFA) criteria instead of the systemic inflammatory response syndrome (SIRS) criteria to classify patients at high risk for death. However, the added value of these new criteria in the emergency department (ED) remains unclear. Thus, we performed this meta-analysis to determine the diagnostic accuracy of the qSOFA criteria in predicting mortality in ED patients with infections and compared the performance with that of the SIRS criteria. ⋯ A qSOFA score ≥ 2 and SIRS score ≥ 2 are strongly associated with mortality in ED patients with infections. However, it is also clear that qSOFA and SIRS have limitations as risk stratification tools for ED patients with infections.