The American journal of emergency medicine
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Randomized Controlled Trial
Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound.
Studies on ocular point-of-care ultrasound vary on whether gel should be directly applied to the eye or on top of an adhesive membrane (i.e., Tegaderm™). However, there are currently no data regarding which approach has better image quality and the impact of patient preference. In this study, we sought to address this gap by assessing the difference in image quality and patient preference between Tegaderm™ versus no Tegaderm™ for ocular ultrasound in the emergency department. ⋯ Tegaderm™ was associated with reduced image quality and no significant difference in patient discomfort when utilized for ocular ultrasound. This study suggests that ocular ultrasound may be better performed without the use of Tegaderm™. Future research should evaluate the impact of Tegaderm™ vs. no Tegaderm™ among more novice users.
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Clinical Trial
Can a voice assistant help bystanders save lives? A feasibility pilot study chatbot in beta version to assist OHCA bystanders.
Evaluating the usefulness of a chat bot as an assistant during CPR care by laypersons. ⋯ The use of a voice assistant could be useful for people with no previous training to perform de out-of-hospital cardiac arrest recognition sequence. Chatbot was able to guide all participants to call 112 and to perform continuous chest compressions. The first version of the chatbot for potential bystanders naive in basic life support needs to be further developed to reduce response times and be more effective in giving feedback on chest compressions.
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Adverse reactions to intravenous (IV) iodinated contrast media are classified by the American College of Radiology (ACR) Manual on Contrast Media as either allergic-like (ALR) or physiologic (PR). Premedication may be beneficial for patients who have prior documented mild or moderate ALR. We sought to perform a retrospective analysis of patients who received computed tomography (CT) imaging in our emergency department (ED) to establish whether listing of an iodinated contrast media allergy results in a delay in care, increases the use of non-contrast studies, and to quantify the incidence of listing iodinated contrast allergies which do not necessitate premedication. ⋯ A chart-documented iodinated contrast allergy resulted in a significant increase in time to obtain a contrast-enhanced CT study. This delay persisted among patients who did not meet ACR criteria for premedication. Appropriately deferring premedication could potentially reduce the ED length-of-stay by over 4 h for these patients.
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A decrease in muscle mass of the diaphragm could be a significant risk factor for pneumonia. The aim of our study was to evaluate whether diaphragm thickness (DT) and density measured on chest computed tomography (CT) were associated with clinical course and mortality in adult patients with coronavirus disease 2019 (COVID-19) in emergency department admission. ⋯ Our study demonstrated that a low diaphragm thickness and density measured on chest CT were associated with severe disease in patients with COVID-19 and could be evaluated as poor prognostic markers.
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Earlier administration of intravenous recombinant tissue-type plasminogen activator (rtPA) and mechanical thrombectomy (MT) improves the neurological prognosis of patients with acute ischemic stroke (AIS). We introduced a new protocol that includes head and chest computed tomography (CT) and magnetic resonance imaging (MRI)/ magnetic resonance angiography (MRA) for all patients, which is quite different from previously evaluated protocols. This study aimed to examine whether this protocol could contribute to the prompt therapeutic intervention of AIS. ⋯ The introduction of a protocol, including CT/MRI imaging, significantly shortened DNT and DPT.