The American journal of emergency medicine
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Coronavirus disease of 2019 (COVID-19) is a lower respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease can impact the cardiovascular system and lead to abnormal electrocardiographic (ECG) findings. Emergency clinicians must be aware of the ECG manifestations of COVID-19. ⋯ This review summarizes the relevant ECG findings associated with COVID-19. Knowledge of these findings in COVID-19-related electrocardiographic presentations may assist emergency clinicians in the evaluation and management of potentially infected and infected patients.
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Comparative Study Observational Study
External validation of prehospital stroke scales for emergent large vessel occlusion.
It is suggested that a prehospital scale should be utilized to identify patients with emergent large vessel occlusion (ELVO). We aimed to perform external validation of nine ELVO scales. ⋯ Stakeholders in the community should choose suitable scales according to their own system conditions.
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Portal vein thrombosis (PVT) is the most common cause of extrahepatic portal vein obstruction in children. Upper gastrointestinal (GI) bleeding and splenomegaly are the most common presenting features. PVT diagnosis is usually delayed in the absence of upper GI bleeding and many children undergo a hematologic work-up due to splenomegaly and signs of hypersplenism. ⋯ The hematologic work-up including a bone marrow aspirate was unrevealing and she was thought to have viral-induced bone marrow suppression and severe iron deficiency anemia. She presented 2 months later with hematemesis and abdominal CT angiography confirmed the diagnosis of PVT with portal cavernoma. Conclusion: PVT should be suspected in any child who presents with afebrile splenomegaly and signs of hypersplenism even in the absence of upper GI bleeding.
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Observational Study
Characterizing pediatric emergency department visits during the COVID-19 pandemic.
We determine how pediatric emergency department (ED) visits changed during the COVID-19 pandemic in a large sample of U.S. EDs. ⋯ Pediatric ED visits fell more sharply than adult ED visits during the COVID-19 pandemic, and remained depressed through June 2020, especially for younger children. Declines were also seen for serious conditions, suggesting that parents may have avoided necessary care for their children.
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Background Violence is an increasingly common and significant problem for youth worldwide. Youth who rely on treatment at urban EDs are more likely to die as the result of violence than any other disease/condition for which they seek care. The first step in helping youth that are at risk, is identifying them. ⋯ Children who were male, non-white, and had been hurt at home or school reported the highest VPET scores. Conclusion VPET has sufficiently strong psychometric function and performs well as a screening tool to predict future violence exposure for youth ages 8-17. Five questions on the VPET screening tool are independently predictive of violence reported at 6 months and four questions at 3 months.