The American journal of emergency medicine
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Monitoring of patient's intravascular volume status without invasive measures remains challenging and unreliable. Our objective was to determine if corrected flow time (FTc) measurement could detect preload reduction with administration of nitroglycerin (NTG) as a surrogate for volume loss. ⋯ Corrected flow time was able to detect a significant difference in preload reduction with 0.3 mg of NTG. The FTc may be an early reliable noninvasive measure to detect changes in intravascular volume status.
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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.