The American journal of emergency medicine
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The aim of this study was to evaluate bioimpedance vector analysis (BIVA) for the diagnosis of acute heart failure (AHF) in patients presenting with acute dyspnea to the emergency department (ED). ⋯ In a population of patients presenting to the ED with dyspnea, BIVA was significantly related to the AHF status but did not improve the diagnostic performance for AHF in addition to BNP alone.
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Comparative Study
Prehospital endotracheal intubation vs extraglottic airway device in blunt trauma.
The objective of the study is to compare outcomes in blunt trauma patients managed with prehospital insertion of an extraglottic airway device (EGD) vs endotracheal intubation (ETI). The null hypothesis was that there would be no difference in mortality for the 2 groups. ⋯ In this preliminary, retrospective analysis, we found no difference in overall survival among trauma patients managed with prehospital EGD and those managed with prehospital ETI.
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Critically ill patients have high mortality and admission rates requiring early recognition and a rapid management. In the present study, we evaluated the prognostic parameters in these patients and the value of perfusion index measurement as a novel tool for accomplishing emergency department (ED) triage. ⋯ Perfusion index as a novel triage instrument was found to be an insignificant tool in predicting hospital admission and mortality of critically ill patients in the ED. However, diabetes and malignancy were found to be independent factors in determining the prognosis of these patients in addition to vital signs and should be considered by ED physicians either in triage field or inside the ED.
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We investigated whether visual feedback from an accelerometer device facilitated high-quality chest compressions during an in-hospital cardiac arrest simulation using a manikin. ⋯ The use of accelerometer feedback devices to facilitate high-quality chest compression may not be appropriate for lightweight rescuers because of the potential for compression depth overestimation.
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Heroin-associated stroke is a rare complication of use. Various proposed mechanisms of heroin-associated ischemic stroke have been proposed, including the following: cardioembolism in the setting of infective endocarditis, hypoxic ischemic brain injury in the setting of hypoxemia and hypotension, and infective arteritis or vasculitis from drug adulterants. A previously healthy 28-year-old woman presented to the emergency department with altered mental status and normal vitals after she was found wandering outside her apartment. ⋯ The patient remained confused with significant memory loss throughout her hospital stay and was eventually discharged to a long-term care facility. Drug abuse should be considered a risk factor for stoke in young adults. In patients with persistent neurologic deficits, physicians must be vigilant and order appropriate workup while managing drug overdose.