The American journal of emergency medicine
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Comparative Study
Comparison between systemic and catheter thrombolysis in patients with pulmonary embolism.
Although systemic thrombolysis (ST) or catheter-directed therapy (CDT) is performed in patients with acute massive or submassive pulmonary embolism (PE), clinical data comparing between both therapies remain limited. We compared clinical outcomes between ST and CDT in patients with acute massive and submassive PE. ⋯ Similar clinical outcomes were shown between ST and CDT in patients with acute massive or submassive PE.
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Observational Study
Twenty-four-hour packed red blood cell requirement is the strongest independent prognostic marker of mortality in ED trauma patients.
Injury severity score, serum lactate, and shock index help the physician determine the severity of injuries present and have been shown to relate to mortality. We sought to determine if an increasing amount of packed red blood cells (PRBCs) given in the first 24hours of admission is an independent predictor of mortality and how it compares to other validated markers. ⋯ Twenty-four-hour PRBC requirement is both a novel independent predictor of and has the greatest correlation to mortality in adult trauma patients when compared to injury severity score, shock index, and serum lactate.
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Observational Study
Ultrasound measurement of inferior vena cava collapse predicts propofol-induced hypotension.
Hypotension is a common side effect of propofol, but there are no reliable methods to determine which patients are at risk for significant propofol-induced hypotension (PIH). Ultrasound has been used to estimate volume status by visualization of inferior vena cava (IVC) collapse. This study explores whether IVC assessment by ultrasound can assist in predicting which patients may experience significant hypotension. ⋯ Patients with IVC-CI≥50% were more likely to develop significant hypotension from propofol. IVC ultrasound may be a useful tool to predict which patients are at increased risk for PIH.
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The Mortality in Severe Sepsis in the Emergency Department (MISSED) score is a newly proposed scoring system. The goal of this study is to determine if the MISSED score is generalizable to an urban tertiary care hospital. ⋯ The MISSED score is useful for predicting mortality in ED patients with severe sepsis.