The American journal of emergency medicine
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Observational Study
Diagnosis and disposition are changed when board-certified emergency physicians use CT for non-traumatic abdominal pain.
To determine the effect of abdominal computed tomographic (CT) scan results on diagnosis and disposition of patients with non-traumatic abdominal pain who were evaluated by board-certified emergency physicians (EPs). ⋯ Abdominal CT use by board certified EPs for nontraumatic abdominal pain changed diagnosis and disposition, with more sent home in lieu of admission. Diagnostic accuracy did not appear to be related to years of clinical experience.
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Observational Study
A prospective study of suicide screening tools and their association with near-term adverse events in the ED.
The goal of this study was to evaluate the relationship between various suicide screening tools and clinical impression with subsequent patient psychiatric admission and near-term adverse emergency department (ED) events. ⋯ Clinical impression alone and the suicide screening tools showed poor predictive value for near-term events. Data from this study highlight the need for the development of ED-based suicide screening instruments capable of identifying those patients with suicidal ideation at greatest risk.
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Observational Study
Is there a potential role for echocardiography in adult patients with community-acquired pneumonia? A pilot study.
The role of echocardiography in adult patients with community-acquired pneumonia (CAP) has not been tested in a clinical trial. The aim of the study was to assess the cardiac changes secondary to CAP by echocardiography and to find out the correlation between echocardiographic findings and the severity of CAP. ⋯ Tricuspid annular plane systolic excursion and elastic properties of aorta may play a role in the diagnosis and clinical assessment of CAP severity, which could potentially guide the development of new prognostic models.
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Emergency endotracheal intubation-related cardiac arrest (CA) is not well documented. This study compares the clinical features and outcomes of intubation-related CA and other causes of inhospital CA. ⋯ Endotracheal intubation-related CA occurred higher than commonly recognized, and patient outcomes were not better than other causes of CA. These data highlight the importance of efforts to prevent intubation-related CA. However, further prospective larger study will be required to generalize this result.
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The inferior vena cava (IVC) parameters, including its diameter and collapsibility index have been evaluated for fluid status for over 30 years, but little is known about the impacts of patient characteristics on IVC parameters. The purpose of this study was to explore the relationships between individual patient characteristics and IVC parameters in healthy Chinese adult volunteers. ⋯ The percentage collapse of IVC and the IVCmax are not substantially influenced by patient characteristics. In contrast, the IVC/Ao index is more susceptible to patient characteristics than IVC.