The American journal of emergency medicine
-
We sought to assess the proportion of ED patients with an electronically detected S(3) or S(4), determine the relation of these heart sounds to heart failure (HF), and analyze how the proportion changes with ED treatment. ⋯ This study suggests the proportion of patients with an electronically detected S(3) in HF is more than 50%, and that its presence is affected by prior treatment with diuretics or vasodilators.
-
Many patients who overdose on sedatives experience a declining mental status and eventually require endotracheal intubation. The goal of this study was to determine if serial bedside Bispectral index (BIS) scores monitoring can be used to detect the eventual need for intubation in overdosed patients who are undergoing observation in the ED. ⋯ The overdosed patients who required intubation during their ED treatment experienced a mean decrease in BIS during the first 20 minutes, compared with those who did not. Bispectral index scores monitoring may prove useful for earlier ED treatment and decision making regarding sedative overdose patients.
-
The digital rectal examination (DRE) may assist physicians in detecting spinal cord injury in patients with blunt trauma. However, the test characteristics of the DRE for detecting spinal cord injury are unknown. ⋯ The DRE is insensitive to spinal cord injury and has a poor positive predictive value. The high specificity must be balanced against the large number of false-positive results.