Articles: emergency-department.
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What clinical features, compiled as a risk stratification tool, identify patients with upper gastrointestinal bleeding that can be safely managed and investigated in an outpatient setting? ⋯ To validate the Glasgow-Blatchford Bleeding Score, a risk stratification tool for upper gastrointestinal bleeding.
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Emergency department (ED) visits in the US have risen dramatically over the past 2 decades. In order to meet the growing demand, mid-level providers (MLPs) - both physician assistants (PAs) and nurse practitioners (NPs) - were introduced into emergency care. Our objective was to test the hypothesis that MLP usage in US EDs continues to rise. ⋯ Mid-level provider use is rising in US EDs. By 2009, approximately one in seven visits involved MLPs, with PAs managing twice as many visits as NPs. Although patients seen by MLPs only are generally of lower acuity, these nationally representative data confirm that MLP care extends beyond minor presentations.
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The aim of this study was to determine the usefulness of end tidal carbon dioxide (ETCO2) monitoring in hypotensive shock patients presenting to the ED. ⋯ The use of ETCO2 in the ED has great potential to be used as a method of non-invasive monitoring of patients in shock.
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Lacerations account for a large number of ED visits. Is there a "golden period" beyond which lacerations should not be repaired primarily? What type of relationship exists between time of repair and wound infection rates? Is it linear or exponential? Currently, the influence of laceration age on the risk of infection in simple lacerations repaired is not clearly defined. We conducted this study to determine the influence of time of primary wound closure on the infection rate. ⋯ Without controlling various confounding factors, the median wound closure time for the lacerations in the wound infection group was statistically significantly longer than in the non-infection group.
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⋯ Our results suggest that the technical qualities of microEEG are non-inferior to a standard commercially available EEG recording device. EEG in the ED is an unmet medical need due to space and time constraints, high levels of ambient electrical noise, and the cost of 24/7 EEG technologist availability. This study suggests that using microEEG with an electrode cap that can be applied easily and quickly can surmount these obstacles without compromising technical quality.