The American journal of emergency medicine
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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.
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It has been hypothesized that body mass index (BMI) and muscle strength (MS) of the rescuers are predictors of adequate external chest compressions (ECC). The aims of this study were: (a) to analyze, in college students, the relationship between BMI and MS with adequate ECC parameters; and (b) to examine whether the association between BMI and adequate ECC parameters is mediated by MS. ⋯ The ability to provide adequate ECC is influenced by the rescuer's MS. Rescuers should be advised to exercise arm strength to improve the quality of CPR.
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Intraosseous (IO) access can be complicated by obesity. Successful placement of a 25 mm IO needle is unlikely when soft tissue depth exceeds 20 mm. ⋯ In obese adults with a palpable TT or BMI ≤43 a 25 mm IO needle is likely adequate at the proximal and distal tibial insertion sites. Empiric use of an extended 45 mm IO needle is advisable at the proximal humeral insertion site in obese patients.
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The aims of this study were to simulate mobile consultation for the coronary computed tomography angiography (CCTA) at the emergency department (ED) and to measure the diagnostic performance of the mobile reading. ⋯ Smartphone reading by the cardiac radiologist was superior to the on-call residents' reading. Further study with real-time mobile consultation needs to be investigated to evaluate whether improvement in diagnostic competency can make a difference in the outcome of patients.