The American journal of emergency medicine
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Comparative Study
A comparison of emergency department versus inhospital chest pain observation units.
US hospitals use observation units (OUs) for safe and cost-effective management of low-risk to moderate-risk patients presenting to the ED with chest pain. This study retrospectively compared the utility of an ED observation unit (EDOU) with an inhospital observation unit (IHOU) for chest pain at the same institution. A 5-month period during which patients with chest pain were admitted to the EDOU was compared with a 5-month period during which patients with chest pain were admitted to the IHOU. ⋯ Fewer patients with chest pain were converted to full inpatient admission from the EDOU, 35 (7.9%) of 440, when compared with the IHOU, 187 (19.2%) of 973 (P<.0001). Mean cost for each patient was US $889.87 (95% CI 862.8-916.9) versus US $1039.70 (95% CI 991.7-1087.7) for each IHOU patient. We conclude that the EDOUs are more cost-effective than IHOUs for management of low-risk to moderate-risk patients with chest pain.
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The aim of the study was to determine if the presence of Trichomonas vaginalis (TV) is associated with an increased risk of coinfection with Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) in female patients presenting to the ED with symptoms consistent with a sexually transmitted disease (STD). ⋯ The presence of TV in female patients presenting to the ED with symptoms consistent with an STD is not associated with an increased risk of coinfection with NG and/or CT.
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The duration of untreated (no cardiopulmonary resuscitation) ventricular fibrillation (VF) needed to produce postdefibrillation pulseless electrical activity (PEA) was determined in 9 anesthetized swine ranging in weight from 20 to 30 kg. VF was induced electrically by a right ventricular catheter electrode, while arterial pressure and the electrocardiogram were recorded. VF was confirmed by the presence of VF waves in the electrocardiogram and a loss of pulsatile arterial pressure. ⋯ Moreover, because of the different initial VF wave frequencies and the different rates of decrease with time, a measurement of VF wave frequency is unlikely to be informative on how long VF had been present. A consistent finding in this swine study of prolonged untreated VF was a rise in blood K+ which increased from a normal prefibrillation value of about 4 mEq/L to 8 to 12 mEq/L at 180 seconds. The longer the duration of VF, the higher the K+.
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Letter Comparative Study
Health services use by older adults in an urban public health system.