The American journal of emergency medicine
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Comparative Study
Clinical performance of early warning scoring systems for identifying sepsis among anti-hypertensive agent users.
Little is known about the accuracy of the quick Sequential Organ Failure Assessment (qSOFA) and the National Early Warning Score (NEWS) in identifying sepsis patients with a history of hypertension on anti-hypertensive agents, which affect vital signs as components of the scoring systems. We aimed to examine the ability of qSOFA and NEWS to predict sepsis among anti-hypertensive agent users by comparing them with non-users. ⋯ The clinical performance of qSOFA and NEWS for identifying sepsis among anti-hypertensive agent users was likely lower than that among non-users.
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Conversion disorder is defined as a disorder with one or more neurological symptoms that accompany psychological conflict, suggesting a physical disorder. It has been shown that patients with conversion disorder have an imbalance in the autonomic nervous system. There are only a limited number of studies that have examined how conversion disorder is related with surface ECG parameters. The present study aimed to investigate the effects of conversion disorder on the surface ECG parameters of patients with conversion disorder admitted to the emergency department. ⋯ This study is the first to show that conversion disorder significantly increases QT, QTc, P wave dispersion, and frontal QRS-T angle.
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Superior Vena Cava (SVC) syndrome is caused by SVC obstruction by external compression or intraluminal thrombus. Patients with the condition can present with upper body swelling, shortness of breath and shock. This case report highlights the use of point-of-care ultrasound (POCUS) to evaluate a patient with SVC syndrome in the emergency department. ⋯ Further investigation confirmed the diagnosis of lymphoma. The SVC can be visualized with transthoracic echocardiography using either the suprasternal, right supraclavicular or right parasternal approach. In this case, the presence of consolidation of the right lung mass provided an acoustic window for the visualization of the SVC using the right parasternal view, thereby allowing for more rapid diagnosis and management.
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Coronary risk scores (CRS) including History, Electrocardiogram, Age, Risk Factors, Troponin (HEART) score and Emergency Department Assessment of Chest pain Score (EDACS) can help identify patients at low risk of major adverse cardiac events. In the emergency department (ED), there are wide variations in hospital admission rates among patients with chest pain. ⋯ A higher ED discharge rate of the group using CRS may indicate that ED physicians have more confidence in discharging low-risk patients based on CRS.
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Observational Study
The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department.
Due to the high mortality and spread rates of coronavirus disease 2019 (COVID-19), there are currently serious challenges in emergency department management. As such, we investigated whether the blood urea nitrogen (BUN)/albumin ratio (BAR) predicts mortality in the COVID-19 patients in the emergency department. ⋯ The BUN, albumin, and BAR levels were found to be reliable predictors of in-hospital mortality in COVID-19 patients, but BAR was found to be a more reliable predictor than the BUN and albumin levels.