Articles: emergency-services.
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Scand J Trauma Resus · Sep 2024
Observational StudyThromboelastography as an early prediction method for hypofibrinogenemia in emergency department patients with primary postpartum hemorrhage.
Timely and accurate assessment of coagulopathy is crucial for the management of primary postpartum hemorrhage (PPH). Thromboelastography (TEG) provides a comprehensive assessment of coagulation status and is useful for guiding the treatment of hemorrhagic events in various diseases. This study aimed to evaluate the role of TEG in predicting hypofibrinogenemia in emergency department (ED) patients with primary PPH. ⋯ Point-of-care TEG could be a valuable tool for the early identification of hypofibrinogenemia in ED patients with primary PPH.
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Data suggest patients suffering acute coronary occlusion myocardial infarction (OMI) benefit from prompt primary percutaneous intervention (PPCI). Many emergency medical services (EMS) activate catheterization labs to reduce time to PPCI, but suffer a high burden of inappropriate activations. Artificial intelligence (AI) algorithms show promise to improve electrocardiogram (ECG) interpretation. The primary objective was to evaluate the potential of AI to reduce false positive activations without missing OMI. ⋯ In this single-center retrospective study, an AI-driven algorithm reduced false positive diagnoses of OMI compared to EMS clinician gestalt. Compared to AI (which missed no OMI), STEMI criteria also reduced false positives but missed 6 true OMI. External validation of these findings in prospective cohorts is indicated.
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Pediatric emergency care · Sep 2024
Point-of-Care Ultrasound Diagnosis of Early Pyomyositis in a Pediatric Patient: A Case Report.
Skin and soft tissue infections are common in the pediatric emergency department. Because pyomyositis occurs deep to the fascial plane, it is often difficult to appreciate on physical examination. ⋯ This case report describes a child who presented to the pediatric emergency department with leg pain and redness, initially concerning for an abscess based on clinical findings. Point-of-care ultrasound diagnosed early pyomyositis, prompting early involvement of the pediatric surgical service and urgent computed tomography imaging, which confirmed the diagnosis.
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Observational Study
Does IV fentanyl, frequently used in emergency departments, change QTC value? A prospective observational study.
Fentanyl is an opioid analgesic frequently used in the emergency department (ED) and is usually administered without knowing the QTC values of the patients or being monitored. However, the effect of fentanyl on QTC, prolongation or shortening, has not been elucidated. This study aimed to determine the effect of fentanyl on QTC. ⋯ Fentanyl prolonged the QTC value statistically significantly. Although no patient developed malignant arrhythmia clinically, our results suggest that this QTC-prolonging effect should be considered when using fentanyl in patients at risk of torsades.