The American journal of emergency medicine
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Admitting patients directly to a heart attack center (HAC) catheter laboratory for primary percutaneous coronary intervention (PPCI) bypassing the emergency department (ED) might be beneficial in delivering treatment of ST-elevation myocardial infarction with superior outcome. ⋯ A direct-access catheter laboratory (HAC) model of PPCI bypassing the ED should be the favored approach to service delivery with superior outcome.
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The objectives of this study are to validate a set of clinical variables to identify patients with pelvic fractures and to determine the sensitivity of anteroposterior (AP) pelvic radiographs in patients with pelvic fractures. ⋯ Previously identified high-risk variables for pelvic fracture identify most but not all patients with pelvic fractures. However, these high-risk variables identify all patients undergoing surgery and may be implemented as screening criteria for pelvic radiography. Anteroposterior pelvic radiographs fail to demonstrate a fracture in a substantial number of patients with pelvic fracture including patients who undergo surgery.
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This study aims to evaluate clinical values and determine the function of a pediatric observation unit (POU) as an alternative to inpatient unit admission for children with newly onset seizures. ⋯ The POU may be an alternative to immediate admission in selected cases of first seizures. Related information such as age, use of anticonvulsants in the ED, serum C-reactive protein value, and clinical diagnosis of febrile seizure are important factors for determining whether pediatric patients with first seizure attack should be admitted or discharged.