The American journal of emergency medicine
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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.
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Brain anoxia after complete avalanche burial and cardiac arrest (CA) may occur despite adequate on-site triage. ⋯ Serum potassium concentration had good predictive value for brain anoxia after complete avalanche burial. This finding further supports the use of serum potassium concentration for extracorporeal life support insertion at hospital admission in this context.
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Clinical Trial
Influence of caudal traction of ipsilateral arm on ultrasound image for supraclavicular central venous catheterization.
The first step for successful ultrasound (US)-guided subclavian vein (SCV) catheterization using a supraclavicular approach is to obtain a good longitudinal image of SCV for in-plane needle placement. We evaluated the efficacy of caudal traction of ipsilateral arm on the exposure of the SCV. ⋯ The caudal traction of ipsilateral arm toward to the knee improves the longitudinal US view of SCV for the supraclavicular approach, without reducing its size. Proper caudal traction of the arm might ensure the high success rate with safe needle insertion technique. Abduction should be avoided during US-guided supraclavicular SCV catheterization.
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Comparative Study
Comparing patients who leave the ED prematurely, before vs after medical evaluation: a National Hospital Ambulatory Medical Care Survey analysis.
Many patients leave the Emergency Department (ED) before beginning or completing medical evaluation. Some of these patients may be at higher medical risk depending on their timing of leaving the ED. ⋯ When comparing all patients who left the ED before completion of care, those who left after versus before medical provider evaluation differed in their patient, hospital, and visit characteristics and may represent a high risk patient group.