The American journal of emergency medicine
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With a steady rise in the number of urgent care centers in the United States and the establishment of urgent care medicine as a specialty, research in the field is likely to emerge. ⋯ Based on our sample, published research in the field of urgent care medicine has evolved. By describing current trends, we hope that clinicians and researchers continue to advance the field by developing high quality research, including prospective, multi-institutional/center studies involving both clinical and non-clinical topics.
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Multicenter Study
Identifying patients with symptoms suspicious for COVID-19 at elevated risk of adverse events: The COVAS score.
Develop and validate a risk score using variables available during an Emergency Department (ED) encounter to predict adverse events among patients with suspected COVID-19. ⋯ Physicians evaluating ED patients with pneumonia, COVID-19, or symptoms suspicious for COVID-19 can apply the COVAS score to assist with decisions to hospitalize or discharge patients during the SARS CoV-2 pandemic.
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Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening and easily misdiagnosed thrombotic microangiopathy disease. Few studies have reported the use of therapeutic plasma exchange (TPE) for TTP in emergency departments in China. The present study was a retrospective analysis of patients with TTP who were treated with TPE in our emergency intensive care unit (EICU). ⋯ TPE had satisfactory results for TTP patients although it was not performed every day. Older male TTP patients exhibited a relatively increased risk of death.
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Severely agitated patients in the emergency department (ED) are often sedated with intramuscularly-administered medications. The evidence base underlying particular medication choices is surprisingly sparse, as existing reviews either have methodological limitations or have included data collected outside of emergent settings. ⋯ Existing trials on the use of intramuscular antipsychotics in the ED/psychiatric ED setting were small, heterogenous, and at a moderate or high risk of bias. Given the clinical importance of this topic, further prospective investigations are desperately needed but are currently unfeasible under Food and Drug Administration Exception From Informed Consent regulations.