The American journal of emergency medicine
-
Multicenter Study Comparative Study
Evaluating community ED crowding: the Community ED Overcrowding Scale study.
The goals of this study were to (1) identify valid variables that correlate with emergency department (ED) crowding and (2) determine a model that could be used to accurately reflect the degree of ED crowding. ⋯ Five variables were highly correlated with community ED crowding and could be used to model the full set of all variables in explaining ED crowding.
-
Review Case Reports
ST-segment elevation after direct current shock mimicking acute myocardial infarction: a case report and review of the literature.
External direct current (DC) shocks are and have long been commonly used for electrical cardioversion/defibrillation of atrial or ventricular arrhythmias. ST-segment elevation after cardio version with DC is an easily ignored phenomenon, occurring acutely and resolving during the first few minutes postshock. Here, we describe electrocardiographic findings of widespread ST-segment elevation lasting at least 1 hour after DC cardioversion for ventricular defibrillation due to Brugada syndrome and mimicking acute myocardial infarction (AMI). This case of ST-segment elevation without a dynamic and evolving AMI underscores the need to consider other causes of ST-segment elevation.
-
Multicenter Study Observational Study
Therapeutic hypothermia after cardiac arrest caused by self-inflicted intoxication: a multicenter retrospective cohort study.
The aim of this study was to describe the epidemiology and outcomes of patients with therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) caused by self-inflicted intoxication. ⋯ Patients with OHCA caused by self-inflicted intoxication represented 2.6% of all OHCA patients. They showed a high rate of unwitnessed cardiac arrest and a very low rate of bystander cardiopulmonary resuscitation. Pesticides were the main cause of cardiac arrest, and these cases had a very high discharge to survival rate.
-
The value of electrocardiogram (ECG) overreads of emergency department (ED) tracings have been questioned in the literature. This review was designed to assess the validity of this criticism. ⋯ Official cardiology overreads seldom affect the clinical outcome of patient care delivered in the ED setting.
-
The American Heart Association/American Stroke Association guidelines recommend all patients presenting to emergency departments (EDs) with a potential stroke be seen within 10 minutes of arrival, although this may not be achieved in all patients. We sought to identify factors associated with delayed evaluation of ED patients with potential stroke. ⋯ In this national sample of patients presenting with strokes to US EDs, patient visits to metropolitan statistical area hospitals and those triaged to less urgent categories were associated with delayed evaluation.