The American journal of emergency medicine
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Difficult intravenous access (DIVA) is a common problem in Emergency Departments (EDs), yet the prevalence and clinical impact of this condition is poorly understood. Ultrasound-guided peripheral intravenous catheter (USGPIV) insertion is a successful modality for obtaining intravenous (IV) access in patients with DIVA. ⋯ DIVA affects many ED patients and leads to delays in PIV access-related care. Nurse insertion of USGPIVs improves care in patients with DIVA.
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Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone. ⋯ We may conclude that the assessments done via a smartphone (photographing and sharing) may not be reliable.
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Assessing the right ventricular function in patients with submassive pulmonary embolism (PE) is pivotal when determining the appropriate treatment pathway. We describe two cases of submassive PE requiring systemic thrombolysis, in which intravenous saline contrast demonstrated a noticeable lack of forward flow in the right ventricle. This technique potentially may indicate impending right ventricular functional collapse and the need for more aggressive intervention.
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Study objective: To estimate the frequency of clinically relevant adverse cardiac events (CRACE) in patients admitted to the hospital for chest pain with an intermediate HEART score (4, 5, 6), non-diagnostic EKG, and a negative initial troponin. ⋯ In this cohort of admitted patients with a documented intermediate-risk HEART score, nonischemic EKG, and negative initial troponin, the occurrence of CRACE during the index hospitalization was 0.5%.