Articles: emergency-department.
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Pol. Arch. Med. Wewn. · Jun 2022
Observational StudyPrognostic value of acid-base balance parameters obtained from peripheral venous blood sample on admission in patients with myocardial infarction treated with percutaneous coronary intervention.
Peripheral venous blood sample may be used to obtain acid‑ base balance parameters (PVA‑BP) measured in rapid point‑of‑care test (POCT) analyzers on admission to an emergency department (ED). Thus, lactates, anion gap (AG), and base excess (BE) may be early prognostic markers in patients with myocardial infarction (MI). ⋯ In the patients admitted to the ED with MI treated with PCI the evaluation of PVA‑BP in POCT analyzers may be a reliable tool for early risk stratification.
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Mechanically ventilated patients have experienced greater periods of prolonged deep sedation during the coronavirus disease (COVID-19) pandemic. Multiple studies from the pre-COVID era demonstrate that early deep sedation is associated with worse outcome. Despite this, there is a lack of data on sedation depth and its impact on outcome for mechanically ventilated patients during the COVID-19 pandemic. We sought to characterize the emergency department (ED) and intensive care unit (ICU) sedation practices during the COVID-19 pandemic, and to determine if early deep sedation was associated with worse clinical outcomes. ⋯ The management of sedation for mechanically ventilated patients in the ICU has changed during the COVID pandemic. Early deep sedation is common and independently associated with worse clinical outcomes. A protocol-driven approach to sedation, targeting light sedation as early as possible, should continue to remain the default approach.
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Observational Study
Accuracy of Emergency Severity Index in older adults.
Emergency Severity Index is a five-level triage tool in the emergency department that predicts the need for emergency department resources and the degree of emergency. However, it is unknown whether this is valid in patients aged greater than or equal to 65 years. ⋯ Emergency Severity Index performed well in predicting high dependency unit/ICU admission rates for both 18-64 years and greater than or equal to 65-year-old patients. It predicted the 3-day mortality for patients aged greater than or equal to 65 years with high accuracy. It was inaccurate in predicting 30-day mortality and hospital admission for both age groups.