The American journal of emergency medicine
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Complicated UTIs (cUTIs) are defined by a heterogenous group of risk factors that place the patient at increased risk of treatment failure in whom urine cultures are recommended. We evaluated the ordering practices for urine cultures for cUTI patients and patient outcomes in an academic hospital setting. ⋯ Over a quarter of cUTI patients in this study did not receive a urine culture. Further studies are needed to assess if improving adherence to urine culturing practices for cUTIs will impact clinical outcomes.
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The diagnostic of primary or secondary headaches in emergency units is mostly based on brain imaging, which is expensive and sometimes hardly accessible. An increase in serum S100B protein has already been found in several neurological conditions inducing brain damage. The objective of this study was to assess the diagnostic performance of S100B serum assay to distinguish primary and secondary headaches among patients with non-traumatic headaches in the emergency department. ⋯ The assay of the S100B protein could be useful in the management of this pathology in emergencies. Future studies taking into account dosing time and etiologies could be conducted in order to refine its use in practice.
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Emergency Department Peer Navigator Programs (EDPN) have been shown to increase the prescribing of medications for opioid use disorder (MOUD) and improve linkage to addiction care. However, what is not known is whether it can improve overall clinical outcomes and healthcare utilization in patients with OUD. ⋯ Our study found that there was an association between implementation of an EDPN program and decreases in ED visits and hospitalizations from both all-causes as well as from opioid-related complications for patients with opioid use disorder.
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Bronchospasm is caused by reversible constriction of the smooth muscles of the bronchial tree. This causes obstruction of the lower airways, which is commonly seen at the emergency department (ED) in patients with acute exacerbation of asthma or chronic obstructive pulmonary disease. ⋯ In this case series, we would like to share our experience delivering inhaled volatile anesthetic gas via a conserving device for three patients with refractory bronchospasm at the ED. Inhaled anesthetic gas is safe, feasible and should be considered as an alternative rescue therapy for ventilated patients with severe lower airway obstruction.