The American journal of emergency medicine
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Observational Study
Ultrasound for the evaluation of soft tissue foreign bodies before and after the addition of fluid to the surrounding interstitial space in a cadaveric model.
Point-of-care ultrasound may be used to facilitate foreign body (FB) localization and removal. We hypothesized that injection of normal saline adjacent to an FB may make it easier to detect. ⋯ Ultrasound was reasonably accurate, sensitive, and specific in identifying 1-cm metal and wood FBs. Although accuracy and sensitivity did improve after normal saline injection, this difference was not significant.
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Observational Study
Ultrasound-guided central venous access: which probe is preferred for viewing the subclavian vein using a supraclavicular approach?
Point-of-care ultrasound guidance using a linear probe is well established as a tool to increase safety when performing a supradiaphragmatic cannulation of the internal jugular central vein. However, little data exist on which probe is best for performing a supradiaphragmatic cannulation of the subclavian vein. ⋯ We observed a preference for a linear probe over an endocavitary probe. Further investigation is necessary to determine which probe is optimal for this application.
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Sexually transmitted infections (STIs) are commonly seen in the ambulatory health care settings such as emergency departments (EDs) and outpatient clinics. Our objective was to assess trends over time in the incidence and demographics of STIs seen in the ED and outpatient clinics compared with office-based clinics using the National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey. ⋯ Although patients with STI are most commonly seen in office-based clinics, EDs represent an important site of care. In particular, ED patients are relatively younger, male, and nonwhite, and less likely to be private insured.
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Observational Study
Sonographic aorta/inferior vena cava cross-sectional area index for evaluation of dehydration in children.
Current studies have not found sufficient evidence to encourage the use of ultrasound for assessing dehydration in children. We introduce a new sonographic parameter, the "aorta/inferior vena cava (IVC) cross-sectional area index" (Ao/IVCA) measured just inferior to the xiphoid process, for the effective evaluation of dehydration in children. ⋯ Ao/IVCA might be a promising index for the assessment of dehydration. The diagnostic performance of Ao/IVCA for dehydration might be higher than that of the method that uses the maximum diameter of IVC and the aorta.
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Observational Study
Predictive performance of quick Sepsis-related Organ Failure Assessment for mortality and intensive care unit admission in patients with infection at the ED.
The objectives of this study are to investigate the performance of the quick Sepsis-related Organ Failure Assessment (qSOFA) in predicting mortality and intensive care unit (ICU) admission in patients with clinically diagnosed infection and to compare its performance with that of Mortality in Emergency Department Sepsis (MEDS), Acute Physiology and Chronic Health Evaluation (APACHE) II, and Sepsis-related Organ Failure Assessment (SOFA). ⋯ Quick SOFA predicted ICU admission with similar performance to that of SOFA, MEDS, and APACHE II. Its prognostic ability was similar to that of SOFA and APACHE II but slightly inferior to that of MEDS.