Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To assess the impact of an emergency department (ED) guideline employing selective use of helical computed tomography (CT) on clinical outcomes of female patients with suspected appendicitis. ⋯ Helical CT is highly accurate in detecting appendicitis in patients with equivocal ED presentations. The use of a guideline employing selective helical CT was associated with a decline in the time from ED presentation to operative intervention in females.
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Naloxone frequently is used to treat suspected heroin and opioid overdoses in the out-of-hospital setting. The authors' emergency medical services system has operated a policy of allowing these patients, when successfully treated, to sign out against medical advice (AMA) in the field. ⋯ Giving naloxone to patients with heroin overdoses in the field and then allowing them to sign out AMA resulted in no identifiable deaths within this study population.
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Multicenter Study
Interrater reliability of criteria used in assessing blunt head injury patients for intracranial injuries.
To determine the interrater reliability of potential predictor variables that may be used to construct a clinical decision rule for emergency computed tomography of the head in blunt head injury victims. ⋯ The clinicians in our study had a substantial level of agreement regarding most clinical criteria assessed in this large sample of patients with blunt head injury.
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To evaluate simultaneously several possible risk factors for blood bank specimen hemolysis. ⋯ Blood bank specimens drawn from Vialon IV catheters (particularly smaller gauge catheters) and from veins outside the antecubital area are at significantly increased risk to hemolyze.
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To test the hypothesis that arterial blood gas (ABG) results for patients with suspected diabetic ketoacidosis (DKA) do not influence emergency physicians' management decisions and to assess correlation and precision between venous pH and arterial pH. ⋯ ABG results rarely influenced emergency physicians' decisions on diagnosis, treatment, or disposition in suspected DKA patients. Venous pH correlated well and was precise enough with arterial pH to serve as a substitute.