The American journal of emergency medicine
-
Elevated blood glucose levels (BGL) are known to be part of the physiologic response to stress following physical trauma. We aimed to study whether a measured BGL might help improve accuracy of field triage. ⋯ Elevated BGL improved prediction of high Injury Severity Score and ICU use among casualties triaged as severe. If future research using BGL measured in the field yields similar results, combining BGL with standard field triage may allow for more accurate identification of casualties who need acute field intervention, have major injury, or require ICU admission.
-
Community-acquired pneumonia (CAP) is a major health problem in the United States and is associated with substantial morbidity, mortality, and health care costs. Patients with CAP commonly present to emergency departments where physicians must make critical decisions regarding diagnosis and management of pneumonia in a timely fashion, with emphasis on efficient and cost-effective diagnostic choices, consideration of emerging antimicrobial resistance, timely initiation of antibiotics, and appropriate site-of-care decisions. ⋯ These new data and additional guidelines pertaining to the treatment of CAP further our knowledge and understanding of this challenging infection. Furthermore, appreciation of the availability of new diagnostic testing and therapeutic options will help meet the demand for improved management of CAP.
-
A recent study showed that increased blood glucose variability was an independent predictor of mortality in cardiac arrest survivors treated with therapeutic hypothermia (TH). We hypothesized that the association of blood glucose variability with outcomes would differ depending on the TH phase, as body temperature affects glucose homeostasis. ⋯ The increased MAGC during the TH maintenance phase was associated with mortality and unfavorable neurologic outcome. However, this study cannot prove a causal association due to the retrospective design. In addition, we showed that the hypoglycemia rate increased significantly during the rewarming phase.
-
Comparative Study Clinical Trial
Pocket mobile smartphone system for the point-of-care submandibular ultrasonography.
Focused ultrasonography of the airway may be useful in the prediction of difficult intubation. The wider use of sonography in quantitative airway assessment may depend on the availability of highly portable, inexpensive, and accurate ultrasound systems. Pocket-sized ultrasound devices are emerging as a useful tool for point-of-care ultrasonography. The aim of this study was to evaluate the suprahyoid airway of healthy volunteers using a smartphone-based ultrasound imaging system in comparison with a platform-based machine. ⋯ Mobisante MobiUS system was able to acquire clinically useful images of the suprahyoid airway and muscular architecture in the mouth floor and allowed accurate measurements of linear distances.