The American journal of emergency medicine
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This pilot study was performed to assess the use of cardiac troponin I to predict respiratory failure in children admitted to the hospital with respiratory syncytial virus (RSV) infections. We enrolled a prospective convenience sample of children under 5 years of age who were admitted to our university-based, tertiary care children's hospital from December 1, 2000, to February 1, 2002, with RSV infections. A cardiac troponin I was drawn at admission. ⋯ A positive cardiac troponin I demonstrated a sensitivity of 100%, specificity 68%, positive predictive value of 30%, negative predictive value of 100%, and accuracy of 72%. The area under the receiver operating characteristic curve was 0.939 (95% confidence interval, 0.820-1.0), suggesting a high degree of discriminatory power in selecting children with respiratory failure. A sample size calculation revealed that a follow-up study of 359 patients is needed before the clinical use of cardiac troponin I for this purpose.
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Clinical Trial
Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam.
The multiple-view focused assessment with sonography for trauma (FAST) exam is an integral tool in the assessment of blunt abdominal trauma. A prospective observational study was performed to compute the average minimum volume of detectable intraperitoneal fluid with the pelvic views of the FAST exam. All adult patients from October 1999 to May 2001, who presented to the ED with blunt abdominal trauma and underwent a clinically indicated diagnostic peritoneal lavage (DPL), were candidates for admission to the pelvic ultrasound study. ⋯ The mean minimal volume of fluid needed for pelvic ultrasound detection by the examiner and reviewer was 157 and 129 cc (n = 7), respectively. The median quantity of fluid for ultrasound detection by both the examiner and reviewer was 100 cc. The pelvic views of the FAST exam identified a significantly smaller quantity of intraperitoneal fluid than previous studies of the right upper quadrant single-view exam.
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The purpose of this study was to determine whether the presence of hematuria or its absence can predict the presence or absence of urinary calculi as determined by computed tomography (CT) scan in patients presenting to the ED with acute abdominal colic. We reviewed the urine analysis and CT scans of all patients presenting to the ED over a 12-month period with acute colic and a clinical suspicion of urinary calculi. Urine samples were drawn on arrival in the ED before CT scanning. ⋯ A total of 3.24% of patients had some degree of obstruction, all of whom had hematuria. The absence of hematuria is not a reliable exclusion criterion for urinary calculi. The detection of urinary stones without hematuria does not imply obstruction.