The American journal of emergency medicine
-
Diagnostic errors made by radiology resident physicians may lead to significant morbidity/mortality and patient dissatisfaction. ⋯ Based on our sample, discrepancies were a small percentage of images performed during "off hours", and were associated with CT scans, missed fractures, and non-emergent outpatient follow-up. We suggest that ED and radiology departments work collaboratively to monitor their own rates of discrepancies, and subsequent morbidities and mortalities, to improve patient care.
-
Comparative Study Observational Study
Early high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure in the ED: A before-after study.
To compare clinical impact after early initiation of high-flow nasal cannula oxygen therapy (HFNC) versus standard oxygen in patients admitted to an emergency department (ED) for acute hypoxemic respiratory failure. ⋯ As compared to standard oxygen, patients with acute hypoxemic respiratory failure treated with HFNC at the ED had better oxygenation, less breathlessness and were more likely to show improved respiratory failure 1 h after initiation.
-
Observational Study
Misdiagnosis of acute subarachnoid hemorrhage in the era of multimodal diagnostic options.
Patients suffering from aneurysmatic Subarachnoid Hemorrhage (SAH) may present with a variety of symptoms. The aim of this study is to evaluate the spectrum of misdiagnoses and to analyze the significance of delay of correct diagnosis on the clinical outcome. ⋯ A straightforward diagnosis of SAH despite diffuse and unspecific symptoms is crucial for the successful treatment of these patients, especially with high grade SAH.
-
Randomized Controlled Trial Multicenter Study Comparative Study
HVNI vs NIPPV in the treatment of acute decompensated heart failure: Subgroup analysis of a multi-center trial in the ED.
Managing respiratory failure (RF) secondary to acute decompensated heart failure (ADHF) with non-invasive positive-pressure ventilation (NIPPV) has been shown to significantly improve morbidity and mortality in patients presenting to the emergency department (ED). This subgroup analysis compares high-velocity nasal insufflation (HVNI), a form of high-flow nasal cannula, with NIPPV in the treatment of RF secondary to ADHF with respect to therapy failure, as indicated by the requirement for intubation or all-cause arm failure including subjective crossover to the alternate therapy. ⋯ In conclusion, this subgroup analysis suggests HVNI may be non-inferior to NIPPV in patients with respiratory failure secondary to ADHF that do not need emergent intubation.
-
Observational Study
Point-of-care lung ultrasound in children with non-cardiac respiratory distress or tachypnea.
The purpose of this study was to evaluate the feasibility and diagnostic benefit of point-of-care ultrasound (PoCLUS) in children with non-cardiac respiratory distress or tachypnea. ⋯ PoCLUS may constitute a beneficial and rational approach in the evaluation of children with increased work of breathing in the ED, and can also expedite the diagnostic process.