The American journal of emergency medicine
-
Comparative Study
Prediction of en-route complications during interfacility transport by outcome predictive scores in ED.
The objective was to determine the accuracy of the outcome predictive scores (Modified Early Warning Score [MEWS]; Hypotension, Low Oxygen Saturation, Low Temperature, Abnormal ECG, Loss of Independence [HOTEL] score; and Simple Clinical Score [SCS]) in predicting en-route complications during interfacility transport (IFT) in emergency department. ⋯ None of the scores had good accuracy in prediction of en-route complications during IFT. MEWS at triage was among the best one already but was not ideal.
-
Observational Study
The first-door-to-balloon time delay in ST-elevation myocardial infarction patients undergoing interhospital transfer.
Interhospital transfer delays for ST-elevation myocardial infarction (STEMI) patients requiring primary percutaneous coronary intervention (PCI) may be shortened by improved regional care systems. We evaluated the transfer process and first door-to-balloon (D1toB) time in STEMI patients who underwent interhospital transfer for primary PCI. ⋯ Patients with STEMI undergoing interhospital transfer did not receive definite care within the recommended therapeutic time window. Delays in the transfer process (length of stay in the referring hospital and interhospital transport time) were major contributors to the delay in the D1toB time.
-
Clinical Trial
A prehospital screening tool utilizing end-tidal carbon dioxide predicts sepsis and severe sepsis.
To determine the utility of a prehospital sepsis screening protocol utilizing systemic inflammatory response syndrome (SIRS) criteria and end-tidal carbon dioxide (ETCO2). ⋯ A prehospital screening protocol utilizing SIRS criteria and ETCO2 predicts sepsis and severe sepsis, which could potentially decrease time to therapeutic intervention.
-
Observational Study
Barriers to outpatient stress testing follow-up for low-risk chest pain patients presenting to an ED chest pain unit.
Outpatient stress testing (OST) after evaluation in the emergency department (ED) is an acceptable evaluation method for patients presenting to the ED with low-risk chest pain (CP). However, not all patients return for OST. Barriers to follow-up evaluation exist and are poorly understood. In this study, we examined the influence of demographic and social characteristics on OST compliance. ⋯ More than one-third of low-risk CP patients do not follow-up with scheduled OST. Of the variables analyzed, both employment status and insurance type were statistically significant and should be included in risk stratification strategies for OST.