The American journal of emergency medicine
-
N95 mask is essential for healthcare workers dealing with the coronavirus disease 2019 (COVID-19). However, N95 mask causes discomfort breathing with marked reduction in air exchange. This study was designed to investigate whether the use of N95 mask affects rescuer's fatigue and chest compression quality during cardiopulmonary resuscitation (CPR). ⋯ Wearing a N95 mask increases rescuer's fatigue and decreases chest compression quality during CPR. Therefore, the exchange of rescuers during CPR should be more frequent than that recommended in current guidelines when N95 masks are applied.
-
Many women in their first trimester present to the Emergency Department (ED) for evaluation. Urinalysis is a common test performed with these patients to evaluate for possible UTI. There are no clear results to determine if a patient requires antibiotic in the ED vs waiting for the culture result to start antibiotics. ⋯ Overall, the presence of Nitrites was the most significant with a specificity of 98.6%, NPV of 81.9% and PPV of 86.6%. Presence of specific historical findings, namely dysuria (88% specificity) and hematuria (93% specificity) performed well for predicting culture positive UTI but performed poorly in ruling out this condition. The diagnosis of a culture confirmed UTI in the ED cannot be reliably predicted using symptomology or labs values other than nitrates.
-
Observational Study
NLR and CRP to albumin ratio as a predictor of in-hospital mortality in the geriatric ED patients.
We aimed to investigate the role of neutrophil to lymphocyte ratio (NLR) and the C-Reactive Protein/Albumin Ratio (CAR), which are obtained from the first laboratory values of the elderly patients at admission to the emergency department (ED), in predicting in-hospital mortality. ⋯ According to our results, the concurrent high levels of NLR and CAR values were found to be more effective in predicting in-hospital mortality compared to a separate evaluation.
-
COVID-19 created lifestyle changes, and induced a fear of contagion affecting people's decisions regarding seeking medical assistance. Concern surrounding contagion and the pandemic has been found to affect the number and type of medical emergencies to which Emergency Medical Services (EMS) have responded. ⋯ EMS must be prepared for changes in patients' behavior due to COVID concerns. Targeting populations at risk for refraining or refusing hospital transport and implementing diverse models of EMS, especially during pandemic times, will allow EMS to assist patients safely, either by reducing truly unnecessary ED visits minimizing contagion or by increasing hospital transports for patients in urgent or emergent conditions.