The American journal of emergency medicine
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Rapid diagnosis (dx) of acutely decompensated heart failure (ADHF) may be challenging in the emergency department (ED). Point-of-care ultrasonography (US) allows rapid determination of cardiac function, intravascular volume status, and presence of pulmonary edema. We test the diagnostic test characteristics of these 3 parameters in making the dx of ADHF among acutely dyspneic patients in the ED. ⋯ In this study, US was 100% specific for the dx of ADHF.
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The aim of this study was to evaluate the necessity of chest x-ray (CXR) in detecting the endotracheal tube (ETT) misplacement after the intubation. ⋯ Although ED intubations have high success rate, the complications of inappropriate intubations are highly remarkable that postintubation CXR remains a necessary step to minimize the misplacement of the tube.
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The 2010 American Heart Association (AHA) for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science has changed the basic life support (BLS) sequence from "A-B-C" to "C-A-B." The AHA explained that this change may shorten the initiation time for chest compressions. In this study, the 2010 AHA guidelines for BLS (2010-BLS) were studied through a simulation program and practiced on a manikin. The time saved in initiating initial chest compressions was calculated, and the significance of the new guidelines was evaluated. ⋯ Chest compressions were initiated earlier by health care providers who were re-educated according to the 2010 AHA guidelines.
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Chest pain represents between 5% and 10% of annual visits to emergency departments (EDs) and near 25% of hospitalizations. Characterization of chest pain is sometimes difficult, and strategies should focus on preventing inappropriate discharge of patients with acute coronary syndrome. The goal of our study is to compare negative predictive value of the algorithm in the chest pain unit using the fourth-generation troponin T assay (4GTT) vs high-sensitivity troponin T assay (HSTT). ⋯ The algorithm in the chest pain unit using HSTT showed to have the same negative predictive value as the algorithm with the 4GTT but with a shorter stay in the ED.
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Current reversal options for warfarin-related bleeding are limited but include fresh frozen plasma, recombinant factor VIIa, or a prothrombin complex concentrate (PCC). There are little data discussing the use of activated 4-factor PCC for warfarin reversal. ⋯ Emergent reversal of warfarin utilizing a fixed, low dose of FEIBA appears to be efficacious, consistent, and safe. Further comparator studies with other reversal agents are needed.