Annals of emergency medicine
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Multicenter Study
Validity of a decision rule to reduce cervical spine radiography in elderly patients with blunt trauma.
A decision instrument based on 5 clinical criteria has been shown to be highly sensitive in selecting patients who require cervical spine imaging after blunt trauma, while simultaneously reducing overall imaging. We examine the performance of this instrument in the elderly and explore some of the common features of geriatric cervical spine injury (CSI). ⋯ The prevalence of CSI, and especially odontoid fracture, is relatively increased among geriatric patients with blunt trauma. The NEXUS decision instrument can be applied safely to these patients, with an expected reduction in cervical imaging comparable with that achieved in nongeriatric patients.
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Multicenter Study
Initial oxygen saturation as a predictor of admission in children presenting to the emergency department with acute asthma.
Previous studies have looked at the relationship between initial oxygen saturation (SaO (2)) and the need for admission in children presenting with an acute asthma exacerbation. If initial SaO (2) value is indeed predictive of admission, then the admission process could be initiated sooner, and time spent in the emergency department could be potentially lessened. ⋯ This large, clinical multicenter study does not support earlier findings that SaO (2) alone is a clinically useful predictor of hospital admission in children who present to the ED with acute asthma.