Annals of emergency medicine
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Comparative Study Observational Study
Identifying Patients Suitable for Discharge After a Single-Presentation High-Sensitivity Troponin Result: A Comparison of Five Established Risk Scores and Two High-Sensitivity Assays.
We compare the ability of 5 established risk scores to identify patients with suspected acute coronary syndromes who are suitable for discharge after a modified single-presentation high-sensitivity troponin result. ⋯ With established risk scores, it may be possible to identify greater than 30% of patients suitable for discharge, with a negative predictive value greater than or equal to 99.5% for the diagnosis of acute myocardial infarction, using a single high-sensitivity troponin test result at presentation. There is variation in high-sensitivity troponin assays, which may have implications in introducing rapid rule-out protocols.
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Foreign bodies can gain entrance to the body through several mechanisms, ie, ingestion, aspiration, and purposeful insertion. For each of these common entry mechanisms, this article examines the epidemiology, clinical presentation, anatomic considerations, and key imaging characteristics associated with clinically relevant foreign bodies seen in the emergency department (ED) setting. We detail optimal use of multiple imaging techniques, including radiography, ultrasonography, fluoroscopy, and computed tomography to evaluate foreign bodies and their associated complications. Important imaging and clinical features of foreign bodies that can alter clinical management or may necessitate emergency intervention are discussed.