The American journal of emergency medicine
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Observational Study
The predictors of perforated appendicitis in the pediatric emergency department: A retrospective observational cohort study.
Appendiceal perforation has significant effects on perioperative morbidity and postoperative outcome. The present study aimed to identify possible predictive factors associated with perforated appendicitis (PA) in children at admission in the emergency department (ED). ⋯ Our data indicate that several clinical and biochemical parameters can reliably distinguish between pediatric PA and NPA at admission in the emergency department.
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We investigated the effectiveness of the Rapid Emergency Medicine Score and the Rapid Acute Physiology Score in identifying critical patients among those presenting to the emergency department with COVID-19 symptoms. ⋯ REMS is able to predict patients with COVID-19-like symptoms without positive rt-PCR for SARS-CoV-2 that are at a high-risk of 30-day mortality. Prospective multicenter cohort studies are needed to provide best scoring system for triage in pandemic clinics.
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The European Resuscitation Council Newborn Life Support Course (ERC- NLS) aims at training healthcare professionals, involved in perinatal care, in order to intervene efficiently and promptly to assist transition or resuscitate neonates who require help at birth. However, limited data exists for the retention of the theoretical knowledge and practical skills provided by the course. This study aims to evaluate the degree of knowledge and skill retention 3 and 6 months after the ERC-NLS provider course. ⋯ Healthcare professionals after the NLS provider course retain satisfactory levels of theoretical knowledge and technical skills even at 6 months post-training, although, there is a decline compared to baseline. Further research is needed in order to establish the proper time and type of refreshment course in order to improve outcomes.
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Many trusted organizations recommend a particular set of gear for hikers. Termed the "10 essentials," the importance of these items to wilderness preparedness has not been critically evaluated. We sought to better understand the value of these items in day hiker preparedness by assessing the association between carried items, the occurrence of adverse events, and satisfaction. ⋯ Carrying more items did not translate into improved satisfaction for day hikers, but was associated with fewer events for which the hiker was unprepared. Other than adverse events related to hunger, thirst, weather, and minor medical events, adverse events were unlikely during this day hike. Nutrition, hydration, and insulation were the items reported as most often needed, followed by a kit to treat minor medical events, while the remaining 6 items were infrequently used.
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Prosthetic valve thrombosis (PVT) is considered an exceptionally rare condition, often associated with pro-thrombotic factors or suboptimal anticoagulant therapy. Guidelines recommend emergent surgery for patients with left heart valve prosthetic thrombosis who present in cardiogenic shock, and systemic thrombolysis is reserved in scenarios where surgery is not immediately available. However, several factors may affect surgical prognosis and are overlooked by current recommendations. We describe the case of a 34-year-old female who presented in the emergency department with cardiogenic shock and acute pulmonary edema due to acute valve thrombosis.